| Abstract | Uvod: Nealkoholna masna bolest jetre označava makrovezikularnu steatozu u ≥5 %
hepatocita bez sekundarnih uzroka poput alkoholnih, medikamentoznih i infektivnih
čimbenika. Lijek-lijek interakcije nastaju kada se učinak jednog lijeka promijeni učinkom
drugog lijeka.
Metode: Ovo retrospektivno istraživanje je provedeno u Općoj bolnici Šibensko-kninske
županije. Dijagnoza NAFLD je postavljena prema kriterijima koji uključuju ultrazvučni nalaz
steatoze jetre s ili bez povišenih vrijednosti ALT i GGT, uz isključenje ostalih jetrenih
bolesti. Primarni cilj istraživanja bio je utvrditi prevalenciju DDI u bolesnika s NAFLD
ovisno o stupnju kliničke značajnosti prema Lexicomp klasifikaciji.
Rezultati: U 69,8 % bolesnika pronađena je barem jedna DDI, 69,8 % bolesnika imalo je
barem jednu potencijalnu C interakciju, 32,6 % barem jednu potencijalnu D interakciju, a
jedan (1,2 %) potencijalnu X interakciju. Najčešće identificirane interakcije bile su one
vezane uz liječenje šećerne bolesti s potencijalnim sinergijskim hipoglikemijskim učinkom.
Bolesnici s barem jednom DDI bili su starije životne dobi (p=0,001) i nižeg indeksa tjelesne
mase (p=0,006). Postojala je statistički značajna povezanost DDI s arterijskom hipertenzijom
(p=0,015), srčanim zatajenjem (p=0,037) i šećernom bolesti (p<0,001). Bolesnici s prisutnom
barem jednom DDI češće su morali barem jednom posjetiti hitnu službu (75,3 % vs. 24,7 %,
p=0,008) i češće su morali biti barem jednom hospitalizirani (75,4 % vs. 24,6 %, p=0,023) u
odnosu na bolesnike bez DDI.
Zaključak: Prevalencija DDI u bolesnika s NAFLD je visoka, a najčešće identificirani DDI
bili su oni vezani za liječenje šećerne bolesti. Potrebno je poznavati DDI u bolesnika s
NAFLD da bi se izbjegli potencijalni neželjeni događaji. |
| Abstract (english) | Introduction: Nonalcoholic fatty liver disease (NAFLD) stands for macrovesicular steatosis
in ≥ 5% of hepatocytes without secondary causes such as alcoholic, medicinal and infectious
factors. Drug-to-drug interactions(DDI) occur when the effect of one drug is changed by the
effect of another drug.
Methods: This retrospective study was conducted in the General Hospital of Šibenik-Knin
County. The diagnosis of NAFLD was made according to criteria that included
ultrasonographic identification of liver steatosis with or without elevated ALT and GGT
values, and with the exclusion of other liver diseases. The primary goal of the study was to
determine the prevalence of DDI in patients with NAFLD according to the Lexicomp
classification.
Results: At least one potential DDI was found in 69.8% of patients, 69.8% of patients had at
least one potential C interaction, 32.6% at least one potential D interaction, and one (1,2%)
potential X interaction. The most commonly identified C and D interactions were of
medications used for the treatment of diabetes mellitus with synergistic hypoglycemic effects.
Patients with at least one DDI were older (p=0.001), underweight (p=0.006) and more often
had arterial hypertension (p=0.015), heart failure (p=0.037) and diabetes mellitus (p<0.001).
Patients with at least one DDI more often had to visit the emergency department (75.3% vs.
24.7%, p=0.008) or had to be hospitalized at least once (75.4 % vs. 24.6 %, p=0.023).
Conclusion: Potential DDIs were very frequent in NAFLD patients and the most frequently
identified ones were those related to the treatment of diabetes mellitus. Physicians should
recognize DDIs in patients with NAFLD in order to avoid potentially adverse clinical
outcomes. |
