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What is the gut feeling telling us about physical activity in colorectal carcinogenesis?

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World Journal of Clinical Cases 2020年第23期8卷 5844-5851页

作者： Maja Cigrovski Berkovic Vjekoslav Cigrovski ines bilic-curcic Anna Mrzljak Department for Endocrinology Diabetes and MetabolismClinical Hospital DubravaZagreb 10000Croatia Faculty of Kinesiology University of ZagrebZagreb 10000Croatia Department of Pharmacology Faculty of MedicineJ J Strossmayer University OsijekOsijek 31000Croatia Department of Medicine Merkur University HospitalZagreb 10000Croatia Department of Medicine School of MedicineUniversity of ZagrebZagreb 10000Croatia

In the last decades,more efforts are focused on the prevention and treatment of malignant diseases,given the increase in all cancers incidence A lifestyle change,including healthy eating habits and regular physical activity,has significantly impacted colorectal cancer *** effect of dose-dependent physical activity on mortality and recurrence rates of colorectal carcinoma has been unequivocally demonstrated in observational ***,clear recommendations are not available on the frequency,duration,and intensity of exercise in patients with colorectal cancer due to the lack of evidence in randomized clinical *** pathophysiological mechanisms,the most plausible explanation appears to be the influence of physical activity on reducing chronic inflammation and insulin resistance with a consequent positive effect on insulin growth factor 1 signaling pathways.

关键词： Physical activity Colorectal cancer Insulin signaling pathway Inflammation Gut microbiota

Semaglutide might be a key for breaking the vicious cycle of metabolically associated fatty liver disease spectrum?

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World Journal of Clinical Cases 2022年第20期10卷 6759-6768页

作者： Maja Cigrovski Berkovic Tanja Rezic ines bilic-curcic Anna Mrzljak Department of Endocrinology DiabetesMetabolism and Clinical PharmacologyClinical Hospital DubravaZagreb 10000Croatia Faculty of Kinesiology University of ZagrebZagreb 10000Croatia Department of Endocrinology and Diabetes Clinical Hospital DubravaZagreb 10000Croatia Department of Endocrinology and Diabetes University Hospital Centre OsijekOsijek 31000Croatia Department of Gastroenterology and Hepatology University Hospital Centre ZagrebZagreb 10000Croatia School of Medicine University of ZagrebZagreb 10000Croatia

Metabolically associated fatty liver disease(MAFLD)is a liver manifestation of metabolic syndrome potentially related to unfavorable hepatic and extrahepatic outcomes and progression to *** to date,there are no approved pharmacotherapies for the treatment of MAFLD,so management focused on lifestyle interventions to encourage weight loss,and treatment of coexisting conditions is the only available ***,the aforementioned is often not potent enough to offer reversal or slow down hepatic inflammation and ***-like peptide-1 receptor agonists have a favorable effect on glycemic management and weight loss of patients with type 2 diabetes mellitus and recently published data suggest their potential in MAFLD *** addition,some of the agents have proven cardiovascular and renal benefits in dedicated cardiovascular outcome trials,making them an interesting therapeutic *** this opinion review,we discuss the role of semaglutide in MAFLD.

关键词： Semaglutide Non-alcoholic fatty liver disease Glucagon-like peptide-1 receptor agonists Metabolically associated fatty liver disease

Post-transplant diabetes mellitus and preexisting liver disease-a bidirectional relationship affecting treatment and management

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World Journal of Gastroenterology 2020年第21期26卷 2740-2757页

作者： Maja Cigrovski Berkovic Lucija Virovic-Jukic ines bilic-curcic Anna Mrzljak Department of Kinesiological Anthropology and Methodology Faculty of KinesiologyUniversity of ZagrebZagreb 10000Croatia Clinical Hospital Dubrava Zagreb 10000Croatia Department of Pharmacology Faculty of MedicineUniversity of J.J.Strossmayer OsijekOsijek 31000Croatia School of Medicine University of ZagrebZagreb 10000Croatia Department of Medicine Division of Gastroenterology and HepatologySisters of Charity University HospitalZagreb 10000Croatia

