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SAŽETAK Hipofosfatemija kao nuspojava parenteralne primjene željeza dobro je opisana u dosadašnjoj literaturi, no jasni protokoli ili preporuke o prevenciji, pravodobnom prepoznavanju i liječenju nisu dostupni. Čimbenici rizika koji dovode do pojave hipofosfatemije kod bolesnika s upalnim bolestima crijeva (IBD) nisu jasno utvrđeni te dodatno otežavaju razumijevanje nastanka hipofosfatemije i dugoročnih komplikacija, a time i potrebne korake u adekvatnom pristupu prevenciji i liječenju. Prikazom serije kliničkih slučajeva četiriju IBD bolesnika želimo pokazati heterogenost kliničke prezentacije hipofosfatemije, utjecaja nutritivnih, upalnih i drugih čimbenika te moguće modalitete liječenja. Također, želimo istaknuti koja je skupina IBD bolesnika izložena dodatnom riziku razvoja ove nuspojave s ciljem pravodobnog dijagnosticiranja i početka liječenja., Hypophosphatemia as a side effect of parenteral iron administration has been well described in the recent literature. However clear protocols or recommendations for prevention, timely recognition and treatment are not available. Different data on risk factors in patients with inflammatory bowel disease (IBD) according to the published papers further complicate the understanding of hypophosphatemia and long-term complications, and thus the necessary steps in an adequate approach to prevention and treatment. By presenting a series of clinical cases of four IBD patients, we want to show the heterogeneity of the clinical presentation of hypophosphatemia, the influence of nutritional, inflammatory and other factors and also possible treatment modalities. Furthermore, we want to point out which group of IBD patients is at additional risk of developing hypophoshatemia, with the aim of timely diagnosis and treatment initiation.

Upalne bolesti crijeva (eng. Inflammatory Bowel Disease, IBD), Crohnova bolest i ulcerozni kolitis, spadaju u kronične i progresivne bolesti. Etiologija im nije u potpunosti razjašnjena, a smatra se da uključuje kombinaciju genskih i okolišnih čimbenika što dovodi do neravnoteže između proupalnih i protuupalnih citokina u gastrointestinalnom traktu. Tijekom posljednjeg desetljeća biološka terapija u potpunosti je izmijenila strategiju liječenja. Ipak, 30 % bolesnika ne odgovori na biološku terapiju, a čak kod 40 % onih koji su inicijalno odgovorili terapija izgubi djelotvornost. Upravo za ove bolesnike postoji potreba za razvojem novih lijekova s drugačijim mehanizmima djelovanja. Modulatori sfingozin-1-fosfat (S1P) receptora predstavljaju novu generaciju lijekova koji čine prekretnicu u liječenju bolesnika s upalnim bolestima crijeva. U 2021. godini Agencija za hranu i lijekove Sjedinjenih Američkih Država i Europska agencija za lijekove su odobrili ozanimod kao prvi selektivni modulator S1P1 i S1P5 izoformi receptora, dok etrasimod predstavlja drugu generaciju modulatora S1P receptora koji trenutno prolazi kroz fazu III. kliničkih ispitivanja. Kako bi ovaj lijek našao svoje mjesto u terapiji upalnih bolesti crijeva potreban je promišljen i sveobuhvatan pristup razvoju učinkovitog i sigurnog farmaceutskog proizvoda s ciljanom dostavom aktivne farmaceutske tvari u područje upale. Za ispitivanje kompatibilnosti etrasimoda i 130 pomoćnih tvari korištena je platforma PharmDE. CACD (eng. Computer Assisted Compatibility Design) pristup pokazao je kako etrasimod nije kompatibilan s pomoćnim tvarima koje u strukturi sadrže hidroksilne skupine.

Objective: The role of adiponectin in hypertension (HT) is still a matter of debate. Obtained conflicting results could be mostly explained with diversity of subjects included in different studies. Our aim was to analyze association of adiponectin and its gene polymorphisms with blood pressure (BP) in a group of normotensive (NT) and untreated HT subjects with normal kidney function. Design and method: Analyses was conducted in 192 subjects (68 m ; age 44 (IQR 31–53)). Those with diabetes, treated HT and chronic kidney disease (eGFR < 60 ml/min) were excluded. BP was measured using Omron M6 device following ESH/ESC guidelines. Adiponectin concentration was determined by ELISA. Genotyping was done using PCR-FRET. Genetic association analyses were done with Arlequin and haplotype analysis with Unphased. Results: There were no differences in plasma adiponectin values (mg/L) between HT and NT (9.75 ; iqr:7.44–17.88 vs.11.35 ; iqr:7.43–12.63 ; P = 0.17) and no associations with systolic or diastolic BP (P > 0.05). Ninety-three persons had genotype −11377C/C, 77 had −11377C/G and 18 −11377G/G ; minor allele frequency (MAF) 30%, with no difference between NT and HT. Polymorphism −11377C > G was not associated with HT in the dominant, codominant, overdominant, recessive or additive model (all p > 0.05). Polymorphism −11391G > A (164 were dominant homozygots and 22 were heterozygots ; MAF 12%, with no difference between NT and HT) also was not associated with HT (OR 2.12 [0.73–6.16]). Haplotype analysis established three haplotypes, C-G (freq. 64%), G-G (30%), C-A (6%) which showed no association with HT well. Conclusions: In our group of NT and untreated HT with normal kidney function adiponectin was not associated with BP even after adjustment for other risk factors. Even more, we did not find an association of two common adiponectin gene polymorphisms with HT. Adiponectin-BP relationship is complex and differs between specific populations. Our conclusions should not be extrapolated to subjects with other characteristics. Studies on larger number are needed.

Prediktivna vrijednost leptina i omjera adiponektina i leptina za hipertenziju i inzulinsku rezistenciju u osoba s niskim kardiovaskularnim rizikom

Introduction and Aims: Visceral obesity is acknowledged risk factor for CKD.Adiponectin (AP) was considered to be related with beneficial clinical course.However, some authors reported opposite results.Our aim was to analyze relationship of AP with blood pressure(BP) values and kidney function in rural population. Methods: Out of 2487 enrolled subjects in cross sectional survey 257(97m and 160f) were included in this analyses.Anthropometric parameters, office BP was measured using Omron device following ESH guidelines ; albumin/creatinine ratio(ACR), eGFR, alpha 1 microglobulin-creatinine, fasting blood glucose, total cholesterol, HOMA-IR index and AP levels were determined. Results: In the subgroup of untreated hypertensives stage 1, viscerally obese subjects comparing to lean had higher values of systolic BP (*148.25 vs.143.40 ; p=0.03), HOMA- IR(*2.72 ; vs.1.98 ; p=0.015), hsCRP (*2.80 ; vs.1.60 ; p=0.05) and ACR(*5.74 ; vs.4.10 ; p=0.08) and lower eGFR(*76.05 ; vs.77.68 ; p=0.027).No differences in AP values were found(9.85 ; vs.7.35 ; p=0.28).In the normotensive subgroup, viscerally obese had higher HOMA- IR(*2.64 ; vs.*1.36 ; p

High salt intake is an important cardiovascular and renal risk factor. Our aim was to determine the relation between salt intake and the metabolic syndrome

One of the goals of our national campaign is to organize salt mapping in a representative, random sample of our population. Excessive salt intake is an important and significant risk factor for hypertension, stroke, left ventricular hypertrophy, proteinuria, osteoporosis, nephrolithiasis, and some cancers.

High salt intake is related to hypertension, cardiovascular mortality, stroke, proteinuria, nephrolithiasis, and to some cancers. In majority of countries worldwide salt intake is several folds higher than recommended.