DOI QR코드

DOI QR Code

Obesity and Functional Gastrointestinal Disorders

비만과 기능성 위장관질환

  • Lee, Kwang-Jae (Department of Internal Medicine, Ajou University School of Medicine)
  • 이광재 (아주대학교 의과대학 내과학교실)
  • Published : 2012.01.25

Abstract

Obesity is prevalent in Korea. An increase in food intake and a decrease in energy expenditure are responsible for obesity. Gut hormones play a role in controlling food intake. Obesity is suggested to be linked to common gastrointestinal functional disorders. Obesity is associated with an increased risk of gastroesophageal reflux disease, Barrett esophagus and esophageal adenocarcinoma. Epidemiologic studies indicate that obesity is associated with chronic gastrointestinal symptoms. This association suggests the possibility that obesity and functional gastrointestinal disorders may be pathophysiologically linked. However, data on the relationship between obesity and functional gastrointestinal disorders are inconsistent. In this paper, we review the role of gastrointestinal hormones in food intake and the relationship between obesity and functional gastrointestinal disorders.

Keywords

References

  1. Valassi E, Scacchi M, Cavagnini F. Neuroendocrine control of food intake. Nutr Metab Cardiovasc Dis 2008;18:158-168. https://doi.org/10.1016/j.numecd.2007.06.004
  2. Neary MT, Batterham RL. Gut hormones: implications for the treatment of obesity. Pharmacol Ther 2009;124:44-56. https://doi.org/10.1016/j.pharmthera.2009.06.005
  3. Suzuki K, Simpson KA, Minnion JS, Shillito JC, Bloom SR. The role of gut hormones and the hypothalamus in appetite regulation. Endocr J 2010;57:359-372. https://doi.org/10.1507/endocrj.K10E-077
  4. Wren AM, Seal LJ, Cohen MA, et al. Ghrelin enhances appetite and increases food intake in humans. J Clin Endocrinol Metab 2001;86:5992. https://doi.org/10.1210/jc.86.12.5992
  5. Levin F, Edholm T, Schmidt PT, et al. Ghrelin stimulates gastric emptying and hunger in normal-weight humans. J Clin Endocrinol Metab 2006;91:3296-3302. https://doi.org/10.1210/jc.2005-2638
  6. Monti V, Carlson JJ, Hunt SC, Adams TD. Relationship of ghrelin and leptin hormones with body mass index and waist circumference in a random sample of adults. J Am Diet Assoc 2006;106:822-828. https://doi.org/10.1016/j.jada.2006.03.015
  7. Lawrence CB, Snape AC, Baudoin FM, Luckman SM. Acute central ghrelin and GH secretagogues induce feeding and activate brain appetite centers. Endocrinology 2002;143:155-162. https://doi.org/10.1210/en.143.1.155
  8. Jequier E. Leptin signaling, adiposity, and energy balance. Ann N Y Acad Sci 2002;967:379-388.
  9. Munzberg H. Leptin-signaling pathways and leptin resistance. Forum Nutr 2010;63:123-132.
  10. Air EL, Benoit SC, Clegg DJ, Seeley RJ, Woods SC. Insulin and leptin combine additively to reduce food intake and body weight in rats. Endocrinology 2002;143:2449-2452. https://doi.org/10.1210/en.143.6.2449
  11. Lutz TA. Amylinergic control of food intake. Physiol Behav 2006; 89:465-471. https://doi.org/10.1016/j.physbeh.2006.04.001
  12. Hollander PA, Levy P, Fineman MS, et al. Pramlintide as an adjunct to insulin therapy improves long-term glycemic and weight control in patients with type 2 diabetes: a 1-year randomized controlled trial. Diabetes Care 2003;26:784-790. https://doi.org/10.2337/diacare.26.3.784
