Nutritivni status u bolesnika s cirozom jetre i upalnim bolestima crijeva

master's thesis

• Title (english): Nutritional assessment in patients with cirrhosis and inflammatory bowel disease
• Author: Eva Pleško
• Mentor: Marko Banić (mentor)
• Committee member: Žarko Babić (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Marko Banić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Nutritivni status pruža informacije o općem stanju i uhranjenosti pojedinca. Svako odstupanje od normalnog nutritivnog statusa naziva se malnutricija. Malnutricija je veoma učestala pojava u pacijenata koji boluju od bolesti kroničnog tijeka. Može biti zamijećena u svim stadijima bolesti te se često povezuje s nepovoljnim ishodom i višim mortalitetom. Nešto veća prevalencija malnutricije zabilježena je kod pacijenata s Crohnovom bolesti, u odnosu na ulcerozni kolitis. Malnutricija se također ubraja u najučestalije komplikacije kompenzirane i dekompenzirane ciroze jetre. U pacijenata s upalnim crijevnim bolestima ključni faktori koji utječu na nutritivni status su smanjeni unos hrane, aktivna upala, smanjena apsorpcija i gubitak nutrijenata za vrijeme aktivne faze bolesti. U cirozi jetre poremećaju nutritivnog statusa doprinose još i hormonski disbalans, disbioza crijevnog mikrobioma, malapsorpcija te konzumacija alkohola. Zbog tolike učestalosti, precizno i brzo određivanje nutritivnog statusa pacijenta je od iznimne važnosti za kliničku primjenu i osiguravanje odgovarajuće skrbi i nutritivne potpore. Niti jedna postojeća metoda procjene nije dovoljno pouzdana kako bi postala zlatnim standardom, stoga se najtočnija procjena statusa dobiva kombiniranjem više različitih metoda. Sama procjena nutritivnog statusa može biti subjektivna i objektivna, a glavne skupine metoda procjene su dijetetičke metode, antropometrijske metode, biokemijske metode te klinički pregled. Danas su u kliničkoj uporabi razni alati za procjenu nutritivnog statusa, kojima se služimo za pokušaj predviđanja toka bolesti te procjene utjecaja nutritivne intervencije na pacijenta. Primjer takvog alata je NRS-2002 (engl. Nutritional Risk Screening - 2002) upitnik. Kombinacija procjene nutritivnog statusa antropometrijskim mjerenjima, NRS2002-upitnikom i laboratorijskim parametrima, prikazana u ovom radu precizniji je način određivanja nutritivnog statusa nego korištenjem svake od navedenih metoda zasebno.

Abstract (english)

Nutritional status provides information about the general condition and nutrition of an individual. Any deviation from normal nutritional status is called malnutrition. Malnutrition is a very common condition in patients suffering from chronic diseases. It can be observed at all stages of the disease and is often associated with an unfavorable outcome and higher mortality. A slightly higher prevalence of malnutrition was observed in patients with CD compared to UC. Also, malnutrition is among the most common complications of compensated and decompensated liver cirrhosis. In patients with inflammatory bowel disease, key factors affecting nutritional status are reduced food intake, active inflammation, and nutrient loss during the active phase of the disease. In liver cirrhosis, hormonal imbalance, intestinal microbiome dysbiosis, malabsorption and alcohol consumption also contribute to nutritional status disorders. Because of this frequency, accurate and rapid determination of a patient’s nutritional status is of utmost importance for clinical application and the provision of appropriate care and nutritional support. No existing assessment method is reliable enough to become the gold standard of assessment, so the most accurate status assessments are obtained by combining several different methods. The assessment of nutritional status itself can be subjective and objective, and the main groups of assessment methods are dietary methods, anthropometric methods, biochemical methods, and clinical examination. Today, various tools are used to assess nutritional status, with purpose to try to predict the course of the disease and assess the impact of nutritional intervention on the patient. An example of such a tool is the NRS-2002 (Nutritional Risk Screening - 2002) questionnaire. The combination of nutritional status assessment by anthropometric measurements, NRS2002-questionnaire, and laboratory parameters, presented in this paper are a more precise way of determining nutritional status than using each of the above methods separately.

• Keywords: nutritivni status; ciroza jetre; IBD; NRS-2002
• Keywords (english): nutritional status; cirrhosis; IBD; NRS-2002
• Language: croatian
• URN:NBN: urn:nbn:hr:105:720328
• 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
• Created on: 2022-04-08 10:20:44