Liver cirrhosis and diabetes mellitus(DM)are both common conditions with significant socioeconomic burden and impact on morbidity and mortality.A bidirectional relationship exists between DM and liver cirrhosis regarding both etiology and disease-related *** 2 DM(T2DM)is a wellrecognized risk factor for chronic liver disease and vice-versa,DM may develop as a complication of cirrhosis,irrespective of its *** transplantation(LT)represents an important treatment option for patients with end-stage liver disease due to non-alcoholic fatty liver disease(NAFLD),which represents a hepatic manifestation of metabolic syndrome and a common complication of *** metabolic risk factors including immunosuppressive drugs,can contribute to persistent or de novo development of DM and NAFLD after LT.T2DM,obesity,cardiovascular morbidities and renal impairment,frequently associated with metabolic syndrome and NAFLD,may have negative impact on short and long-term outcomes following *** treatment of DM in the context of chronic liver disease and post-transplant is challenging,but new emerging therapies such as glucagon-like peptide-1 receptor agonists(GLP-1RAs)and sodium–glucose cotransporter 2 inhibitors(SGLT2i)targeting multiple mechanisms in the shared pathophysiology of disorders such as oxidative stress and chronic inflammation are a promising tool in future patient management.

关键词： Diabetes mellitus Liver transplantation Non-alcoholic fatty liver disease Metabolic syndrome Insulin-resistance Glucagon-like peptide-1 receptor agonists Sodium–glucose cotransporter 2 inhibitors

Hypothyroidism and Nonalcoholic Fatty Liver Disease:Pathophysiological Associations andTherapeutic Implications

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Journal of Clinical and Translational Hepatology 2020年第3期8卷 347-353页

作者： Tomislav Kizivat Ivana Maric Dunja Mudri ines bilic curcic Dragan Primorac Martina Smolic University of Osijek Faculty of MedicineOsijekCroatia University Hospital Osijek OsijekCroatia St Catherine Specialty Hospital Zagreb&ZabokCroatia University of Split School of Medicine SplitCroatia Eberly College of Science State CollegePenn State UniversityPAUSA The Henry C Lee College of Criminal Justice&Forensic Sciences University of New HavenWest HavenCTUSA University of Rijeka School of Medicine RijekaCroatia University of Osijek Faculty of Dental Medicine&Health OsijekCroatia

Nonalcoholic fatty liver disease(NAFLD)is a complex clinical entity which can be secondary to many other diseases including hypothyroidism,characterized by lowering of thyroid hormones and increased thyroid stimulating hormone(TSH).A lot of emerging data published recently advocates the hypothesis that hypothyroid induced NAFLD could be a separate clinical entity,even suggesting possible treatment options for NAFLD involving substitution therapy for hypothyroidism along with lifestyle *** addition,a whole new field of research is focused on thyromimetics in NAFLD/NASH treatment,currently in phase 3 clinical *** this critical review we summarized epidemiological and pathophysiological evidence linking these two clinical entities and described specific treatment options with the accent on promising new agents in NAFLD treatment,specifically thyroid hormone receptor(THR)agonist and its metabolites.

关键词： NAFLD MAFLD Hypothyroidism Metabolic syndrome Thyromimetics

Prehabilitation of overweight and obese patients with dysglycemia awaiting bariatric surgery: Predicting the success of obesity treatment

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World Journal of Diabetes 2022年第12期13卷 1096-1105页

作者： Maja Cigrovski Berkovic ines bilic-curcic Anna Mrzljak Silvija Canecki Varzic Vjekoslav Cigrovski Department of Endocrinology Diabetes and Clinical PharmacologyClinical Hospital DubravaZagreb 10000Croatia Faculty of Kinesiology University of ZagrebZagreb 10000Croatia Faculty of Medicine University of Osijek Osijek 31000Croatia Department of Endocrinology and Diabetes Clinical Hospital Centre OsijekOsijek 31000Croatia Department of Gastroenterology and Hepatology University Hospital Center ZagrebZagreb 10000Croatia School of Medicine University of ZagrebZagreb 10000Croatia

Bariatric surgery offers the best health results in overweight and obese patients but is not a risk and/or complication-free *** cases with additional hyperglycemia,the burden of surgery can be even higher and alter both shortterm and long-term *** bariatric surgery offers glycemic improvements and in the case of early onset diabetes disease remission,weight loss results are lower than for obese patients without *** multimodal programs,usually including interventions related to patients’performance,nutritional and psychological status as well as currently available pharmacotherapy before the surgery itself might considerably improve the immediate and late postoperative ***,there are still no clear guidelines addressing the prehabilitation of obese patients with dysglycemia undergoing bariatric surgery and therefore no unique protocols to improve patients’*** this minireview,we summarize the current knowledge on prehabilitation before bariatric surgery procedures in patients with obesity and dysglycemia.