  13. Ueno N, Inui A, Iwamoto M, et al. Decreased food intake and body weight in pancreatic polypeptide-overexpressing mice. Gastroenterology 1999;117:1427-1432. https://doi.org/10.1016/S0016-5085(99)70293-3
  14. Lieverse RJ, Masclee AA, Jansen JB, Rovati LC, Lamers CB. Satiety effects of the type A CCK receptor antagonist loxiglumide in lean and obese women. Biol Psychiatry 1995;37:331-335. https://doi.org/10.1016/0006-3223(94)00136-Q
  15. Lieverse RJ, Jansen JB, Masclee AA, Lamers CB. Satiety effects of a physiological dose of cholecystokinin in humans. Gut 1995;36:176-179. https://doi.org/10.1136/gut.36.2.176
  16. Jordan J, Greenway FL, Leiter LA, et al. Stimulation of cholecystokinin-A receptors with GI181771X does not cause weight loss in overweight or obese patients. Clin Pharmacol Ther 2008;83:281-287. https://doi.org/10.1038/sj.clpt.6100272
  17. Abbott CR, Monteiro M, Small CJ, et al. The inhibitory effects of peripheral administration of peptide YY(3-36) and glucagon-like peptide-1 on food intake are attenuated by ablation of the vagal-brainstem-hypothalamic pathway. Brain Res 2005; 1044:127-131. https://doi.org/10.1016/j.brainres.2005.03.011
  18. Kim D, MacConell L, Zhuang D, et al. Effects of once-weekly dosing of a long-acting release formulation of exenatide on glucose control and body weight in subjects with type 2 diabetes. Diabetes Care 2007;30:1487-1493. https://doi.org/10.2337/dc06-2375
  19. Cohen MA, Ellis SM, Le Roux CW, et al. Oxyntomodulin suppresses appetite and reduces food intake in humans. J Clin Endocrinol Metab 2003;88:4696-4701. https://doi.org/10.1210/jc.2003-030421
  20. Wynne K, Park AJ, Small CJ, et al. Subcutaneous oxyntomodulin reduces body weight in overweight and obese subjects: a double-blind, randomized, controlled trial. Diabetes 2005; 54:2390-2395. https://doi.org/10.2337/diabetes.54.8.2390
  21. Batterham RL, Cowley MA, Small CJ, et al. Gut hormone PYY (3-36) physiologically inhibits food intake. Nature 2002;418: 650-654. https://doi.org/10.1038/nature00887
  22. Abbott CR, Small CJ, Kennedy AR, et al. Blockade of the neuropeptide Y Y2 receptor with the specific antagonist BIIE0246 attenuates the effect of endogenous and exogenous peptide YY(3-36) on food intake. Brain Res 2005;1043:139-144. https://doi.org/10.1016/j.brainres.2005.02.065
  23. Yang SY, Lee OY, Bak YT, et al. Prevalence of gastroesophageal reflux disease symptoms and uninvestigated dyspepsia in Korea: a population-based study. Dig Dis Sci 2008;53:188-193. https://doi.org/10.1007/s10620-007-9842-0
  24. Lee SY, Lee KJ, Kim SJ, Cho SW. Prevalence and risk factors for overlaps between gastroesophageal reflux disease, dyspepsia, and irritable bowel syndrome: a population-based study. Digestion 2009;79:196-201. https://doi.org/10.1159/000211715
  25. El-Serag HB, Graham DY, Satia JA, Rabeneck L. Obesity is an independent risk factor for GERD symptoms and erosive esophagitis. Am J Gastroenterol 2005;100:1243-1250. https://doi.org/10.1111/j.1572-0241.2005.41703.x
  26. Jacobson BC, Somers SC, Fuchs CS, Kelly CP, Camargo CA Jr. Body-mass index and symptoms of gastroesophageal reflux in women. N Engl J Med 2006;354:2340-2348. https://doi.org/10.1056/NEJMoa054391
  27. Iovino P, Angrisani L, Galloro G, et al. Proximal stomach function in obesity with normal or abnormal oesophageal acid exposure. Neurogastroenterol Motil 2006;18:425-432. https://doi.org/10.1111/j.1365-2982.2006.00768.x
