Access restricted to higher education institution's students and staff
master's thesis
ZNAĈAJ INKRETINSKOG SUSTAVA U PATOFIZIOLOGIJI I LIJEĈENJU ŠEĆERNE BOLESTI

Lucia Španjol-Pandelo (2015)
Metadata
TitleZNAĈAJ INKRETINSKOG SUSTAVA U PATOFIZIOLOGIJI I LIJEĈENJU ŠEĆERNE BOLESTI
AuthorLucia Španjol-Pandelo
Mentor(s)Sanja Klobučar Majanović (thesis advisor)
Abstract
Inkretini su hormoni ĉiji se receptori nalaze po cijelom tijelu, a poseban interes plijeni njihov uĉinak na homeostazu glukoze i odrţavanje tjelesne teţine. GIP i GLP-1 pospješuju sintezu i luĉenje inzulina, smanjuju luĉenje glukagona, potiĉu proliferaciju β-stanica i pomaţu u mršavljenju. Ovi uĉinci inkretinskog sustava umanjeni su u šećernoj bolesti. Iako je dokazano da poremećeno djelovanje inkretina nije uzrok dijabetesa, već jedna od njegovih posljedica, njihov se uĉinak iskorištava u razvijanju najnovije terapije. Agonisti GLP-1 receptora i inhibitori DPP-IV lijekovi su koji dovode do jednakih uĉinaka u tijelu kao i nativni hormon, ali s duljim djelovanjem. U monoterapiji (koja nije odobrena u Hrvatskoj) agonisti GLP-1 receptora sniţavaju razinu HbA1c za 0.5-1.5%, a u kombinaciji s oralnim hipoglikemikom, HbA1c pada za 1.9%, pokazale su studije. Osim toga, agonisti GLP-1 receptora dovode do znaĉajnog gubitka tjelesne teţine. Inhibitori DPP-IV imaju sliĉan uĉinak te dovode do pada razine HbA1c za oko 1%, a u kombinaciji s oralnim hipoglikemikom za 2%. Ovi inkretinski lijekovi nemaju uĉinka na mršavljenje. Dodatna prednost terapije inkretinima pred dosadašnjom jest smanjen broj i intenzitet nuspojava. Tijekom kliniĉkih istraţivanja najĉešće prijavljivane bile su nuspojave GIT-a, ali bile su u pravilu prolazne, smirujući se s vremenom. Najviše zabrinjavajuća jest pojava akutnog pankreatitisa i razvoja karcinoma pankreasa koji su zabiljeţeni u nekoliko pacijenata koji su dobivali terapiju inkretinima. Naknadnim studijama nije utvrĊena povezanost pankreatitisa i karcinoma s inkretinskim lijekovima. Ipak, potrebna su daljnja istraţivanja, a i protok vremena, kako bismo postali svjesni svih njihovih pozitivnih i negativnih osobitosti.
KeywordsIncretins Diabetes Mellitus Type 2 Gastric Inhibitory Polypeptide DPP4 protein human Glucagon-Like Peptide-1 Receptor
GranterSveučilište u Rijeci
Medicinski fakultet
Lower level organizational unitsKatedra za internu medicinu
PlaceRijeka
StateCroatia
Scientific field, discipline, subdisciplineBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Internal Medicine
Study programme typeuniversity
Study levelintegrated undergraduate and graduate
Study programmeMedicine
Academic title abbreviationdr. med.
Genremaster's thesis
Language Croatian
Defense date2015
Parallel abstract (English)
Incretins are hormones whose receptors can be found throughout the human body. Their effect on glucose homeostasis and body weight is an area of broad interest. GIP and GLP-1 hormones induce insulin synthesis and secretion, inhibit glucagon secretion, stimulate β-cell proliferation, and promote weight loss. These effects of the incretin system are reduced in type 2 diabetes. Although it has been proven that the impaired incretin functions are not the cause of diabetes, but rather its consequence, the positive effects of the incretins are being used in the development of newest therapies. GLP-1 receptor agonists and DPP-IV inhibitors are therapeutic agents that have the same effects as the native hormone, only with a longer action. As monotherapy (which has not been approved in Croatia) GLP-1 receptor agonists reduce the levels of HbA1c by 0.5-1.5%, combined with an oral antidiabetic medication the level of HbA1c drops up to 1.9%, the studies show. Also, GLP-1 receptor agonists lead to significant weight loss. DPP-IV inibitors have a similar effect, lowering the levels of HbA1c by 1%, and combined with an oral antidiabetic, by 2%. These agents do not have an effect on weight loss. Another advantage of the incretin therapy is a lower incidence and intensity of adverse effects. During clinical trials the most reported adverse effects were gastrointestinal, but they were found to be mostly of short duration. The most concerning, though, is an emersion of acute pancreatitis and pancreatic cancer, which have been reported in several patients receiving incretin therapy. Later studies on this side effect did not find a connection between acute pancretitis and pancreatic cancer and incretin therapy. Further studies, as well as time flow, are necessry in order to become aware of its benefits and its limitations.
Parallel keywords (Croatian)inkretini šećerna bolest tipa 2 dijabetes GLP-1 glukgonu sliĉan peptid GIP glukoza-ovisni inzulinotropni polipeptid DPP-IV agonisti GLP-1 receptora inhibitori DPP-IV
Resource typetext
Access conditionAccess restricted to higher education institution's students and staff
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:184:154971
CommitterBosa Licul