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Risk Factors for Colorectal Adenoma–Acknowledging the Burden of NAFLD

Journal of Clinical and Translational Hepatology 2019年第2期7卷 97-98页

作者： Marko Duvnjak Sanja Stojsavljević lucija virović jukić Lea Smirčić Duvnjak School of Medicine University of ZagrebZagrebCroatia Department of Gastroenterology and Hepatology Sisters of Charity University Hospital CenterZagrebCroatia Department of Endocrinology and Metabolic Diseases Vuk Vrhovac University Clinic for DiabetesMerkur University HospitalZagrebCroatia

Global trends of diet have changed in Western and Eastern countries,featuring foods that are highly processed,contain saturated fat and carry excessive carbohydrate ***,accompanied by lower levels of physical activity,due to a more sedentary lifestyle,and the overweight/obesity epidemic,is the reason we are facing a rise in occurrence of new cases of metabolic ***,these patients are at substantial risk of developing the well-known complications related to each of the components of metabolic syndrome,those being insulin resistance/diabetes mellitus,arterial hypertension,hyperlipidemia and visceral obesity.

关键词： obesity NAFLD arterial

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Pathogenesis and management issues for non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2007年第34期13卷 4539-4550页

作者： Marko Duvnjak Ivan Leroti Neven Bari Vedran Tomai lucija virovi juki Vedran Velagi Division of Gastroenterology and Hepatology Department of Medicine 'Sestre milosrdnice' University Hospital Vinogradska 29 Zagreb 10000 Croatia

Nonalcoholic fatty liver disease (NAFLD) has, although it is a very common disorder, only relatively recently gained broader interest among physicians and scientists. Fatty liver has been documented in up to 10 to 15 percent of normal individuals and 70 to 80 percent of obese individuals. Although the pathophysiology of NAFLD is still subject to intensive research, several players and mechanisms have been suggested based on the substantial evidence. Excessive hepatocyte triglyceride accumulation resulting from insulin resistance is the first step in the proposed 'two hit' model of the pathogenesis of NAFLD. Oxidative stress resulting from mitochondrial fatty acids oxidation, NF-κB-dependent inflammatory cytokine expression and adipocytokines are all considered to be the potential factors causing second hits which lead to hepatocyte injury, inflammation and fibrosis. Although it was initially believed that NAFLD is a completely benign disorder, histologic follow-up studies have showed that fibrosis progression occurs in about a third of patients. A small number of patients with NAFLD eventually ends up with end-stage liver disease and even hepatocellular carcinoma. Although liver biopsy is currently the only way to confirm the NAFLD diagnosis and distinguish between fatty liver alone and NASH, no guidelines or firm recommendations can still be made as for when and in whom it is necessary. Increased physical activity, gradual weight reduction and in selected cases bariatric surgery remain the mainstay of NAFLD therapy. Studies with pharmacologic agents are showing promising results, but available data are still insufficient to make specific recommendations; their use therefore remains highly individual.

关键词： Non-alcoholic fatty liver disease Metabolic

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Adipokines and proinflammatory cytokines, the key mediators in the pathogenesis of nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2014年第48期20卷 18070-18091页

作者： Sanja Stojsavljevi? Marija Gomer?i? Pal?i? lucija virovi? juki? Lea Smir?i? Duvnjak Marko Duvnjak Department of Gastroenterology and Hepatology Clinic of Internal medicine Clinical hospital center "Sestre milosrdnice" 10000 Zagreb Croatia University Hospital for Diabetes Endocrinology and Metabolic Diseases Vuk Vrhovac 10000 Zagreb Croatia

Nonalcoholic fatty liver disease (NAFLD) is a condition in which excess fat accumulates in the liver of a patient with no history of alcohol abuse or other causes for secondary hepatic steatosis. The pathogenesis of NAFLD and nonalcoholic steatohepatitis (NASH) has not been fully elucidated. The “two-hit“ hypothesis is probably a too simplified model to elaborate complex pathogenetic events occurring in patients with NASH. It should be better regarded as a multiple step process, with accumulation of liver fat being the first step, followed by the development of necroinflammation and fibrosis. Adipose tissue, which has emerged as an endocrine organ with a key role in energy homeostasis, is responsive to both central and peripheral metabolic signals and is itself capable of secreting a number of proteins. These adipocyte-specific or enriched proteins, termed adipokines, have been shown to have a variety of local, peripheral, and central effects. In the current review, we explore the role of adipocytokines and proinflammatory cytokines in the pathogenesis of NAFLD. We particularly focus on adiponectin, leptin and ghrelin, with a brief mention of resistin, visfatin and retinol-binding protein 4 among adipokines, and tumor necrosis factor-α, interleukin (IL)-6, IL-1, and briefly IL-18 among proinflammatory cytokines. We update their role in NAFLD, as elucidated in experimental models and clinical practice.

关键词： Nonalcoholic fatty liver disease Cytokines Adipokines Adiponectin Leptin Tumor necrosis factor-α Interleukin-6 Interleukin-1 Interleukin-18 Ghrelin

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Hepatitis C Virus, Insulin Resistance, and Steatosis

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Journal of Clinical and Translational Hepatology 2016年第1期4卷 66-75页

作者： Dominik Kralj lucija virovi(c) juki(c) Sanja Stojsavljevi(c) Marko Duvnjak Martina Smoli(c) Ines Bili(c) (C)ur(c)i(c) Department of Gastroenterology and Hepatology Sisters of Charity University Hospital Center Zagreb Croatia Department of Pharmacology Faculty of Medicine University of Osijek Osijek Croatia Department of Pharmacology Faculty of MedicineUniversity of Osijek Department of Endocrinology and metabolism disorders University Hospital Center Osijek Osijek Croatia

Hepatitis C virus (HCV) is one of the main causes of liver disease *** steatosis is a common finding in many hepatic and extrahepatic disorders,the most common being metabolic syndrome (MS).Overtime,it has been shown that the frequent coexistence of these two conditions is not coincidental,since many epidemiological,clinical,and experimental studies have indicated HCV to be strongly associated with liver steatosis and numerous metabolic ***,we present an overview of publications that provide clinical evidence of the metabolic effects of HCV and summarize the available data on the pathogenetic mechanisms of this *** has been shown that HCV infection can induce insulin resistance (IR) in the liver and peripheral tissues through multiple *** research has suggested that HCV interferes with insulin signaling both directly and indirectly,inducing the production of several proinflammatory *** replication,assembly,and release from hepatocytes require close interactions with lipid droplets and host *** modulation of lipid metabolism in host cells can induce hepatic steatosis,which is more pronounced in patients with HCV genotype *** risk of steatosis depends on several viral factors (including genotype,viral load,and gene mutations) and host features (visceral obesity,type 2 diabetes mellitus,genetic predisposition,medication use,and alcohol consumption).HCV-related IR and steatosis have been shown to have a remarkable clinical impact on the prognosis of HCV infection and quality of life,due to their association with resistance to antiviral therapy,progression of hepatic fibrosis,and development of hepatocellular ***,HCV-induced IR,oxidative stress,and changes in lipid and iron metabolism lead to glucose intolerance,arterial hypertension,hyperuricemia,and atherosclerosis,resulting in increased cardiovascular mortality.

关键词： Hepatitis C virus Metabolic syndrome Insulin resistance Steatosis

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