Title Uloga inkretina u smanjenju kardiovaskularnog rizika Title (english) The role of incretin therapy in reduction of cardiovascular risk Author Ana-Maria Lulić Mentor Spomenka Ljubić (mentor)Committee member Lea Smirčić-Duvnjak (predsjednik povjerenstva)Committee member Jasenka Markeljević (član povjerenstva)Committee member Spomenka Ljubić (član povjerenstva)Granter University of Zagreb Defense date and country 2018-07-13, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Šećerna bolest tipa 2 (DMT2) predstavlja rastući javnozdravstveni problem i najveći zdravstveni izazov 21. stoljeća na globalnoj razini. Procjenjuje se da gotovo 425 milijuna ljudi u svijetu boluje od šećerne bolesti, dok od njenih posljedica godišnje umire 4 milijuna ljudi. Kardiovaskularne bolesti najčešći su uzrok morbiditeta i mortaliteta osoba oboljelih od šećerne bolesti. Šećerna bolest tipa 2 smatra se nezavisnim čimbenikom rizika za razvoj ishemijske bolesti srca, moždanog udara i preuranjene smrti. Smatra se da rizik za razvoj koronarne bolesti srca (KBS) i periferne arterijske bolesti (PAB) raste 2-4 puta, dok je rizik razvoja moždanog udara čak 10 puta veći kod dijabetičnih bolesnika mlađih od 55 godina. Osobe sa šećernom bolešću tipa 2 i koegzistentnom kardiovaskularnom bolesti (KVB) imaju dvostruko veći rizik da od nje i umru, u usporedbi s populacijom bez DMT2. Iako je kardiovaskularni rizik i smrtnost od KVB usko povezan sa kontrolom glikemije, čini se da je usmjerenost isključivo na postizanje ciljnih vrijednosti glikoziliranog hemoglobina (HbA1c) nedovoljno učinkovito u smanjenju učestalosti loših kardiovaskularnih ishoda kod dijabetičnih bolesnika. Stoga se danas sve više teži razvoju i implementaciji novih lijekova u terapijske režime liječenja DMT2, koji će, osim regulacije glikemije, povoljno djelovati i na kardiovaskularne čimbenike rizika (pretilost, hipertenzija, dislipidemija) često prisutne kod oboljelih. Čini se da bi terapije na bazi inkretina mogle ispunjavati sve navedene uvjete. Inkretinski modulatori efikasni su u regulaciji glikemije, dobro se toleriraju i imaju zadovoljavajući sigurnosni profil. Ostvarivanjem protektivnih učinaka na β-stanice gušterače, inkretinski modulatori potencijalno bi mogli odgoditi pojavu ili usporiti napredovanje bolesti. Povoljan učinak na kardiovaskularne čimbenike rizika (pretilost, hipertenziju, dislipidemiju, endotelnu disfunkciju) opažen u kratkoročnim studijama mogao bi za posljedicu imati smanjenje kardiovaskularnog morbiditeta i mortaliteta.
Abstract (english) Type 2 diabetes mellitus (T2DM) is a growing public health problem and major health challenge of the 21st century. It is estimated that nearly 425 million people in the world are suffering from diabetes, and 4 million deaths per year are considered to be diabetes related. Cardiovascular diseases (CVD) are the most common cause of morbidity and mortality of diabetic patients. Type 2 diabetes is considered to be an independent risk factor for the development of ischemic heart disease, stroke and premature death. Diabetic patients have a 2-4 fold increased risk of developing coronary and peripheral artery disease, while the risk of stroke is 10 times greater in diabetic patients under the age of 55. Furthermore, coexistence of T2DM and CVD doubles the risk of CVD related death. Although cardiovascular risk and CVD mortality are closely related to glycemic control, it seems that focusing solely on achieving target values of glycosylated hemoglobin (HbA1c) is insufficiently effective in reducing the incidence of poor cardiovascular outcomes in diabetic patients. Hence, more efforts are being made nowadays towards the development and implementation of new drugs in therapeutic regimens for T2DM, which would, in addition to glycemic control, also demonstrate a beneficial effect on cardiovascular risk factors (obesity, hypertension, dyslipidemia). It appears that incretin-based therapies could meet our expectations regarding these desired characteristics. They are effective in regulating glycemia, well tolerated and have a satisfactory safety profile. By achieving protective effects on pancreatic β-cells, the incretin modulators could potentially delay the onset or slow the progression of the disease. Favorable effects on cardiovascular risk factors (obesity, hypertension, dyslipidemia, endothelial dysfunction) observed in short-term studies could result in a reduction of cardiovascular morbidity and mortality.
Keywords
šećerna bolest tipa 2
inkretinski analozi
DPP-4 inhibitori
kardiovaskularni rizik
kardiovaskularne bolesti
Keywords (english)
type 2 diabetes mellitus
incretin analogs
DPP-4 inhibitors
cardiovascular risk
cardiovascular disease
Language croatian URN:NBN urn:nbn:hr:105:171425 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2019-01-07 09:25:26
