medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»medalphabet-321Research ArticleСтатьиГастроэзофагеальная рефлюксная болезнь и ожирение: кто виноват и что делать?Gastroesophageal reflux disease and obesity: who is to blame and what to do?СиманенковВ. И.SimanenkovV. I.noemail@neicon.ruТихоновС. В.TikhonovS. V.noemail@neicon.ruЛищукН. Б.LishchukN. B.noemail@neicon.ruФГБОУ ВО «Северо-Западный государственный медицинский университет имени И. И. Мечникова» Минздрава РоссииРоссияNorth-Western State Medical University n.a. I. I. MechnikovRussian Federation201701092017327Практическая гастроэнтерология510Copyright © Симаненков В.И., Тихонов С.В., Лищук Н.Б., 20172017Симаненков В.И., Тихонов С.В., Лищук Н.Б.Simanenkov V.I., Tikhonov S.V., Lishchuk N.B.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/321

Статья посвящена результатам собственного исследования, посвященного проблеме коморбидности ГЭРБ и ожирения. Пациентам с ГЭРБ проводилось антропометрическое обследование, суточная рН-импедансометрия верхних отделов желудочно-кишечного тракта, фиброгастродуоденоскопия, определялся компонентный состав тела. Индекс массы тела и процентное содержание жировой ткани в организме не имели значимой корреляционной связи с функциональными нарушениями в гастроэзофагеальной зоне в отличие от величины окружности талии и отношении окружности талии к окружности бедер. При увеличении окружности талии и отношения окружности талии к окружности бедер отмечалось достоверное увеличение болюсного времени в пищеводе за счет присутствия слабокислого и щелочного, но не кислого рефлюктата, увеличение количества некислых проксимальных рефлюксов.

The article is about the results of our research of the comoibidity of GERD and obesity. Patients with GERD was performed daily pH-impedancemetry of upper gastrointestinal tract, fibrogastroscopy, anthropometric survey, impedancemetry of body. Body mass index and the percentage of body fat had no significant correlation with functional disturbances in the gastroesophageal area, in contrast to the waist circumference and against the waist circumference / hips circumference. With an increase in waist circumference and waist circumference / hips circumference noted a significant increase in the time of bolus in the esophagus due to the presence of weakly acidic and alkaline bolus, but not acidic.

ГЭРБожирениеабдоминальное ожирениерН-импедансометриянекислые (смешанныещелочные) рефлюксыGERDobesityabdominal obesitypH Impedance measurementnon-acidic (mixedalkaline) refluxesReferencesJacobson B. S., Somers S. C., Fuchs C. S. et al. Body-mass index and symptoms of gastroesophageal reflux in women. N Engl J Med. 2006; 354 (22): 2340-8.Jacobson B. S., Somers S. C., Fuchs C. S. et al. Body-mass index and symptoms of gastroesophageal reflux in women. N Engl J Med. 2006; 354 (22): 2340-8.Nocon M., Labenz J., Jaspersen D. et al. Association of body mass index with heartburn, regurgitation, and esophagitis: results of the progression of gastroesophageal reflux disease study. J Gastroenterol Hepatol. 2007; 22 (11): 1728-1731.Nocon M., Labenz J., Jaspersen D. et al. Association of body mass index with heartburn, regurgitation, and esophagitis: results of the progression of gastroesophageal reflux disease study. J Gastroenterol Hepatol. 