Studies of recent years show that the problem of abdominal-visceral obesity is gaining in importance, the steady growth of which is observed in almost all countries. Gastroesophageal reflux disease belongs to the most common diseases in patients with obesity. At present, the question of the metabolic activity of visceral fat as a factor in the pathogenesis of GERD is being investigated. Aim. Investigation of the level of serum concentration of the proinflammatory cytokine (interleukin 6), the biologically active substance -adipokin (leptin) and C-reactive protein, taking into account the BMI of patients with obesity and intra-arterialpH monitoring data and esophagogastroduodenoscopy. Material and methods. The main group consisted of 51 patients, in the age group from 30 to 60 years, suffering from GERD and obesity. The average age of the patients was 42.3 ± 2.11 years. Obesity of the 1st degree in BMI was in 19 people; obesity of the 2nd degree - in 23 people; obesity of the third degree in 9 patients. The level of leptin, interleukin 6 and C-reactive protein was determined, anthropometric examination with calculation of body mass index (BMI) and waist measurement (OT) to determine the degree of obesity and its type. To verify the diagnosis of GERD and determine its endoscopic form, esophagogastroduodenoscopy was performed using flexible endoscopes and intra-esophageal pH monitoring. Results. The level of serum concentration of interleukin 6, leptin and C-reactive protein in patients of the main group is higher than in the control group. A correlation between these indicators, the degree of obesity and the DeMeester index, reflecting the presence and severity of gastroesophageal reflux and the results of esophagogastroduodenoscopy, was revealed. Conclusion. Thus, the metabolic activity of visceral fat is one of the factors contributing to the increase in the duration and the number ofpathological refluxes leading to the development of erosive forms of esophagitis, which must be taken into account when choosing a program for the treatment ofpatients suffering from GERD and obesity.
The role of visceral-abdominal obesity in the development of gastroesophageal reflux disease.