Učestalost različitih tipova sindroma iritabilnog kolona kod pacijenata sa nealkoholnom masnom jetrom
Sažetak
Uvod: Nealkoholna masna jetra (NAFLD) je preterana akumulacija masti koja se otkriva putem imidžing metoda ili histološki, kod osoba koje nisu konzumirale alkohol. Povezana je sa insulinskom rezistencijom i metaboličkim sindromom. Sindrom iritabilnog kolona (IBS) je funkcionalni gastrointestinalni poremećaj, gde ne postoje morfološki poremećaji u digestivnom sistemu i čiju dijagnozu postavljamo na osnovu Rome IV kriterijuma.
Cilj rada: Utvrđivanje zastupljenosti različitih tipova IBS-a kod različitih stepena steatoze, radi razmatranja moguće povezanosti i međusobnog uticaja ove dve bolesti.
Materijal i metode: U retrospektivnoj studiji sprovedenoj u Klinici za gastroenterohepatologiju Univerzitetskog Kliničkog centra Srbije, od januara do juna 2020., dijagnostikovana su 49 pacijenata, starosti preko 18 godina, sa dijagnozom NAFLD i IBS. Na osnovu ultrazvučnog pregleda, pacijenti su klasifikovani na one sa I, II i III stepenom steatoze jetre, a prema Rome IV kriterijumima, na IBS-C, IBS-D i IBS-M tip. Beleženi su podaci o: Body Mass Index-u (BMI), hiperglikemiji, vrednostima holesterola, triglicerida, ALT-a, AST-a, γGT-a, Diabetes melitus-u (DM), arterijskoj hipertenziji, gastroezofagusno-refluksnoj bolesti (GERB) i holelitijazi.
Rezultati: Ukupan broj ispitanika sa NAFLD i IBS je bio 49, prosečne starosti 52,02±13,44 godine, 63% žena i 37% muškaraca. IBS-C i IBS-D tip je bio više zastupljen kod žena (69% i 91%), a IBS-M tip kod muškaraca (75%). Razlika u učestalosti tipova IBS-a prema stepenu NAFLD nije bila statistički značajna. Visoko povišen BMI, hiperglikemija, holesterol, trigliceridi, ALT, AST, γGT, DM, GERB i holelitijaza su pretežno bili zastupljeni u II i III stepenu steatoze, dok prisustvo arterijske hipertenzija nije pokazalo statističku značajanu razliku. Statistički značajna razlika je postojala samo kod pacijenata sa povišenim holesterolom, sa najvećom zastupljenošću kod IBS-C tipa (77%).
Zaključak: Pacijenti oboleli od NAFLD i IBS-a su pretežno ženskog pola. NAFLD je povezan sa metaboličkim sindromom, insulinskom rezistencijom, GERB-om i holelitijazom. Nije pokazana povezanost između stepena steatoze jetre i tipa IBS-a, osim povišenih vrednosti holesterola sa III stepenom steatoze i IBS-C tipom.
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