Utjecaj jetrene steatoze na tijek i ishod sepse

doctoral thesis

• Title (english): The effect of liver steatosis on the course and outcome of sepsis
• Author: Juraj Krznarić
• Mentor: Adriana Vince (mentor)
• Committee member: Bruno Baršić (predsjednik povjerenstva)
• Committee member: Radovan Radonić (član povjerenstva)
• Committee member: Tajana Filipec Kanižaj (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Infectious Diseases); Zagreb
• Defense date and country: 2025-03-27, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Infectology
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Ovo prospektivno opservacijsko istraživanje u trajanju od 16 mjeseci uključilo je odrasle bolesnike koji su bili hospitalizirani zbog sepse stečene u vanbolničkim uvjetima. Od 378 uključenih, u njih 46% dijagnosticiran je NAFLD. Bolesnici s NAFLD-om bili su stariji te su češće ispunjavali kriterije metaboličkog sindroma. Nisu uočene razlike u ishodištu i etiologiji sepse. Bolesnici s NAFLD-om pokazali su veću prevalenciju akutne bubrežne insuficijencije, potrebe za hemodijalizom te povećanu potrebu za invazivnom mehaničkom ventilacijom. Bolnički mortalitet bio je gotovo dvostruko viši u grupi s NAFLD-om. Multivarijatna analiza pokazala je neovisnu povezanost NAFLD-a s mortalitetom bez obzira na druge čimbenike metaboličkog sindroma. Također je FAST skor identificiran kao precizan prediktor mortaliteta. Nadalje, eksperimentalni biomarkeri CK-18 i adiponektin evaluirani su kao markeri statusa jetre. U bolesnika s NAFLD-om razine CK-18 u krvi bile su povišene, dok su razine adiponektina snižene i obrnuto za non-NAFLD skupinu, što bi moglo biti korisno u probiru, dijagnostici i praćenju bolesnika s jetrenom steatozom. Ovo istraživanje ističe učestalost NAFLD-a među bolesnicima sa sepsom te značajan utjecaj NAFLD-a na ishod liječenja. Specifični biomarkeri kao što su CK-18 i adiponektin mogu biti korisni u dijagnostici i praćenju bolesnika s jetrenom steatozom, dok FAST skor može koristiti kao prediktor mortaliteta.

Abstract (english)

This prospective observational study, conducted over 16 months, included adult patients who were hospitalized due to community-acquired sepsis. Of the 378 patients, 46% were diagnosed with NAFLD. These patients were older and more frequently met the criteria for metabolic syndrome. No differences were observed in the etiology of sepsis. Patients with NAFLD showed a higher prevalence of acute kidney injury, need for hemodialysis, and the need for invasive mechanical ventilation. Hospital mortality was almost twice as high in the NAFLD group. Multivariate analysis showed an independent association of NAFLD with mortality regardless of other factors of metabolic syndrome. Also the FAST score as an accurate
predictor of mortality was identified. Furthermore, biomarkers CK-18 and adiponectin were evaluated as markers of liver status. In patients with NAFLD, blood levels of CK-18 were elevated, while adiponectin levels were decreased, and vice versa for the non-NAFLD group. Our study highlights the prevalence of NAFLD among patients with sepsis and the significant
impact of NAFLD on treatment outcomes. Specific biomarkers such as CK-18 and adiponectin may be useful in diagnosing and monitoring patients with hepatic steatosis, while the FAST score can serve as a predictor of mortality.

• Keywords: steatoza jetre; sepsa stečena u zajednici; metabolički sindrom; FAST skor; CK-18; adiponektin
• Keywords (english): liver steatosis; community-acquired sepsis; metabolic syndrome; FAST score; CK-18; adiponectin
• Language: croatian
• URN:NBN: urn:nbn:hr:105:005550
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 92 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2025-04-02 11:35:35