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Article ; Online: Burden of obesity in gastrointestinal and liver diseases.

Krznaric, Zeljko

United European gastroenterology journal

2022 Volume 10, Issue 7, Page(s) 629–630

MeSH term(s)	Gastrointestinal Tract ; Humans ; Liver Diseases/complications ; Liver Diseases/diagnosis ; Liver Diseases/epidemiology ; Obesity/complications ; Obesity/epidemiology
Language	English
Publishing date	2022-08-31
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	2728585-6
ISSN	2050-6414 ; 2050-6406
ISSN (online)	2050-6414
ISSN	2050-6406
DOI	10.1002/ueg2.12302
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Article ; Online: Young GI angle: European Specialty Examination in Gastroenterology and Hepatology exam: Tips and tricks.

Domislovic, Viktor / Krznaric, Zeljko / Heinrich, Henriette

United European gastroenterology journal

2023 Volume 11, Issue 9, Page(s) 907–910

MeSH term(s)	Gastroenterology/education ; European Union ; Education, Medical, Graduate
Language	English
Publishing date	2023-10-20
Publishing country	England
Document type	News
ZDB-ID	2728585-6
ISSN	2050-6414 ; 2050-6406
ISSN (online)	2050-6414
ISSN	2050-6406
DOI	10.1002/ueg2.12480
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Article ; Online: Predictive value of faecal calprotectin in ulcerative colitis - single centre experience.

Grgić, Dora / Golubić, Karlo / Brinar, Marko / Krznarić, Željko

Annals of medicine

2022 Volume 54, Issue 1, Page(s) 1570–1577

Abstract: Objectives: Faecal calprotectin is an important biomarker used in the evaluation of inflammatory bowel disease. The aim of this study was to establish the value of faecal calprotectin concentration as a predictor of remission in ulcerative colitis and ... ...

Abstract	Objectives: Faecal calprotectin is an important biomarker used in the evaluation of inflammatory bowel disease. The aim of this study was to establish the value of faecal calprotectin concentration as a predictor of remission in ulcerative colitis and its correlation with laboratory, endoscopic and clinical findings. Methods: The single centre study included 126 adult patients with established diagnosis of ulcerative colitis consecutively visiting our Day clinic from March 2017 to March 2019. We measured serum biomarkers- CRP, haemoglobin, leukocytes and platelets. Faecal calprotectin was determined from stool, and endoscopy was performed with calculation of MAYO endoscopic subscore system (MES 0-1: remission, and MES 2-3: active disease). Clinical assessment was done by using Mayo score for ulcerative colitis (clinical Mayo score <2:remission, >5: active disease).The statistical analysis was performed using an univariate and multivariate model of disease remission prediction using logistic regression. Results: According to univariate analysis the increase of faecal calprotectin concentration by 10 ug/g is associated with an 8% decrease in probability of disease remission (OR 0.9921, Conclusion: Our results have shown that faecal calprotectin is an independent predictor of remission in UC patients. The results of our study represent real-life data from a single university centre dealing with FC as a prognostic marker in patients with UC. KEY MESSAGESFaecal calprotectin is an independent predictor of remission in UC patients.Recent studies have suggested that calprotectin correlates well with endoscopic activity of inflammation but correlation of faecal calprotectin in a phase of remission hasn't been evaluated yet.We have found that other inflammatory biomarkers do not correlate well with either endoscopic or clinical activity in ulcerative colitis.
MeSH term(s)	Adult ; Biomarkers/metabolism ; C-Reactive Protein/metabolism ; Colitis, Ulcerative/diagnosis ; Feces/chemistry ; Humans ; Inflammatory Bowel Diseases ; Leukocyte L1 Antigen Complex/analysis
Chemical Substances	Biomarkers ; Leukocyte L1 Antigen Complex ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2022-05-30
Publishing country	England
Document type	Journal Article
ZDB-ID	1004226-x
ISSN	1365-2060 ; 1651-2219 ; 0785-3890 ; 1743-1387
ISSN (online)	1365-2060 ; 1651-2219
ISSN	0785-3890 ; 1743-1387
DOI	10.1080/07853890.2022.2082518
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Article ; Online: Nutritional issues and considerations in the elderly: an update.

