The Effect of Abdominal Visceral Fat, Circulating Inflammatory Cytokines, and Leptin Levels on Reflux Esophagitis

Nam, Su Youn; Choi, Il Ju; Ryu, Kum Hei; Park, Bum-Joon; Kim, Young Woo; Kim, Hyun Beom; Kim, Jeong Seon

doi:10.5056/jnm14114

Cited by 35 publications

(34 citation statements)

References 28 publications

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“…who announced that a diminished level of adiponectin was found in a patient with severe GERD assessed by video esophagography. In contrast to our study, a study by Nam et al 15. showed that adiponectin had no overall relationship with reflux esophagitis.…”

Section: Discussioncontrasting

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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Section: Discussioncontrasting

confidence: 99%

Adiponectin level changes among Egyptians with gastroesophageal reflux disease

et al. 2018

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“…Several population‐based studies and meta‐analyses have reported that general obesity, expressed by elevated body mass index (BMI) is one of the important risk factors for developing GERD symptoms and endoscopically diagnosed erosive esophagitis. Recently, abdominal obesity, which is typically measured in terms of waist circumference (WC), has also been revealed as independent risk factor . Thus, recent studies have investigated the association between changes in weight or WC and GERD, and have shown that weight gain or increase in WC is positively associated with the development of GERD symptoms or erosive esophagitis .…”

Section: Introductionmentioning

confidence: 99%

Weight loss and waist reduction is associated with improvement in gastroesophageal disease reflux symptoms: A longitudinal study of 15 295 subjects undergoing health checkups

Park

Lee

Yang

et al. 2016

Neurogastroenterology Motil

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“…7,16,17,58 A male-predominant gender bias including reflux esophagitis, BE, and EAC allude to sex and gender differences in the vulnerability or resistance of the esophageal epithelium to caustic compounds of gastroduodenal contents. 16,59 Decreased estrogen after menopause might be related with the rise in the incidence and severity of reflux esophagitis (Fig.…”

Section: Role Of Estrogenmentioning

confidence: 99%

Sex and Gender Differences in Gastroesophageal Reflux Disease

Kim

2016

J Neurogastroenterol Motil

128

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It is important to understand sex and gender-related differences in gastroesophageal reflux disease (GERD) because gender-related biologic factors might lead to better prevention and therapy. Non-erosive reflux disease (NERD) affects more women than men. GERD symptoms are more frequent in patients with NERD than in those with reflux esophagitis. However, men suffer pathologic diseases such as reflux esophagitis, Barrett's esophagus (BE), and esophageal adenocarcinoma (EAC) more frequently than women. The prevalence of reflux esophagitis is significantly increased with age in women, especially after their 50s. The mean age of EAC incidence in women is higher than in men, suggesting a role of estrogen in delaying the onset of BE and EAC. In a chronic rat reflux esophagitis model, nitric oxide was found to be an aggravating factor of esophageal injury in a male-predominant way. In addition, the expression of esophageal occludin, a tight junction protein that plays an important role in the esophageal defense mechanism, was up-regulated in women. This explains the male predominance of reflux esophagitis and delayed incidence of BE or EAC in women. Moreover, the symptoms such as heartburn, regurgitation, and extra-esophageal symptoms have been more frequently reported by women than by men, suggesting that sex and gender play a role in symptom perception. Differential sensitivity with augmented symptoms in women might have diagnostic and therapeutic influence. Furthermore, recent studies have suggested that hormone replacement therapy has a protective effect against esophageal cancer. However, an anti-inflammatory role of estrogen remains compelling, which means further study is necessary in this area.

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The Effect of Abdominal Visceral Fat, Circulating Inflammatory Cytokines, and Leptin Levels on Reflux Esophagitis

Cited by 35 publications

References 28 publications

Adiponectin level changes among Egyptians with gastroesophageal reflux disease

Adiponectin level changes among Egyptians with gastroesophageal reflux disease

Weight loss and waist reduction is associated with improvement in gastroesophageal disease reflux symptoms: A longitudinal study of 15 295 subjects undergoing health checkups

Sex and Gender Differences in Gastroesophageal Reflux Disease

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