Povezanost plazmatske koncentracije peptida 1 sličnog glukagonu i čimbenika rasta fibroblasta-21 s regulacijom glikemije, lipidemijom i mikrovaskularnim komplikacijama u bolesnika sa šećernom bolešću tipa 1

doctoral thesis

• Title (english): The relationship of plasma concentrations of glucagone-like peptide 1 and fibroblast growth factor-21 with glucoregulation, lipidemia and microvascular complications in diabetes mellitus type 1 individuals
• Author: Karin Zibar
• Mentor: Lea Smirčić-Duvnjak (mentor)
• Committee member: nije dostupno (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2015-03-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences
• Universal decimal classification (UDC): 61 - Medical sciences

Abstract

Cilj. Ispitati povezanost koncentracija peptida 1 sličnog glukagonu (GLP-1) i
čimbenika rasta fibroblasta-21 (FGF-21) s glikemijom, lipidemijom i
mikrovaskularnim komplikacijama u osoba sa šećernom bolesti tipa 1 (ŠBT1).
Analizirati međuodnos GLP-1 i FGF-21 te ispitati povezanost GLP-1 i FGF-21 s
inzulinskom rezistencijom (IR), metaboličkim sindromom (MS), glukagonom i
dnevnom dozom inzulina. Usporediti koncentracije GLP-1 i FGF-21 između
osoba sa ŠBT1 i zdravih kontrolnih ispitanika. ----- Metode i ispitanici. U 30 osoba sa ŠBT1 te 10 zdravih ispitanika izmjerene su
plazmatske koncentracije GLP-1 i FGF-21 postupkom ELISA. Podaci su
analizirani pomoću statističkog programa SPSS 15.0, a značajnost je
prihvaćena na razini P<0,05. ----- Rezultati. Viša koncentracija GLP-1 je bila statistički značajno neovisno
povezana s nižom glikemijom natašte te s nižom koncentracijom ukupnog
kolesterola. Viša koncentracija GLP-1 nije bila povezana s nižom prevalencijom
dijabetičke nefropatije i dijabetičke retinopatije, a bila je povezana s nižom
prevalencijom dijabetičke neuropatije. Niža koncentracija bazalnog FGF-21 je
bila statistički značajno neovisno povezana s boljom regulacijom glikemije.
Koncentracija FGF-21 nije bila povezana s parametrima lipidemije. Niža
koncentracija FGF-21 nije bila povezana s nižom prevalencijom dijabetičke
nefropatije i dijabetičke retinopatije, međutim, nađena je razlika u koncentraciji
FGF-21 s obzirom na različite stupnjeve dijabetičke neuropatije, a istodobno
ovisno i o inzulinskoj osjetljivosti (IO). U bolesnika s većom IO viši stupanj
dijabetičke neuropatije bio je praćen većom koncentracijom FGF-21. Nije
nađena povezanost GLP-1 s FGF-21 ni GLP-1 s glukagonom. Postprandijalni
FGF-21 je pozitivno korelirao s bazalnom vrijednosti glukagona. Statistički
značajno veći GLP-1 nađen je u osoba s MS. Osobe s većom koncentracijom
FGF-21 imale su statistički značajno veću IO. Nije nađena povezanost GLP-1 i
FGF-21 s dnevnom dozom inzulina. Osobe sa ŠBT1 su imale statistički
značajno niže bazalne koncentracije GLP-1 i FGF-21 u odnosu na zdrave
kontrolne ispitanike. ----- Zaključak. Veća koncentracija GLP-1 je bila neovisno povezana s nižom
glikemijom natašte te s nižom koncentracijom ukupnog kolesterola. Niža
koncentracija FGF-21 je bila povezana s boljom regulacijom glikemije, dok nije
bila povezana s boljim lipidnim profilom. Nađena je devijacija bazalnih
koncentracija GLP-1 i FGF-21 oboljelih od ŠBT1 u odnosu na zdrave ispitanike.
Temeljem rezultata prikazanog istraživanja s velikom se vjerojatnošću može
zaključiti da GLP-1 i FGF-21 imaju značajnu ulogu u patofiziologiji ŠBT1. Stoga
je uz postojeću inzulinsku terapiju moguć na njima temeljen budući terapijski
doprinos i u osoba sa ŠBT1.

Abstract (english)

Aim. To examine relationship of glucagon-like peptide 1 (GLP-1) and fibroblast
growth factor- 21 (FGF-21) with glycemia, lipidemia and microvascular
complications in type 1 diabetes mellitus (T1DM) patients. To analyze mutual
relation between GLP-1 and FGF-21 and to examine relationship of GLP-1 and
FGF-21 with insulin resistance (IR), metabolic syndrome (MS), glucagon and
daily insulin dosage, respectively. To compare GLP-1 and FGF-21
concentrations between T1DM patients and healthy controls, respectively. ----- Materials and methods. In 30 T1DM patients and 10 healthy controls GLP-1
and FGF-21 concentrations were measured by ELISA. Data were analyzed by
SPSS 15.0 with statistical significance at P<0.05. ----- Results. Higher GLP-1 was statistical significantly independently related to the
lower fasting glycaemia and lower total cholesterol concentration, respectively.
Higher GLP-1 was not related to the lower diabetic nephropaty or diabetic
retinopathy prevalence, respectively, but it was related to the lower prevalence
of diabetic neuropathy, at marginal significance level. Lower basal FGF-21 was
statistical significantly independently associated with better glycaemia control.
FGF-21 was not related to lipidaemia parameters. Lower FGF-21 was not
associated with lower diabetic nephropathy or diabetic retinopathy, respectively.
However, significant difference in FGF-21 was related to the different diabetic
neuropathy stages and insulin sensitivity (IS), at the same time. Patients with
higher IS and more severe diabetic neuropathy stage had higher FGF-21. GLP-
1 concentration was not related to FGF-21 concentration and the GLP-1 was
not related to the glucagon concentration. Postprandial FGF-21 positively
correlated with basal glucagon. Statistical significantly higher GLP-1 was found
in patients with MS. Patients with higher FGF-21 concentrations had statistical
significantly better IS. GLP-1 and FGF-21 concentrations did not corelate with
daily insulin dosage, respectively. T1DM patients had statistical significantly
lower basal GLP-1 and FGF-21 than healthy controls, respectively. ----- Conclusion. Higher GLP-1 concentration was independently related with lower
fasting glycaemia and with lower total cholesterol concentration, respectively.
Lower FGF-21 was associated with better glycaemia control, but not with better
lipid profile. Significant deviation of basal GLP-1 and FGF-21 was found in
T1DM patients in comparison with healthy controls. The results of the research
support an important role of GLP-1 and FGF-21 in the pathogenesis of T1DM.
Therefore, future therapy based on the hormones seems possible also in T1DM
patients, along with insulin therapy.

• Keywords: medicina
• Keywords (english): medicine
• Language: croatian
• URN:NBN: urn:nbn:hr:105:673491
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstva (doktor/doktorica znanosti, područje biomedicine i zdravstva)
• Type of resource: Text
• Extent: 168 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-05-05 07:29:59