prikaz prve stranice dokumenta Prediktori nealkoholnog steatohepatitisa u bolesnika s nejasnim porastom aktivnosti alanin-aminotransferaze
No public access
doctoral thesis
Prediktori nealkoholnog steatohepatitisa u bolesnika s nejasnim porastom aktivnosti alanin-aminotransferaze
doktorski rad
Rijeka: University of Rijeka, Faculty of Medicine, 2010. urn:nbn:hr:188:924420
Puljiz, Željko
University of Rijeka
Faculty of Medicine

Institutional repository: Repository of the University of Rijeka Library

Cite this document

Puljiz, Ž. (2010). Prediktori nealkoholnog steatohepatitisa u bolesnika s nejasnim porastom aktivnosti alanin-aminotransferaze : doktorski rad (Doctoral thesis). Rijeka: University of Rijeka, Faculty of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:188:924420

Puljiz, Željko. "Prediktori nealkoholnog steatohepatitisa u bolesnika s nejasnim porastom aktivnosti alanin-aminotransferaze : doktorski rad." Doctoral thesis, University of Rijeka, Faculty of Medicine, 2010. https://urn.nsk.hr/urn:nbn:hr:188:924420

Puljiz, Željko. "Prediktori nealkoholnog steatohepatitisa u bolesnika s nejasnim porastom aktivnosti alanin-aminotransferaze : doktorski rad." Doctoral thesis, University of Rijeka, Faculty of Medicine, 2010. https://urn.nsk.hr/urn:nbn:hr:188:924420

Puljiz, Ž. (2010). 'Prediktori nealkoholnog steatohepatitisa u bolesnika s nejasnim porastom aktivnosti alanin-aminotransferaze : doktorski rad', Doctoral thesis, University of Rijeka, Faculty of Medicine, accessed 28 December 2024, https://urn.nsk.hr/urn:nbn:hr:188:924420

Puljiz Ž. Prediktori nealkoholnog steatohepatitisa u bolesnika s nejasnim porastom aktivnosti alanin-aminotransferaze : doktorski rad [Doctoral thesis]. Rijeka: University of Rijeka, Faculty of Medicine; 2010 [cited 2024 December 28] Available at: https://urn.nsk.hr/urn:nbn:hr:188:924420

Ž. Puljiz, "Prediktori nealkoholnog steatohepatitisa u bolesnika s nejasnim porastom aktivnosti alanin-aminotransferaze : doktorski rad", Doctoral thesis, University of Rijeka, Faculty of Medicine, Rijeka, 2010. Available at: https://urn.nsk.hr/urn:nbn:hr:188:924420

Metadata
TitlePrediktori nealkoholnog steatohepatitisa u bolesnika s nejasnim porastom aktivnosti alanin-aminotransferaze : doktorski rad
AuthorŽeljko Puljiz
MentorIzet Hozo (mentor)
MBZ: 117151
Committee memberIvan Kraus (predsjednik povjerenstva)
Committee memberMarko Duvnjak (član povjerenstva)
Committee memberDražen Kovač (član povjerenstva)
GranterUniversity of Rijeka
Faculty of Medicine
Rijeka
Defense date and country2010-01-01, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Universal decimal classification
(UDC)		616 - Pathology. Clinical medicine
Abstract
Cilj istraživanja: Incidencija pretilosti i steatoze jetre je u porastu širom svijeta. Gotovo jedna četvrtina populacije u zapadnim zemljama pati od nealkoholne masne bolesti jetre (NAFLD-a). Cilj ovog rada je odrediti učestalost i prediktore nealkoholnog steatohepatitisa (NASH-a). U bolesnika sa nejasnim porastom aktivnosti alanin-amonotransferaze (ALT-a) u serumu. Na taj način bi se mogla izbjeći biopsija jetre, koja nije neophodna u bolesnika s običnom steatozom. Ranije studije nisu dale ujednačene rezultate niti odgovor na pitanje kako razlikovati NASH od steatoze jetre. Ultrazvuk (UZ), kompjuterizirana tomografija (CT) i magnetska rezonanca (MR) imaju visoku osjetljivost za steatozu ali ne i za NASH. Bolesnici i metode: U studiju su uključeni bolesnici oba spola s nejasnim porastom ALT-a u serumu (≥ 50 IU/ml). Svim bolesnicima je učinjena biopsija jetre a NASH je stupnjevan po protokolu NASH Activity Score (NAS) od 0 do 8 zbroj NAS ≥5 govori za NASH, a <5 za non NASH. U studiju je uključeno 100 bolesnika (46 žena i 54 muškarca). Prosječna je dob bila 38,62±10,48 i analiziranim najznačajnijim biokemijskim, antropometrijskim i hormonskim biomarkerima. Rezultati: Prosječni BMI je bio 26,94±3,16 (kg/m²), inzulinska rezistencija (HOMA-IR) 5,73±7,53. Rezultati su uspoređeni sa patohistološkim nalazom kao relevantom dijagnostičkom metodom. U 81% bolesnika utvrđen je NAFLD (n=81), a u 32 (32%) NASH. Visoka razina triglicerida, niski HDL, hipertenzija, nivo inzulina i glukoze i povišene vrijednosti feritina značajno koreliraju s NASH-om. Zaključak: Kao u ranijim studijima inzulinska rezistencija (IR) se pokazala zaštitnim znakom NASH-a. Vrijednosti HOMA-IR, BMI i sistolička hipertenzija istovremeno, značajan su prediktor NASH-a.
Abstract (english)
Objectives: Incidence of obesity and hepatic steatosis is increasing worldwide. Almost one quarter of western countries population suffer from non alcoholic fatty liver disease (NAFLD). Aim of this study is to determine frequency and predictors of nonalcoholic steatohepatitis (NASH) in patients with unexplained alanine aminotransferase activity elevation (ALT), and therefore avoid unnecessary biopsies in cases of simple steatosis. Earlier studies gave us different results and haven't answered the question how to distinguish NASH from simple steatosis. Ultrasound (US), computed tomography (CT) and magnetic resonance (MRI) can detect steatosis with great sensitivity level, but not NASH. Patients and Methods: Study enrolled patients both sex with unexplained high ALT serum activity (≥50 IU/ml). All these patients underwent liver biopsy and NASH is staged by NASH activity score (NAS) from 0 to 8. Score ≥5 meant NASH, while <5 meant non NASH. Study included 100 patients of both sex (46 women and 54 men) with mean age 38.62±10.48, and with defined certain biochemical, antropometric and hormone biomarkers. Results: BMI was 26.94±3.16 (kg/m2), insulin resistance HOMA-IR 5.73±7.53. Results are compared to patohistologic finding as relevant method. These results showed us that 81% of patients (n=81) had NAFLD (minimal stage at least), and 32 (32%) had nonalcoholic steatohepatitis (NASH). High triglyceride, low HDL, hypertension, fasting serum insulin and glucose and high feritin serum levels correspond with NASH. Conclusion: As in earlier studies, insulin resistance as basic mechanism of NAFLD and NASH, was confirmed. Very predictive non invasive tools for diagnose of NASH include BMI, HOMA-IR and systolic hypertension.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:188:924420
Study programmeTitle: Biomedicine Postgraduate (doctoral) study programme
Study programme type: university
Study level: postgraduate
Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
Catalog URLhttps://libraries.uniri.hr/cgi-bin/unilib.cgi?form=D1120820059
Type of resourceText
Extent99 str.
File originBorn digital
Access conditionsClosed access
Terms of useLicence In copyright icon
Created on2017-01-19 18:22:09