Title Poremećaji glukoregulacije u cirozi
Title (english) Disorders of glucoregulation in cirrhosis
Author Rafaela Novak
Mentor Anna Mrzljak (mentor)
Committee member Tina Dušek (predsjednik povjerenstva)
Committee member Jasenka Markeljević (član povjerenstva)
Committee member Anna Mrzljak (član povjerenstva)
Granter University of Zagreb School of Medicine (Department of Internal Medicine) Zagreb
Defense date and country 2020-07-17, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Internal Medicine
Abstract UVOD: Poremećaj glukoregulacije jedna je od brojnih komplikcija ciroze jetre. Disregulacija glukoze može varirati od intolerancije glukoze do manifestnog hepatogenog diabetesa, a stadij jetrene bolesti može utjecati na težinu metaboličkog poremećaja. Cilj ovog rada jest utvrditi učestalost i opsežnost poremećaja glukoregulacije u osoba s alkoholnom cirozom jetre prema težini jetrene bolesti. ----- METODE: U istraživanje uključeno je 73 odrasla bolesnika s alkoholnom cirozom jetre bez prethodne šećerne bolesti. Bolesnici su stratificirani u dvije grupe prema težini jetrene bolesti, Child-Turcotte-Pugh (CTP) stadiji A+B te CTP stadij C te su analizirane razlike u metaboličkim faktorima (glukozi u serumu, inzulinu, inzulinskoj rezistenciji, leptinu, adiponektinu, lipidnom profilu). ----- REZULTATI: Od 73 bolesnika 29 (39,7%) ih se nalazilo u CTP A+B skupini te 44 (60,3%) u CTP C skupini. Većina (78,1%) bolesnika imalo je inzulinsku rezistenciju. Skupine CTP A+B i CTP C se međusobno nisu razlikovale prema vrijendostima glikemije, inzulina, C-peptida i inzulinske rezistencije. Bolenici u CTP C skupini imali su značajno niže vrijednosti HbA1c (p=0,003), više vrijednosti leptina (p=0,022) i adiponektina (0,003) u odnosu na CTP A+B. Vrijednosti leptina pozitivno su korelirale sa inzulinom (p<0,001) i inzulinskom rezistencijom (p=0,003). Skupina CTP-C imala je značajno niže vrijednosti kolesterola, LDL-a, HDL-a i triglicerida u odnosu na skupinu CTP A+B. ----- ZAKLJUČAK: Metabolički poremećaji su česta pojava u uznapredovaloj bolesti jetre. Inzulinska rezistencija prisutna je u većine bolesnika. Vrijednosti leptina i adiponektina u serumu povećavaju se težinom jetrene bolesti, pri čemu vrijednosti leptina pozitivno koreliraju s vrijednostima inzulinske rezistencije.
Abstract (english) INTRODUCTION: Glucoregulation disorder is one of the numerous complications of liver cirrhosis. Glucose dysregulation in liver cirrhosis may vary from glucose intolerance to manifest hepatogenous diabetes, whereas the stages of liver disease may influence the severity of the metabolic disorder. The aim of this study is to determine the frequency and range of glucoregulation disorders in patients with alcoholic liver cirrhosis regarding liver disease severity. ----- METHODS: This study included 73 patients with alcoholic liver cirrhosis, who previously didn't have diabetes mellitus. The patients were stratified into two groups regarding liver cirrhosis severity, Child-Turcotte-Pugh (CTP) stages A and B, and CTP stage C, in addition to analyzing their differences between metabolic factors (glucose, insulin, insulin resistance, leptin, adiponectin, lipid profile). ----- RESULTS: Out of 73 patients, 29 (39.7%) of them were in the CTP A+B group and 44 of them were in the CTP C group. 78,1% of the patients had insulin resistance. Groups CTP A+B and CTP C didn't differ regarding glycemia, insulin, C-peptide and insulin resistance values. Patients in the CTP C group had significantly lower values of HbA1c (p=0.003), higher values of leptin (p=0.022) and adiponectin (p=0.003), compared to the group CTP A+B. Values of leptin also positively correlated to insulin (p<0.001) and insulin resistance (p=0.003). The group CTP C had significantly lower values of cholesterol, LDL, HDL and triglycerides, compared to the group CTP A+B. ----- CONCLUSION: Metabolic disturbances are a common finding in the advanced hepatic disease. Insulin resistance is present in most patients. Serum values of leptin and adiponectin rise with the severity of the liver disease, while values of leptin positively correlate with values of insulin resistance.
Keywords
ciroza jetre
alkoholna ciroza jetre
glukoregulacija
intolerancija glukoze
Keywords (english)
liver cirrhosis
alcoholic liver cirrhosis
glucoregulation
glucose intolerance
Language croatian
URN:NBN urn:nbn:hr:105:062249
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2021-04-16 07:26:33