Role of obesity in GORD-related disorders

El–Serag, Hashem B.

doi:10.1136/gut.2007.127878

Cited by 127 publications

(92 citation statements)

References 44 publications

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“…However, their exact pathogenetic role is still unclear, and the beneficial effect of specific recommended changes in lifestyle habits is controversial [10] . It is a common belief that some foods may induce or worsen GERD symptoms; in fact, in daily clinical practice, this leads to medical staff advising patients to avoid the suspected foods [47] .…”

Section: Dietary Habits In Patients With Gastroesophageal Refux Diseamentioning

confidence: 99%

“…However, the most important reflux mechanism in obese subjects seems to be a transient lower esophageal sphi ncter relaxation [10] , generated by gastric distension, which leads to intense stimulation of both stretch and tension mechanoreceptors in the proximal stomach [4243] . Recently, a European study investigated the prevalence of central adiposity, metabolic syndrome, and a proin flammatory state in patients with Barrett's esophagus, and found that the proinflammatory impact of adipocytokines associated with the metabolic syndrome of central adi posity may play an important role in the pathogenesis of esophageal cancer [4445] .…”

Section: Role Of Metabolic Changesmentioning

confidence: 99%

“…In the primitive type the main pathogenetic mechanism is considered to be a transient lower esophageal sphincter relaxation [10] that is a visceral reflex occurring mainly in response to gastric distension.…”

Section: Introductionmentioning

confidence: 99%

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Metabolic syndrome and gastro-esophageal reflux: A link towards a growing interest in developed countries

Ierardi

Rosania²,

Principe³

et al. 2010

WJGP

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The aim of this Editorial is to describe the growing possibility of a link between gastro-esophageal reflux disease (GERD) and metabolic syndrome on the light of recent epidemiological and pathophysiological evidence. The state of the art of GERD is described, based on recent definitions, pathophysiological evidence, epidemiology in developed countries, clinical subtypes together with a diagnostic approach specifically focussed on the appropriateness of endoscopy. Metabolic syndrome is accurately defined and the pivotal role of in sulin resistance is emphasized. The strong relationship between GERD and metabolic syndrome has been pathophysiologically analyzed, taking into account the role of obesity, mechanical factors and metabolic changes. Data collected by our group regarding eating habits and GERD are briefly summarized at the end of a pathophysiological analysis. The literature on the subject strongly supports the possibility that lifestyle and eating habits may be involved in both GERD and metabolic syndrome in developed countries.

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Section: Dietary Habits In Patients With Gastroesophageal Refux Diseamentioning

confidence: 99%

Section: Role Of Metabolic Changesmentioning

confidence: 99%

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Metabolic syndrome and gastro-esophageal reflux: A link towards a growing interest in developed countries

Ierardi

Rosania²,

Principe³

et al. 2010

WJGP

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“…Visceral adipose tissue is biologically active and can secrete pro‐inflammatory cytokines, especially IL‐6 and tumor necrosis factor‐α, which lead to insulin resistance 30. In addition, these cytokines may also be associated with a chronic inflammatory state in obesity, thus increasing the risk of erosive esophagitis 31. Nevertheless, it remains unclear what the underlying metabolic mechanisms are and whether other humoral factors are involved in the pathogenesis of obesity‐related erosive esophagitis.…”

Section: Discussionmentioning

confidence: 99%

Adiponectin level changes among Egyptians with gastroesophageal reflux disease

et al. 2018

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Background and AimVisceral fat is an important endocrine organ that secretes different bioactive substances such as adipocytokines. The aim of this study was to investigate the adiponectin level changes among patients with erosive gastroesophageal reflux disease (GERD)and its consequence on pathogenesis.MethodsIn this study, 150 subjects were selected and divided into four groups: Group І (n = 40) were healthy individuals with an average body mass index and had no gastrointestinal tract symptoms; Group ІІ (n = 50) were patients with mild to moderate erosive esophagitis; Group ІІІ (n = 40) were patients with severe erosive esophagitis; and finally, Group ІV (n = 20) were patients with Barrett's esophagus. Upper gastrointestinal endoscopy was performed for Groups II, III, and IV only, and histopathological assessment was conducted for the suspicious cases of Barrett's esophagus. The measurement of serum adiponectin was performed for all groups using the ELISA test.ResultsOur results revealed that the serum level of adiponectin was significantly lower in patients with different grades of GERD as well Barrett's esophagus as compared to healthy controls (P‐value < 0.001). Additionally, the serum level of adiponectin was correlated with different grades of GERD as the highest level of the adiponectin was found in the control group (11.05 ± 2.58) followed by mild to moderate GERD (6.39 ± 1.64) and then severe GERD (2.42 ± 1.00); finally, the lowest level was detected in the Barrett's esophagus group (1.99 ± 0.47). Our study showed significant correlation between body mass index, waist circumference, and waist–hip ratio on one hand and serum adiponectin level on the other hand, with a statistically significant difference (P‐value < 0.001). The best cut‐off value for serum adiponectin was 7.7 (μg/mL), with a sensitivity of 91.8% and specificity of 97.5%.ConclusionsLow serum adiponectin level appears to be associated with an increased risk of erosive esophagitis, and visceral fat accumulation is related to the impaired secretion of adiponectin, which may have an influence on the pathogenesis of GERD.

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“…After 10 and 20 years of follow-up, the NCCP-GI [30][31][32][33][34][35][36] The NCCP-GI group displayed less overall survival at all time points, specifically 70.1% at 10 years and 51.8% at 20 years, compared with their NCCP-U counterparts. The univariate analysis revealed an association between the NCCP-GI group and increased mortality (hazard ratio, 1.79; P=.007).…”

Section: Gi Testingmentioning

confidence: 99%