2007; 22 (11): 1728-1731.El-Serag H.B., Ergun G. A., Pandolfino J. et al. Obesity increases esophageal acid exposure. Gut. 2007; 56 (6): 749-755.El-Serag H.B., Ergun G. A., Pandolfino J. et al. Obesity increases esophageal acid exposure. Gut. 2007; 56 (6): 749-755.Ruhl C.E., Everhart J.E. Overweight, but not high dietary fat intake, increases risk of gastroesophageal reflux disease hospitalization: The NHANES I Epidemiologic follow up study. First National Health and Nutrition Examination Survey. Ann Epidemiol. 1999; 9:424-435.Ruhl C.E., Everhart J.E. Overweight, but not high dietary fat intake, increases risk of gastroesophageal reflux disease hospitalization: The NHANES I Epidemiologic follow up study. First National Health and Nutrition Examination Survey. Ann Epidemiol. 1999; 9:424-435.Corley D. A., Kubo A., Levin T. R. et al. Abdominal obesity and body mass index as risk factors for Barrett's esophagus. Gastroenterology. 2007; 133 (1): 34-41.Corley D. A., Kubo A., Levin T. R. et al. Abdominal obesity and body mass index as risk factors for Barrett's esophagus. Gastroenterology. 2007; 133 (1): 34-41.Hampel H., Abracham N., El-Serag H. B. Meta-analisis: obesity and the risk of GERD and its complications. Ann Int Med. 2005; 143 (3): 199-211.Hampel H., Abracham N., El-Serag H. B. Meta-analisis: obesity and the risk of GERD and its complications. Ann Int Med. 2005; 143 (3): 199-211.Mathus-Vliegen E.M., M. van Weeren, P. V. Van Eerten LOS function and obesity: the impact of untreated obesity, weight loss, and chronic gastric balloon distension. Digestion. 2003; 68: 161-168.Mathus-Vliegen E.M., M. van Weeren, P. V. Van Eerten LOS function and obesity: the impact of untreated obesity, weight loss, and chronic gastric balloon distension. Digestion. 2003; 68: 161-168.Fraser-Moodie C.A., Norton B., Gornall C., et al. Weight loss has an independent beneficial effect on symptoms of gastrooesophageal reflux in patients who are overweight. Scand J Gastroenterol. 1999; 4: 337-340.Fraser-Moodie C.A., Norton B., Gornall C., et al. Weight loss has an independent beneficial effect on symptoms of gastrooesophageal reflux in patients who are overweight. Scand J Gastroenterol. 1999; 4: 337-340.O’Brien T.F. Lower esophageal sphincter pressure (LESP) and esophageal function in obese humans. J Clin Gastroenterol. 1980; 2: 145-148.O’Brien T.F. Lower esophageal sphincter pressure (LESP) and esophageal function in obese humans. J Clin Gastroenterol. 1980; 2: 145-148.Kendrick M. L., Houghton S. G. Gastroesophageal reflux disease in obese patients: the role of obesity in management. Dis Esophagus. 2006; 19 (2): 57-63.Kendrick M. L., Houghton S. G. Gastroesophageal reflux disease in obese patients: the role of obesity in management. Dis Esophagus. 2006; 19 (2): 57-63.Wildi S. M., Tutuian R., Castell D. O. The influence of rapid food intake on postprandial reflux: studies in healthy volunteers. Am J Gastroenterol. 2004; 99: 1645-1651.Wildi S. M., Tutuian R., Castell D. O. The influence of rapid food intake on postprandial reflux: studies in healthy volunteers. Am J Gastroenterol. 2004; 99: 1645-1651.Wilson L. J., Ma W., Hirschowtiz B. I. Association of obesity with hiatal hernia and esophagitis. Am J Gastroenterol. 1999; 94: 2840-2844.Wilson L. J., Ma W., Hirschowtiz B. I. Association of obesity with hiatal hernia and esophagitis. Am J Gastroenterol. 1999; 94: 2840-2844.Wu J. C., Mui L. M., Cheung C.M. et al. Obesity is associated with increased transient lower esophageal sphincter relaxation. Gastroenterology. 