  28. Nocon M, Labenz J, Willich SN. Lifestyle factors and symptoms of gastro-oesophageal reflux-a population-based study. Aliment Pharmacol Ther 2006;23:169-174. https://doi.org/10.1111/j.1365-2036.2006.02727.x
  29. El-Serag HB, Ergun GA, Pandolfino J, Fitzgerald S, Tran T, Kramer JR. Obesity increases oesophageal acid exposure. Gut 2007;56:749-755. https://doi.org/10.1136/gut.2006.100263
  30. El-Serag HB, Kvapil P, Hacken-Bitar J, Kramer JR. Abdominal obesity and the risk of Barrett's esophagus. Am J Gastroenterol 2005;100:2151-2156. https://doi.org/10.1111/j.1572-0241.2005.00251.x
  31. Freeman HJ. Risk of gastrointestinal malignancies and mechanisms of cancer development with obesity and its treatment. Best Pract Res Clin Gastroenterol 2004;18:1167-1175. https://doi.org/10.1016/S1521-6918(04)00107-6
  32. Veugelers PJ, Porter GA, Guernsey DL, Casson AG. Obesity and lifestyle risk factors for gastroesophageal reflux disease, Barrett esophagus and esophageal adenocarcinoma. Dis Esophagus 2006;19:321-328. https://doi.org/10.1111/j.1442-2050.2006.00602.x
  33. Edelstein ZR, Farrow DC, Bronner MP, Rosen SN, Vaughan TL. Central adiposity and risk of Barrett's esophagus. Gastroenterology 2007;133:403-411. https://doi.org/10.1053/j.gastro.2007.05.026
  34. Iovino P, Angrisani L, Tremolaterra F, et al. Abnormal esophageal acid exposure is common in morbidly obese patients and improves after a successful Lap-band system implantation. Surg Endosc 2002;16:1631-1635. https://doi.org/10.1007/s00464-001-9225-0
  35. Wu JC, Mui LM, Cheung CM, Chan Y, Sung JJ. Obesity is associated with increased transient lower esophageal sphincter relaxation. Gastroenterology 2007;132:883-889. https://doi.org/10.1053/j.gastro.2006.12.032
  36. Pandolfino JE, El-Serag HB, Zhang Q, Shah N, Ghosh SK, Kahrilas PJ. Obesity: a challenge to esophagogastric junction integrity. Gastroenterology 2006;130:639-649. https://doi.org/10.1053/j.gastro.2005.12.016
  37. Koppman JS, Poggi L, Szomstein S, Ukleja A, Botoman A, Rosenthal R. Esophageal motility disorders in the morbidly obese population. Surg Endosc 2007;21:761-764. https://doi.org/10.1007/s00464-006-9102-y
  38. Suter M, Dorta G, Giusti V, Calmes JM. Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients. Obes Surg 2004;14:959-966. https://doi.org/10.1381/0960892041719581
  39. Quiroga E, Cuenca-Abente F, Flum D, Dellinger EP, Oelschlager BK. Impaired esophageal function in morbidly obese patients with gastroesophageal reflux disease: evaluation with multichannel intraluminal impedance. Surg Endosc 2006;20:739-743. https://doi.org/10.1007/s00464-005-0268-5
  40. Frederiksen SG, Johansson J, Johnsson F, Hedenbro J. Neither low-calorie diet nor vertical banded gastroplasty influence gastro-oesophageal reflux in morbidly obese patients. Eur J Surg 2000;166:296-300. https://doi.org/10.1080/110241500750009122
  41. Kjellin A, Ramel S, Rössner S, Thor K. Gastroesophageal reflux in obese patients is not reduced by weight reduction. Scand J Gastroenterol 1996;31:1047-1051. https://doi.org/10.3109/00365529609036885
  42. Fraser-Moodie CA, Norton B, Gornall C, Magnago S, Weale AR, Holmes GK. Weight loss has an independent beneficial effect on symptoms of gastro-oesophageal reflux in patients who are overweight. Scand J Gastroenterol 1999;34:337-340. https://doi.org/10.1080/003655299750026326
