Effect of adipocytokines disbalance on the function of the lower esofhageal sphincter in patients with type 2 diabetes mellitus against the background of obesity
Journal Title: Сучасна гастроентерологія - Year 2019, Vol 0, Issue 5
Abstract
The review presents the recent data on the pathogenesis of gastroesophageal reflux disease (GERD) against the background of type 2 diabetes mellitus (DM 2). An analysis of studies of the comorbidity of these nosologies has been carried out, diagnostic significance of the distribution of fat deposits has been examined. It has been revealed that perivascular and visceral adipose tissue against the background of DM 2 undergo considerable functional changes, that results in the formation of peripheral insulin resistance. The changes in eating behaviors based on the levels of adipocytokines (ghrelin, leptin) have been analyzed. Ghrelin concentration was significantly reduced in patients with an overweight and empty stomach. According to the recent data, normal body weight promotes reducing postprandial ghrelin level, which does not normally take place in people with obesity. High leptin levels and the onset of leptin resistance are associated with the trigger of insulin resistance. It is believed that increased GERD morbidity may be explained by the increasing number of overweight people. Insulin resistance, dyslipidemia, hyperglycemia play an important role in the chronic systemic inflammation of esophageal mucosa. Pathogenetic GERD mechanisms can also include the leptin resistance against the background of obesity and decreasing of the ghrelin concentration. Low ghrelin level is associated with slow-up the motility process of the upper parts of the digestive tract and increase the risk of pathological reflux. New data proving the correlation between adipocytokines with lower esophageal sphincter tone in patients with DM 2 and obesity have been presented. The perspective investigations in this area should be purposed on the study of possible risk factors, pathogenesis processes and peculiarities of the GERD course in patients with DM 2 against the background of obesity with the aim of optimization of the diagnosis, prophylaxis and treatment of these pathologies, and prevention of their negative effects on the quality of life and health of this group of patients.
Authors and Affiliations
L. V. Zhuravlyova, O. S. Keleberda
Keywords
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- EP ID EP675479
- DOI 10.30978/MG-2019-5-75
- Views 126
- Downloads 0
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