2007; 132 (3): 883-889.Wu J. C., Mui L. M., Cheung C.M. et al. Obesity is associated with increased transient lower esophageal sphincter relaxation. Gastroenterology. 2007; 132 (3): 883-889.Pandolfino J. E., El-Serag H.B., Zhang Q. et al. Obesity: a challenge to esophagogastric junction integrity. Gastroenterology. 2006; 130 (3): 639-649.Pandolfino J. E., El-Serag H.B., Zhang Q. et al. Obesity: a challenge to esophagogastric junction integrity. Gastroenterology. 2006; 130 (3): 639-649.Chang P. Obesity and GERD. Gastroenterol Clin N Am. 2014; 43: 161-173Chang P. Obesity and GERD. Gastroenterol Clin N Am. 2014; 43: 161-173Wisen O., Johansson C. Gastrointestinal function in obesity: motility, secretion, and absorption following a liquid test meal. Meta. 1992; 41: 390-395.Wisen O., Johansson C. Gastrointestinal function in obesity: motility, secretion, and absorption following a liquid test meal. Meta. 1992; 41: 390-395.Симаненков В. И., Тихонов С. В., Лищук Н. Б. Гетерогенность ГЭРБ. Миф или реальность. РМЖ. 2016; 17: 1119-1124Симаненков В. И., Тихонов С. В., Лищук Н. Б. Гетерогенность ГЭРБ. Миф или реальность. РМЖ. 2016; 17: 1119-1124Sifrim D., Dupont L, Blondeau K. et al. Weakly acidic reflux in patients with chronic unexplained cough during 24 hour pressure, pH, and impedance monitoring. Gut. 2005; 54:449-54.Sifrim D., Dupont L, Blondeau K. et al. Weakly acidic reflux in patients with chronic unexplained cough during 24 hour pressure, pH, and impedance monitoring. Gut. 2005; 54:449-54.Sifrim D., Mittal R., Fass R. et al. Review article: Acidity and volume of the refluxate in the genesis of gastro-oesophageal reflux disease symptoms. Aliment Pharmacol Ther. 2007; 5 (9): 1003-17.Sifrim D., Mittal R., Fass R. et al. Review article: Acidity and volume of the refluxate in the genesis of gastro-oesophageal reflux disease symptoms. Aliment Pharmacol Ther. 2007; 5 (9): 1003-17.Boeckxstaens G. E., Smout A. Systematic review: Role of acid, weakly acidic and weakly alkaline reflux in gastro-oesophagealreflux disease. Aliment Pharmacol Ther. 2010; 32: 334-43.Boeckxstaens G. E., Smout A. Systematic review: Role of acid, weakly acidic and weakly alkaline reflux in gastro-oesophagealreflux disease. Aliment Pharmacol Ther. 2010; 32: 334-43.Giurcan R., Voiosu T.A. The effects of itopride on oesophageal motility and lower oesophageal sphincter function in man. Rom J Intern Med. 2010; 48: 9-15.Giurcan R., Voiosu T.A. The effects of itopride on oesophageal motility and lower oesophageal sphincter function in man. Rom J Intern Med. 2010; 48: 9-15.Scarpellini E., Vos R., Blondeau K. et al. Functional dyspepsia: a pragmatic approach. Aliment Pharmacol Ther. 2011; 33 (1): 99-105.Scarpellini E., Vos R., Blondeau K. et al. Functional dyspepsia: a pragmatic approach. Aliment Pharmacol Ther. 2011; 33 (1): 99-105.Лищук Н. Б., Симаненков В. И., Тихонов С. В. Дифференцированная терапия «некислых» форм гастроэзофагеальной рефлюксной болезни. Терапевтический архив. 2017; 89 (4): 57-63.Лищук Н. Б., Симаненков В. И., Тихонов С. В. Дифференцированная терапия «некислых» форм гастроэзофагеальной рефлюксной болезни. Терапевтический архив. 2017; 89 (4): 57-63.www.rlsnet.ru/tn_index_id_36285.htm. Обращение от 21.09.2017.www.rlsnet.ru/tn_index_id_36285.htm. Обращение от 21.09.2017.https://www.rlsnet.ru/tn_index_id_3308.htm. Обращение от 21.09.2017.https://www.rlsnet.ru/tn_index_id_3308.htm. Обращение от 21.09.2017.

The authors declare that there are no conflicts of interest present.