Title Uloga faktora rasta i diferencijacije - 15 (GDF-15) u upalnim bolestima crijeva
Title (english) Role of growth differentiation factor - 15 (GDF-15) in inflammatory bowel disease
Author Ante Tonkić
Mentor Joško Božić (mentor)
Committee member Željko Puljiz (predsjednik povjerenstva)
Committee member Milenko Bevanda (član povjerenstva)
Granter University of Split School of Medicine Split
Defense date and country 2024-12-17, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Internal Medicine
Universal decimal classification (UDC ) 616 - Pathology. Clinical medicine
Abstract Cilj istraživanja: Ciljevi ovog istraživanja bili su usporediti serumske koncentracije GDF-15 između bolesnika s upalnim bolestima crijeva i zdravih kontrola, te ispitati povezanost serumske koncentracije GDF-15 i drugih kliničkih, antropometrijskih i laboratorijskih pokazatelja u pacijenata s upalnim bolestima crijeva. Upalne bolesti crijeva su kronične imunološki posredovane bolesti relapsno remitirajućeg tijeka. Osim simptoma i komplikacija koje zahvaćaju probavni trakt, u ovim bolestima pojavljuju se i različite ekstraintestinalne manifestacije koje značajno doprinose ukupnom morbiditetu i mortalitetu. Serumske koncentracije GDF-15 pokazale su se kao neovisni prediktor loših ishoda u mnogim bolestima. Ispitanici i postupci: U studiju je uključeno 90 odraslih pacijenata kojima je dijagnosticirana upalna bolest crijeva, od toga 42 s ulceroznim kolitisom i 48 s Crohnovom bolesti, i 63 zdrave osobe odgovarajuće dobi i spola. Svi ispitanici su podvrgnuti fizikalnom pregledu, nakon čega im je izmjerena visina i težina te izračunat indeks tjelesne mase. Nakon toga izmjeren im je opsega struka i bokova i arterijskog tlaka. te potom uzorkovana krv za analizu. Stupanj aktivnosti bolesti procjenjivala su dva specijalista gastroenterologije uže specijalizirana za upalne bolesti crijeva, koristeći bodovne sustave sukladno važećim smjernicama. Koncentracije serumskog GDF-15 analizirane su elektroluminescentnim imunoesejem na Cobas e8000 analizatoru (Elecsys, Roche Diagnostics). Rezultati: Serumske koncentracije GDF-15 bile su značajno više u pacijenata s upalnim bolestima crijeva u odnosu na kontrolnu skupinu [prosječno 800 pg/ml (512-1154 pg/ml) u IBD skupini naspram 412 pg/ml (407-424 pg/ml) u kontrolnoj skupini, P < 0,001]. Nije bilo značajne razlike u serumskim koncentracijama GDF-15 između pacijenata s Crohnovom bolesti i ulceroznim kolitisom [(prosječno 807 pg/ml (554-1451 pg/ml) u pacijenata s Crohnovom bolesti i 790 pg/ml (509-956 pg/ml) u pacijenata s ulceroznim kolitisom, P = 0,324)]. Analiza multiple linearne regresije pokazala je da serumske koncentracije GDF-15 mogu biti prediktor upalnih bolesti crijeva neovisno o dobi, spolu ili koncentracijama CRP. Uz to, utvrđena je i povezanost između GDF-15 i pokazatelja anemije. Zaključak: Istraživanje je utvrdilo značajno veće koncentracije GDF-15 u pacijenata s upalnim bolestima crijeva u usporedi s kontrolnom skupinom. Rezultati ovog istraživanja ukazuju na moguću ulogu ovog biomarkera u patofiziologiji upalnih bolesti crijeva. Ipak i dalje ostaje nejasno može li se GDF-15 koristiti kao prognostički indikator u pacijenata s upalnim bolestima crijeva.
Abstract (english) Research aims: Aims of this research study were to compare the serum concentrations of GDF 15 between inflammatory bowel disease patients and healthy controls, as well as to investigate the connection between the serum concentrations of GDF-15 and other clinical, antropometric and laboratory parameters in IBD patients. Inflammatory bowel disease is a group of chronic immune mediated diseases characterized by periods of relapse and remission. In addition to symptoms and complications involving the digestive tract, this population of patients is burdened by various extraintestinal manifestations which substantially contribute to greater morbidity and mortality. As serum concentrations of growth-differentiation factor-15 (GDF-15) were shown to be an independent predictor of poor outcomes in many diseases, we aimed to explore an association between GDF-15 and IBD. Study participants and procedures: The study included 90 adult patients diagnosed with IBD, 42 of which were ulcerative colitis patients and 48 Crohn disease patients, as well as 63 healthy age and sex-matched controls. Physical examination was performed on all study participants, after which height and weight measurements were taken, and body mass index calculated. Next, hip and waist circumference along with blood pressure were performed, as well as blood sampling for laboratory tests. Disease activity assessment was performed by two independent gastroenterology specialists with a special interest in inflammatory bowel disease treatment, using current and validated scoring systems. Serum GDF-15 concentrations were analyzed using the electrochemiluminescence immunoassay on the Cobas e800 analyzer (Elecsys, Roche Diagnostics). Results: In IBD patients, serum GDF-15 concentrations were significantly higher in comparison to the healthy controls [GDF-15 concentration averaged 800 pg/ml (512-1154 pg/ml) in the IBD group compared to 412 pg/ml (407-424 pg/ml) in the control group, P < 0.001)]. No difference in GDF-15 serum concentrations was found between patients with Crohn’s disease and ulcerative colitis [(average GDF-15 concentrations of 807 pg/ml (554-1451 pg/ml) in the Crohn's disease group and 790 pg/ml (509-956 pg/ml) in the ulcerative colitis group, P = 0.324)]. Moreover, multiple linear regression analysis showed that GDF-15 levels predict CD and UC severity independent of age, sex and C-reactive protein levels. Conclusion: Results showed significantly higher average serum concentrations of GDF-15 in the IBD group compared to the control group. Finally, an association between GDF-15 and indices of anemia was established. Overall, the results of the present study suggest a potential role of this biomarker in IBD pathophysiology. Yet, it remains elusive whether GDF-15 might be used as a prognostic indicator in these patients.
Keywords
upalne bolesti crijeva
čimbenik diferenciracije rasta 15
Keywords (english)
Inflammatory Bowel Diseases
Growth Differentiation Factor 15
Language croatian
URN:NBN urn:nbn:hr:171:270662
Study programme Title: Biology of Neoplasms Study programme type: university Study level: postgraduate Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
Type of resource Text
File origin Born digital
Access conditions Open access Embargo expiration date: 2024-12-17
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Created on 2024-12-10 09:18:00