Vranešić Bender, Darija / Krznarić, Željko

Croatian medical journal

2020 Volume 61, Issue 2, Page(s) 180–183

Language	English
Publishing date	2020-05-07
Publishing country	Croatia
Document type	Journal Article
ZDB-ID	1157623-6
ISSN	1332-8166 ; 0353-9504
ISSN (online)	1332-8166
ISSN	0353-9504
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Article ; Online: Predictive value of faecal calprotectin in ulcerative colitis – single centre experience

Dora Grgić / Karlo Golubić / Marko Brinar / Željko Krznarić

Annals of Medicine, Vol 54, Iss 1, Pp 1570-

2022 Volume 1577

Abstract: Objectives Faecal calprotectin is an important biomarker used in the evaluation of inflammatory bowel disease. The aim of this study was to establish the value of faecal calprotectin concentration as a predictor of remission in ulcerative colitis and its ...

Abstract	Objectives Faecal calprotectin is an important biomarker used in the evaluation of inflammatory bowel disease. The aim of this study was to establish the value of faecal calprotectin concentration as a predictor of remission in ulcerative colitis and its correlation with laboratory, endoscopic and clinical findings.Methods The single centre study included 126 adult patients with established diagnosis of ulcerative colitis consecutively visiting our Day clinic from March 2017 to March 2019. We measured serum biomarkers- CRP, haemoglobin, leukocytes and platelets. Faecal calprotectin was determined from stool, and endoscopy was performed with calculation of MAYO endoscopic subscore system (MES 0–1: remission, and MES 2–3: active disease). Clinical assessment was done by using Mayo score for ulcerative colitis (clinical Mayo score <2:remission, >5: active disease).The statistical analysis was performed using an univariate and multivariate model of disease remission prediction using logistic regression.Results According to univariate analysis the increase of faecal calprotectin concentration by 10 ug/g is associated with an 8% decrease in probability of disease remission (OR 0.9921, p < .05). In the multivariate analysis, faecal calprotectin remained a significant predictor of disease remission (OR 0.9948, 95% CI 0.9914–0.9982, p = .0028), however, with a significant contribution of C-reactive protein (OR 0.8340, 95% CI 0.7085–0.9818, p = .0292). According to our model the cut off value for faecal calprotectin was 154 ug/g.Conclusion Our results have shown that faecal calprotectin is an independent predictor of remission in UC patients. The results of our study represent real-life data from a single university centre dealing with FC as a prognostic marker in patients with UC. KEY MESSAGESFaecal calprotectin is an independent predictor of remission in UC patients.Recent studies have suggested that calprotectin correlates well with endoscopic activity of inflammation but correlation of faecal calprotectin in ...
Keywords	Faecal calprotectin ; inflammatory bowel disease ; ulcerative colitis ; faecal markers ; biomarkers ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-12-01T00:00:00Z
Publisher	Taylor & Francis Group
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Diagnosis of malnutrition in patients with gastrointestinal diseases: recent observations from a Global Leadership Initiative on Malnutrition perspective.

Cederholm, Tommy / Krznaric, Zeljko / Pirlich, Matthias

Current opinion in clinical nutrition and metabolic care

2020 Volume 23, Issue 5, Page(s) 361–366

Abstract: Purpose of review: To review recent reports on techniques and tools for screening and diagnosis of malnutrition in gastrointestinal disease, in the light of the newly published definition of malnutrition by the Global Leadership Initiative on ... ...

Abstract	Purpose of review: To review recent reports on techniques and tools for screening and diagnosis of malnutrition in gastrointestinal disease, in the light of the newly published definition of malnutrition by the Global Leadership Initiative on Malnutrition (GLIM). Recent findings: In 2019, the GLIM concept of malnutrition was published advocating a two-step procedure; first, screening, and second confirmation of the diagnosis that requires a combination of phenotypic and etiologic criteria. Three studies in patients with gastrointestinal disorders so far published utilize the GLIM criteria. Otherwise, traditional tools, as Nutrition Risk Screening-2002, Malnutrition Universal Screening Tool or Subjective Global Assessment are used, and confirm that malnutrition is observed in a substantial number of patients with inflammatory bowel diseases (IBDs), serious liver disorders and various forms of pancreatitis. Common for these disorders is an extensive loss of muscle mass, which is one of the GLIM phenotypic criteria. Such patients often undergo abdominal computed tomography scans that enable psoas muscle mass at L3 or L4 level to be calculated. Summary: The GLIM criteria for the diagnosis of malnutrition are feasible for IBD, liver and pancreas diseases. Pending studies expect to provide data on the clinical relevance to diagnose malnutrition by the GLIM concept.
MeSH term(s)	Consensus ; Gastrointestinal Diseases/complications ; Humans ; Malnutrition/diagnosis ; Malnutrition/etiology ; Mass Screening/standards ; Nutrition Assessment
Language	English
Publishing date	2020-07-23
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1460178-3
ISSN	1473-6519 ; 1363-1950
ISSN (online)	1473-6519
ISSN	1363-1950
DOI	10.1097/MCO.0000000000000678
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Article: Blood-Based Biomarkers Reflecting Protease 3 and MMP-12 Catalyzed Elastin Degradation as Potential Noninvasive Surrogate Markers of Endoscopic and Clinical Disease in Inflammatory Bowel Disease.