关键词： Bariatric surgery Obesity Dysgylcemia Diabetes outcome Prehabilitation

Shifting perspectives-interplay between non-alcoholic fatty liver disease and insulin resistance in lean individuals

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World Journal of Hepatology 2021年第1期13卷 80-93页

作者： ines bilic-curcic Maja Cigrovski Berkovic Lucija Virovic-Jukic Anna Mrzljak Department of Pharmacology Faculty of MedicineUniversity of J.J.Strossmayer OsijekOsijek 31000Croatia Clinical Hospital Center Osijek Osijek 31000Croatia Department of Kinesiological Anthropology and Methodology Faculty of KinesiologyUniversity of ZagrebZagreb 10000Croatia Clinical Hospital Dubrava Zagreb 10000Croatia Department of Medicine Division of Gastroenterology and HepatologySisters of Charity University HospitalZagreb 10000Croatia School of Medicine University of ZagrebZagreb 10000Croatia Department of Medicine Merkur University HospitalZagreb 10000Croatia

Non-alcoholic fatty liver disease(NAFLD)has become a significant public health burden affecting not only obese individuals but also people with normal *** opposed to previous beliefs,this particular subset of patients has an increased risk of all-cause mortality and worse outcomes than their obese *** development of NAFLD in lean subjects seems to be interconnected with metabolic phenotype,precisely visceral fat tissue,sarcopenia,and insulin ***,we summarize available data focusing on the co-dependent relationship between metabolic phenotype,insulin resistance,and development of NAFLD in lean individuals,suggesting more appropriate tools for measuring body fat distribution for the screening of patients at risk.

关键词： Non-alcoholic fatty liver disease Metabolic phenotype Lean individuals Insulin resistance Visceral fat tissue Sarcopenia

Coagulation and Endothelial Dysfunction Associated with NAFLD:Current Status and Therapeutic Implications

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Journal of Clinical and Translational Hepatology 2022年第2期10卷 339-355页

作者： Doris Ogresta Anna Mrzljak Maja Cigrovski Berkovic ines bilic-curcic Sanja Stojsavljevic-Shapeski Lucija Virovic-Jukic Department of Gastroenterology and Hepatology Sestre Milosrdnice University Hospital CenterZagrebCroatia Depart-ment of Gastroenterology and Hepatology University Hospital Center ZagrebZagrebCroatia Department of Medicine University of ZagrebSchool of MedicineZagrebCroatia Department for Endocrinology Diabetes and PharmacologyUniversity Hospital DubravaZagrebCroatia Department of Kinesiological Anthropology and Methodology Faculty of KinesiologyUniversity of Zagreb Department of Pharmacology Faculty of MedicineUniversity of JJ StrossmayerOsijekCroatia Department of Diabetes Endocrinology and Metabolism DisordersUniversity Hospital OsijekOsijekCroatia

Non-alcoholic fatty liver disease(NAFLD)is closely related to insulin resistance,type 2 diabetes mellitus,and *** is nowadays considered a multisystem disease with a strong association with cardiovascular disease and arterial hypertension,which interfere with changes in the coagulation *** disorders are common in patients with hepatic impairment and are dependent on the degree of liver *** with NAFLD may have preserved overall hemostatic profile,but many studies suggest a trend toward a procoagulant *** state in NAFLD patients may even induce progression of hepatic *** dysfunction is present in the systemic and portal vein circulation in NAFLD patients,and platelets are being recognized as modulators of liver diseases through various *** a literature review,we discuss possible disorders in the coagulation cascade and fibrinolysis,endothelial dysfunction,and platelet abnormalities in patients with *** the processes and mechanisms involved in the hemostatic abnormalities associated with NAFLD,directly related to liver disease or indirectly related through inflam-matory processes and metabolic disorders,several potential therapeutic targets have been identified and reviewed here.

