Uloga vitamina D u patogenezi i liječenju kroničnih bolesti jetre

master's thesis

• Title (english): The role of vitamin D in the pathogenesis and treatment of chronic liver diseases
• Author: Tin Rosan
• Mentor: Anna Mrzljak (mentor)
• Committee member: Lucija Virović Jukić (predsjednik povjerenstva)
• Committee member: Marija Bakula (član povjerenstva)
• Committee member: Anna Mrzljak (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Vitamin D je ključni nutrijent s brojnim pleiotropnim učincima na zdravlje i razne kronične bolesti. Hormonska uloga očituje se ne samo djelovanjem na klasične ciljne organe uključene u homeostazu kalcija, već i djelovanjem na brojna druga tkiva i ciljne organe. Posljednjih desetljeća zabilježen je eksponencijalni porast zanimanja za vitaminom D, posebice jer se nedostatak vitamina D povezuje s višestrukim bolestima, a globalno se bilježi da postoji visok nedostatak vitamina D. Mjerenje 25(OH)D u serumu služi za biokemijsku procjenu vitaminskog statusa jer odražava zalihe tog vitamina u tijelu. Prema Smjernicama za prevenciju, prepoznavanje i liječenje nedostataka vitamina D u odraslih koncentracija 25(OH)D u plazmi manja od 50 nmol/L definira se kao nedostatak (deficit) , 50-75 nmol/L kao manjak (insuficijenciju) , a koncentracija veća od 75 nmol/L odražava adekvatnu razinu vitamina D. Suplementi vitamina D najčešće su korištena strategija za postizanje odgovarajućeg vitaminskog statusa u organizmu. Vitamin D2 i D3 još uvijek su najčešći oblici suplementacije vitaminom D. Osim nedovoljnog stvaranja vitamina D u koži te nedovoljnog unosa hranom ili suplementima, različite bolesti i lijekovi mogu dovesti do nedostatka vitamina D. Čak 93% bolesnika s kroničnom bolešću jetre ima nedovoljnu razinu vitamina D, a gotovo jedna trećina njih pokazuje ozbiljan deficit. Niske razine vitamina D zbog ograničenog izlaganja sunčevoj svjetlosti uobičajene su među pacijentima s kroničnim bolestima i vjerojatno su važan uzrok nedostatka vitamina D kod završnog stadija bolesti jetre. Drugi uzroci niske razine vitamina D mogu uključivati smanjenu jetrenu hidroksilaciju, povećan ekstrahepatičan unos vitamina D u masno tkivo, oslabljenu crijevnu apsorpciju i smanjeni unos hranom. Brojni patofiziološki mehanizmi leže u pozadini nedostatka vitamina D u bolesnika s kroničnim bolestima jetre. Cilj ovog preglednog rada je opisati ulogu vitamina D na nastanak i progresiju kroničnih jetrenih bolesti te istražiti ulogu suplementacije vitaminom D na ishode najčešćih kroničnih jetrenih bolesti.

Abstract (english)

Vitamin D is a crucial nutrient with numerous pleiotropic effects on health and various chronic diseases. Its hormonal role is manifested not only by its action on classical target organs involved in calcium homeostasis but also by its effects on numerous other tissues and target organs. Over the past decades, there has been an exponential increase in interest in vitamin D, particularly because vitamin D deficiency is associated with multiple diseases, and there is a global prevalence of vitamin D deficiency. Measuring 25-hydroxyvitamin D [25(OH)D] in the serum serves as a biochemical assessment of vitamin status as it reflects the body's vitamin D stores. According to the guidelines for the prevention, recognition, and treatment of vitamin D deficiency in adults, a concentration of 25(OH)D in the plasma of less than 50 nmol/L is defined as a deficiency, 50-75 nmol/L as an insufficiency, and a concentration greater than of 75 nmol/L reflects an adequate vitamin D level. Vitamin D supplements are commonly used to achieve an appropriate vitamin status in the body. Vitamin D2 and D3 are still the most common forms of vitamin D supplementation. In addition to inadequate synthesis of vitamin D in the skin and insufficient intake through food or supplements, various diseases, conditions, and medications can lead to vitamin D deficiency. As much as 93% of patients with chronic liver disease have insufficient levels of vitamin D, and nearly one-third of them show severe deficiency. Low levels of vitamin D due to limited sunlight exposure are common among patients with chronic diseases and are likely an important cause of vitamin D deficiency in cirrhosis and end-stage liver disease. Other causes of low vitamin D levels may include reduced hepatic hydroxylation, increased extrahepatic uptake of vitamin D in adipose tissue, impaired intestinal absorption, and decreased dietary intake. There are numerous pathophysiological mechanisms underlying vitamin D deficiency in patients with chronic liver diseases. The aim of this review is to describe the role of vitamin D on the onset and progression of chronic liver diseases and to investigate the role of vitamin D supplementation on the outcomes of the most common chronic liver diseases.

• Keywords: 25(OH)D; nedostatak vitamina D; kronične bolesti jetre; suplementacija
• Keywords (english): 25(OH)D; vitamin D deficiency; chronic liver diseases; supplementation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:887208
• 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: 2023-10-31 08:53:19