Pehrsson, Martin / Domislovic, Viktor / Alexdottir, Marta Sorokina / Brinar, Marko / Karsdal, Morten Asser / Barisic, Ana / Krznaric, Zeljko / Mortensen, Joachim Høg

Journal of clinical medicine

2023 Volume 13, Issue 1

Abstract: Chronic inflammation in inflammatory bowel disease (IBD) triggers significant extracellular matrix remodeling, including elastin remodeling, leading to severe clinical complications. Novel methods to assess intestinal tissue destruction may act as ... ...

Abstract	Chronic inflammation in inflammatory bowel disease (IBD) triggers significant extracellular matrix remodeling, including elastin remodeling, leading to severe clinical complications. Novel methods to assess intestinal tissue destruction may act as surrogate markers of endoscopic disease activity, relieving patients of invasive endoscopy. We explored the noninvasive blood-based biomarkers ELP-3 and ELM-12, measuring elastin degradation in IBD. In a study involving 104 Crohn's disease (CD), 39 ulcerative colitis (UC), and 29 healthy donors, we assessed these biomarkers' association with endoscopic and clinical disease activity using ELISA. Patients were evaluated based on the SES-CD and CDAI for CD patients and modified MES and partial Mayo for UC patients. ELP-3 and ELM-12 were elevated in patients with IBD. Discerning CD patients in endoscopic remission and mild from moderate to severe, ELP-3 provided an AUC of 0.69 and ELM-12 an AUC of 0.73. The ELP-3 biomarker was associated with UC patients and provided the highest diagnostic power of 0.87 for remission vs. active clinical disease. The data suggest an association of ELP-3 with active CD and ELM-12 with endoscopic remission in CD patients. Additionally, ELP-3 could identify UC patients with active clinical disease from patients in remission. The noninvasive biomarkers ELP-3 and ELM-12 could be potential surrogate biomarkers of elastin degradation and endoscopic and clinical disease markers.
Language	English
Publishing date	2023-12-19
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13010021
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Article ; Online: Neutrophil-mediated type IV collagen degradation is elevated in patients with mild endoscopic ulcerative colitis reflecting early mucosal destruction.

Alexdottir, Marta S / Pehrsson, Martin / Domislovic, Viktor / Godskesen, Line E / Krag, Aleksander / Kjeldsen, Jens / Brinar, Marko / Barisic, Ana / Bay-Jensen, Anne-Christine / Karsdal, Morten A / Krznaric, Zeljko / Mortensen, Joachim H

Scientific reports

2024 Volume 14, Issue 1, Page(s) 1641

Abstract: Neutrophils play a significant role in sustaining chronic inflammation in Inflammatory Bowel Disease. The intestinal basement membrane acts as a barrier for immunological homeostasis, where the α3 and α4 chains of type IV collagen are expressed on the ... ...