关键词： Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Insulin resistance Coagulation Endothelial dysfunction Platelet dysfunction Thrombosis

Exploring new treatment options for polycystic ovary syndrome: Review of a novel antidiabetic agent SGLT2 inhibitor

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World Journal of Diabetes 2021年第7期12卷 932-938页

作者： Jelena Marinkovic-Radosevic Maja Cigrovski Berkovic Egon Kruezi ines bilic-curcic Anna Mrzljak Department of Endocrinology Diabetes and MetabolismSisters of Charity Clinical Hospital CentreZagreb 10000Croatia Department of Endocrinology DiabetesMetabolism and Clinical PharmacologyClinical Hospital DubravaZagreb 10000Croatia Department of Kinesiological Anthropology and Methodology Faculty of KinesiologyUniversity of ZagrebZagreb 10000Croatia Department of Gynecology and Obstetrics Sisters of Charity Clinical Hospital CentreZagreb 10000Croatia Department of Pharmacology Faculty of MedicineUniversity of J.J.Strossmayer OsijekOsijek 31000Croatia Clinical Hospital Center Osijek Osijek 31000Croatia School of Medicine University of ZagrebZagreb 10000Croatia Department of Gastroenterology and Hepatology University Hospital Centre ZagrebZagreb 10000Croatia

Polycystic ovary syndrome(PCOS)is the most common endocrinopathy in women of reproductive age associated with long-term metabolic and cardiovascular consequences.A plethora of symptoms and their severity differentiate on an individual level,giving the syndrome numerous *** to menstrual cycle abnormalities,women suffer from irregular menstrual bleeding,difficulty in conception,and ***,the risk of pregnancy complications such as gestational diabetes mellitus,hypertensive disorders of pregnancy,and preterm birth are higher in women with PCOS than in the general ***,women with PCOS have comorbidities such as dyslipidemia,obesity,glucose intolerance or diabetes type 2,non-alcoholic fatty liver disease,and metabolic syndrome,which all influence the treatment *** insulinsensitizing agents,although good for some of the metabolic derangements,do not offer long-term cardiovascular benefits;therefore,new treatment options are of paramount ***-glucose co-transporter-2(SGLT-2)inhibitors,a new class of antidiabetic agents with beneficial cardiovascular,bodyweight,and antihyperglycemic effects,although not approved for the treatment of PCOS,might be an attractive therapeutic addition in the PCOS ***,recent studies with SGLT-2 inhibitors showed promising improvements in anthropometric parameters and body composition in patients with *** is important to further explore the SGLT-2 inhibitors potential as an early therapeutic option because of the PCOS-related risk of metabolic,reproductive,and psychological consequences.

关键词： Polycystic ovary syndrome Sodium-glucose co-transporter-2 inhibitors Metabolic risk Cardiovascular risk Metabolic syndrome Insulin resistance Obesity Type 2 diabetes mellitus Dyslipidemia

Fear of hypoglycemia,a game changer during physical activity in type 1 diabetes mellitus patients

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World Journal of Diabetes 2021年第5期12卷 569-577页

作者： Maja Cigrovski Berkovic ines bilic-curcic Lavinia La Grasta Sabolic Anna Mrzljak Vjekoslav Cigrovski Department of Endocrinology DiabetesMetabolism and Clinical PharmacologyUniversity Hospital DubravaZagreb 10000Croatia Department of Pharmacology Faculty of MedicineUniversity of J.J.Strossmayer OsijekOsijek 31000Croatia Department of Pediatric Endocrinology Diabetes and MetabolismUniversity Hospital Centre Sestre MilosrdniceZagreb 10000Croatia Department of Medicine Merkur University HospitalZagreb 10000Croatia School of Medicine University of ZagrebZagreb 10000Croatia Faculty of Kinesiology University of ZagrebZagreb 10000Croatia

Hypoglycemia limits optimal glycemic management of patients with type 1 diabetes mellitus(T1DM).Fear of hypoglycemia(FoH)is a significant psychosocial consequence that negatively impacts the willingness of T1DM patients to engage in and profit from the health benefits of regular physical activity(e.g.,cardiometabolic health,improved body composition,cardiovascular fitness,quality of life).Technological advances,improved insulin regimens,and a better understanding of the physiology of various types of exercise could help ameliorate *** narrative review summarizes the available literature on FoH in children and adults and tools to avoid it.

关键词： Hypoglycemia Fear of hypoglycemia Type 1 diabetes mellitus Physical activity Modern technology Exercise management