Фенотип ожирения и гастроэзофагеальной рефлюксной болезни в контексте коморбидности у больных с сердечно-сосудистыми заболеваниями
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Maev I.V., Yurenev G.L., Mironova E.M., Yureneva-Thorzhevskaya T.V. Phenotype of obesity and gastroesophageal reflux disease in the context of comorbidity in patients with cardiovascular diseases. Therapeutic Archive. 2019; 91 (2): 8–133. DOI: 10.26442/00403660.2019.02.000099
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Ключевые слова: артериальная гипертензия, ГЭРБ, коморбидность, избыточная масса тела, ожирение, адипонектин, лептин.
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The relevance of studying such problems as gastroesophageal reflux disease (GERD) and obesity is caused by their high prevalence in the developed countries of the world. Epidemiological data indicate that obesity is a significant risk factor for developing GERD due to increased intra-abdominal pressure and gastroesophageal gradient, slowing of gastric evacuation and formation of hiatal hernia. Abdominal obesity increases the likelihood of complications of GERD: erosive esophagitis, Barrett's esophagus and adenocarcinoma. This fact is connected with humoral influences: increased production of pro-inflammatory cytokines and leptin, and decreased secretion of adiponectin. Treatment of comorbid patients requires higher dosages and longer courses of antisecretory medicines, and an additional prescription of ursodeoxycholic acid.
Keywords: GERD, comorbidity, оverweight, obesity, adiponectin, leptin.
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14. Gray DS. Diagnosis and prevalence of obesity. Med Clin North Am. 1989;73(1):1-13.
15. Ze EY, Kim BJ, Kang H, Kim JG. Abdominal visceral to subcutaneous adipose tissue ratio is associated with increased risk of erosive esophagitis. Dig Dis Sci. 2017;62(5):1265-71. doi: 10.1007/s10620-017-4467-4
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18. Slawik M, Vidal-Puig AJ. Lipotoxicity, overnutrition and energy metabolism in aging. Ageing Res Rev. 2006;5(2):144-64. doi: 10.1016/j.arr.2006.03.004
19. Ye J. Mechanisms of insulin resistance in obesity. Front Med. 2013;7(1):14-24. doi: 10.1007/s11684-013-0262-6
20. Chang P, Friedenberg F. Obesity and GERD. Gastroenterol Clin North Am. 2014;43(1):161-73. doi: 10.1016/j.gtc.2013.11.009
21. Ogunwobi O, Mutungi G, Beales IL. Leptin stimulates proliferation and inhibits apoptosis in Barrett's esophageal adenocarcinoma cells by cyclooxygenase-2-dependent, prostaglandin-E2-mediated transactivation of the epidermal growth factor receptor and c-Jun NH2-terminal kinase activation. Endocrinology. 2006;147(9):4505-16. doi: 10.1210/en.2006-0224
22. Rubenstein JH, Kao JY, Madanick RD, Zhang M, Wang M, Spacek MB, Donovan JL, Bright SD, Shaheen NJ. Association of adiponectin multimers with Barrett's oesophagus. Gut. 2009;58(12):1583-9. doi: 10.1136/gut.2008.171553
23. Kelesidis I, Kelesidis T, Mantzoros CS. Adiponectin and cancer: a systematic review. Br J Cancer. 2006;94(9):1221-5. doi: 10.1038/sj.bjc.6603051
24. Isachenkova OA. Nutritional behavior as an important factor in the development of obesity and diseases comorbid with it. Ozhirenie i Metabolizm. 2015;12(4):14-7 (In Russ.)
25. Wadden TA, Phelan S. Assessment of quality of life in obese individuals. Obes Res. 2002 Nov;10 Suppl 1:50-7. doi: 10.1038/oby.2002.190
26. Yanagisawa M, Yu RK. The expression and functions of glycoconjugates in neural stem cells. Glycobiology. 2007 Jul;17(7):57-74. doi: 10.1093/glycob/cwm018
27. Vaishnav B, Bamanikar A, Maske P, Reddy A, Dasgupta S. Gastroesophageal reflux disease and its association with body mass index: clinical and endoscopic study. J Clin Diagn Res. 2017;11(4):01-04. doi: 10.7860/JCDR/2017/24151.9562
28. Suter M, Dorta G, Giusti V, Calmes JM. Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients. Obes Surg. 2004;14(7):959-66. doi: 10.1381/0960892041719581
29. Quiroga E, Cuenca-Abente F, Flum D. Impaired esophageal function in morbidly obese patients with gastroesophageal reflux disease: evaluation with multichannel intraluminal impedance. Surg Endosc. 2006;20(5):739-43. doi: 10.1007/s00464-005-0268-5
30. Trukhmanov AS, Evsyutina YuV. Heartburn in gastroesophageal reflux disease – the mechanism of development and approaches to therapy. Russkii Meditsinskii Zhurnal. 2017;(10):707-10 (In Russ.)
31. Truhmanov AS, Dzhahaja NL, Kajbysheva VO, Storonova OA. New aspects of treatment recommendations for patients with gastroesophageal reflux disease. Gastrojenterologija i Gepatologija. 2013;1(4):1-9 (In Russ.)
32. Kouklakis G, Moschos J, Kountouras J, Mpoumponaris A, Molyvas E, Minopoulos G. Relationship between obesity and gastroesophageal reflux disease as recorded by 3-hour esophageal pH monitoring. Rom J Gastroenterol. 2005;14(2):117-21.
33. Koppman JS, Poggi L, Szomstein S, Ukleja A, Botoman A, Rosenthal R. Esophageal motility disorders in the morbidly obese population. Surg Endosc. 2007 May;21(5):761-4. doi: 10.1007/s00464-006-9102-y
34. Kahrilas PJ, Shi G, Manka M, Joehl RJ. Increased frequency of transient lower esophageal sphincter relaxation induced by gastric distention in reflux patients with hiatal hernia. Gastroenterology. 2000;118(4):688-95.
35. Fisher BL, Pennathur A, Mutnick JL, Little AG. Obesity correlates with gastroesophageal reflux. Dig Dis Sci. 1999;44(11):2290-4. doi: 10.1023/A:1026617106755
36. Маev IV, Yurenev GL, Burkov SG. Mnogolikaya GERB: problemy i resheniya [The Many Faces of GERD: problems and solutions]. Мoscow: GEOTAR-Media; 2015. 386 p. (In Russ.)
37. Wu JC, Mui LM, Cheung CM, Chan Y, Sung JJ. Obesity is associated with increased transient lower esophageal sphincter relaxation. Gastroenterology. 2007;132(3):883-9. doi: 10.1053/j.gastro.2006.12.032
38. Bredenoord AJ. Mechanisms of reflux perception in gastroesophageal reflux disease: a review. Am J Gastroenterol. 2012;107(1):8-15. doi: 10.1038/ajg.2011.286
39. Pandolfino JE, El-Serag HB, Zhang Q, Shah N, Ghosh SK, Kahrilas PJ. Obesity: a challenge to esophagogastric junction integrity. Gastroenterology. 2006;130(3):639-49. doi: 10.1053/j.gastro.2005.12.016
40. Nilsson M, Johnsen R, Ye W, Hveem K, Lagergren J. Obesity and estrogen as risk factors for gastroesophageal reflux symptoms. JAMA. 2003;290(1):66-72. doi: 10.1001/jama.290.1.66
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ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава России, Москва
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I.V. Maev, G.L. Yurenev, E.M. Mironova, T.V. Yureneva-Thorzhevskaya
A.I. Evdokimov Moscow State University of Medicine and Dentistry of the Ministry of Health of the Russian Federation, Moscow, Russia