Abstract	Neutrophils play a significant role in sustaining chronic inflammation in Inflammatory Bowel Disease. The intestinal basement membrane acts as a barrier for immunological homeostasis, where the α3 and α4 chains of type IV collagen are expressed on the mucosal surface. We wanted to develop a biomarker reflecting early tissue injury, providing an opportunity for intervention. Two competitive enzyme-linked immunosorbent assays (ELISAs) quantifying human neutrophil elastase (HNE) degraded neo-epitopes of COL4A3 and COL4A4 were developed and investigated in two observational cohorts (n = 161, n = 100). A biomarker of MMP-mediated degradation of COL4A1 (C4M) was used for comparison. In Cohort 1, patients with mild endoscopic ulcerative colitis showed elevated levels of C4A3-HNE compared to those with severe disease. C4M had a strong positive correlation with disease activity. C4A3-HNE/C4M provided superior discrimination between mild and severe endoscopic disease and negatively correlated to disease activity. In Cohort 2, C4A4-HNE and C4A4-HNE/C4M showed similar trends. C4A3-HNE and C4A4-HNE possibly reflect early intestinal tissue injury. Combining the markers with a biomarker of another α-chain of the same collagen provides information on two distinct stages of mucosal damage. These biomarkers may be used to monitor disease flare-up in patients in remission, reducing the need for frequent endoscopic procedures.
MeSH term(s)	Humans ; Colitis, Ulcerative/metabolism ; Collagen Type IV/metabolism ; Neutrophils/metabolism ; Basement Membrane/metabolism ; Biomarkers/metabolism
Chemical Substances	Collagen Type IV ; Biomarkers
Language	English
Publishing date	2024-01-18
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-024-52208-y
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Article ; Online: Understanding, prevention and treatment of refeeding syndrome. The role of thiamine

Dina Ljubas Kelečić / Darija Vranešić Bender / Željko Krznarić

Liječnički vjesnik, Vol 143, Iss 3-4, Pp 120-

2021 Volume 129

Abstract: Refeeding syndrome (RFS) is a serious and potentially fatal complication that occurs in patients with severe malnutrition of various etiologies after repeated, uncontrolled introduction of a diet, especially carbohydrates. Complications of RFS develop ... ...

Abstract	Refeeding syndrome (RFS) is a serious and potentially fatal complication that occurs in patients with severe malnutrition of various etiologies after repeated, uncontrolled introduction of a diet, especially carbohydrates. Complications of RFS develop due to rapid metabolic changes that occur during the switch from catabolism to anabolism, and cellular depletion of phosphorus, potassium, magnesium and micronutrients, and can affect one or more organ systems. Most of RFS complications associated with vitamin deficiency are related to thiamine deficiency. Due to its coenzyme role in the metabolism of carbohydrates and branched chain amino acids, thiamine is an important factor in maintaining the normal function primarily of cerebral energy metabolism. Understanding the basic biochemistry during starvation, and consequently the mechanisms and factors influencing metabolic changes during RFS, is important for timely identification of patients at risk and prevention of RFS and also many clinical complications it can cause regardless of nutritional support modality.
Keywords	refeeding syndrome – complications ; physiopathology ; prevention and control ; therapy ; malnutrition – metabolism ; nutritional support – adverse effects ; hypophosphatemia – complications ; etiology ; thiamine – physiology ; therapeutic use ; thiamine deficiency – complications ; magnesium deficiency – therapy ; hypokalemia – therapy ; wernicke encephalopathy – etiology ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2021-04-01T00:00:00Z
Publisher	Hrvatski liječnički zbor
Document type	Article ; Online
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Article: The Mediterranean and Nordic Diet: A Review of Differences and Similarities of Two Sustainable, Health-Promoting Dietary Patterns.

Krznarić, Željko / Karas, Irena / Ljubas Kelečić, Dina / Vranešić Bender, Darija

Frontiers in nutrition

2021 Volume 8, Page(s) 683678

Abstract: The Mediterranean diet (MD) and the Nordic diet (ND) share more similarities than differences. Both diets are based on typical local and seasonal foods, share similar nutritional recommendations based on plant-based dietary principles, and are both now ... ...

Abstract	The Mediterranean diet (MD) and the Nordic diet (ND) share more similarities than differences. Both diets are based on typical local and seasonal foods, share similar nutritional recommendations based on plant-based dietary principles, and are both now orienting toward environmental protection and sustainability. The main difference between the two diets is the primary fat source. Olive oil is the synonym for MD while the ND uses more rapeseed/canola oil. While longitudinal epidemiological studies support adherence to MD as a way to prevent chronic diseases, ND still needs more such studies because the current results are discrepant. Notably, studies that assessed the association between both diets and lower risks of chronic diseases, disability, and mortality from specific and all causes, implied that ND could also have an advantageous effect as MD. Hopefully, there will be more longitudinal and large prospective studies in the future that will provide more evidence-based recommendations.
Language	English
Publishing date	2021-06-25
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2776676-7
ISSN	2296-861X
ISSN	2296-861X
DOI	10.3389/fnut.2021.683678
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