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New Drugs on the Block—Emerging Treatments for Nonalcoholic Steatohepatitis

Journal of Clinical and Translational Hepatology 2021年第1期9卷 51-59页

作者： Sanja Stojsavljevic-Shapeski Marko duvnjak Lucija Virovic-Jukic Davor Hrabar lea smircic duvnjak Department of Gastroenterology and Hepatology Clinical Hospital Center Sestre MilosrdniceZagrebCroatia Polyclinic duvnjak ZagrebCroatia University of Applied Health Science ZagrebCroatia School of Medicine University of ZagrebZagrebCroatia Vuk Vrhovac University Clinic-UH Merkur ZagrebCroatia

Patients with nonalcoholic steatohepatitis(NASH)are at higher risk of progression to advanced stages of fibrosis,cirrhosis,hepatocellular carcinoma and other end-stage liver disease *** addressing treatment of NASH,we have limited approved options,and the mainstay of therapy is lifestyle *** research and revelation in the field of pathogenesis of NASH has offered new possibilities of treatment and emerging new drugs that are being tested currently in numerous preclinical and clinical *** drugs target almost all steps in the pathogenesis of NASH to improve insulin sensitivity,glucose and lipid metabolism,to inhibit de novo lipogenesis and delivery of lipids to the liver,and to influence apoptosis,inflammation and *** NASH is a multifactorial disease,in the future we could identify the predominating pathological mechanism and,by choosing the most appropriate specific medication,tailor the treatment for every patient individually.

关键词： Fatty liver Steatohepatitis Nonalcoholic fatty liver disease Treatment

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Impact of creatinine methodology on glomerular filtration rate estimation in diabetes

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World Journal of Diabetes 2017年第5期8卷 222-229页

作者： Marijana Vucic Lovrencic Vanja Radisic Biljak Kristina Blaslov Sandra Bozicevic lea smircic duvnjak Department of Laboratory Medicine Merkur University Hospital Vuk Vrhovac University Clinic Merkur University Hospital

AIM To evaluate the influence of creatinine methodology on the performance of chronic kidney disease(CKD)-Epidemiology Collaboration Group-calculated estimated glomerular filtration rate(CKD-EPI-eGFR) for CKD diagnosis/staging in a large cohort of diabetic patients. METHODS Fasting blood samples were taken from diabetic patients attending our clinic for their regular annual examination, including laboratory measurement of serum creatinine and *** Our results indicated an overall excellent agreement in CKD staging(kappa = 0.918) between the Jaffé serum creatinine-and enzymatic serum creatinine-based CKDEPI-eGFR, with 9% of discordant cases. As compared to the enzymatic creatinine, the majority of discordances(8%) were positive, i.e., associated with the more advanced CKD stage re-classification, whereas only 1% of cases were negatively discordant if Jaffé creatinine was used for eGFR calculation. A minor proportion of the discordant cases(3.5%) were re-classified into clinically relevant CKD stage indicating mildly to moderately decreased kidney function(< 60 m L/min per 1.73 m^2). Significant acute and chronic hyperglycaemia, assessedas plasma glucose and Hb A1 c levels far above the recommended glycaemic goals, was associated with positively discordant cases. Due to a very low frequency, positive discordance is not likely to present a great burden for the health-care providers, while intensified medical care may actually be beneficial for the small number of discordant patients. On the other hand, a very low proportion of negatively discordant cases(1%) at the 60 m L/min per 1.73 m^2 eGFR level indicate a negligible possibility to miss the CKD diagnosis, which could be the most prominent clinical problem affecting patient care, considering high risk of CKD for adverse patient outcomes. CONCLUSION This study indicate that compensated Jaffé creatinine procedure, in spite of the glucose-dependent bias, is not inferior to enzymatic creatinine in CKD diagnosis/

关键词： Diabetes Estimated glomerular filtration rate Chronic kidney disease-Epidemiology Collaboration Group Creatinine Enzymatic method Chronic kidney disease Impact Compensated Jaffé method

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