  43. Frezza EE, Ikramuddin S, Gourash W, et al. Symptomatic improvement in gastroesophageal reflux disease (GERD) following laparoscopic Roux-en-Y gastric bypass. Surg Endosc 2002;16:1027-1031. https://doi.org/10.1007/s00464-001-8313-5
  44. Lara MD, Kothari SN, Sugerman HJ. Surgical management of obesity: a review of the evidence relating to the health benefits and risks. Treat Endocrinol 2005;4:55-64. https://doi.org/10.2165/00024677-200504010-00006
  45. van Oijen MG, Josemanders DF, Laheij RJ, van Rossum LG, Tan AC, Jansen JB. Gastrointestinal disorders and symptoms: does body mass index matter? Neth J Med 2006;64:45-49.
  46. Delgado-Aros S, Locke GR 3rd, Camilleri M, et al. Obesity is associated with increased risk of gastrointestinal symptoms: a population-based study. Am J Gastroenterol 2004;99:1801-1806. https://doi.org/10.1111/j.1572-0241.2004.30887.x
  47. Talley NJ, Quan C, Jones MP, Horowitz M. Association of upper and lower gastrointestinal tract symptoms with body mass index in an Australian cohort. Neurogastroenterol Motil 2004;16: 413-419. https://doi.org/10.1111/j.1365-2982.2004.00530.x
  48. Talley NJ, Howell S, Poulton R. Obesity and chronic gastrointestinal tract symptoms in young adults: a birth cohort study. Am J Gastroenterol 2004;99:1807-1814. https://doi.org/10.1111/j.1572-0241.2004.30388.x
  49. Aro P, Ronkainen J, Talley NJ, Storskrubb T, Bolling-Sternevald E, Agréus L. Body mass index and chronic unexplained gastrointestinal symptoms: an adult endoscopic population based study. Gut 2005;54:1377-1383. https://doi.org/10.1136/gut.2004.057497
  50. Cardoso-Junior A, Coelho LG, Savassi-Rocha PR, et al. Gastric emptying of solids and semi-solids in morbidly obese and non-obese subjects: an assessment using the 13C-octanoic acid and 13C-acetic acid breath tests. Obes Surg 2007;17: 236-241. https://doi.org/10.1007/s11695-007-9031-4
  51. Jackson SJ, Leahy FE, McGowan AA, Bluck LJ, Coward WA, Jebb SA. Delayed gastric emptying in the obese: an assessment using the non-invasive (13)C-octanoic acid breath test. Diabetes Obes Metab 2004;6:264-270. https://doi.org/10.1111/j.1462-8902.2004.0344.x
  52. Cummings DE, Weigle DS, Frayo RS, et al. Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. N Engl J Med 2002;346:1623-1630. https://doi.org/10.1056/NEJMoa012908
  53. Hansen TK, Dall R, Hosoda H, et al. Weight loss increases circulating levels of ghrelin in human obesity. Clin Endocrinol (Oxf) 2002;56:203-206. https://doi.org/10.1046/j.0300-0664.2001.01456.x
  54. Lee KJ, Cha DY, Cheon SJ, Yeo M, Cho SW. Plasma ghrelin levels and their relationship with gastric emptying in patients with dysmotility-like functional dyspepsia. Digestion 2009;80:58-63. https://doi.org/10.1159/000215389
  55. Cremonini F, Locke GR 3rd, Schleck CD, Zinsmeister AR, Talley NJ. Relationship between upper gastrointestinal symptoms and changes in body weight in a population-based cohort. Neurogastroenterol Motil 2006;18:987-994. https://doi.org/10.1111/j.1365-2982.2006.00816.x
  56. Foster A, Laws HL, Gonzalez QH, Clements RH. Gastrointestinal symptomatic outcome after laparoscopic Roux-en-Y gastric bypass. J Gastrointest Surg 2003;7:750-753. https://doi.org/10.1016/S1091-255X(03)00092-1

Cited by

  1. Dietary and Demographical Risk Factors for Oesophageal Squamous Cell Carcinoma in the Eastern Anatolian Region of Turkey Where Upper Gastrointestinal Cancers are Endemic vol.16, pp.5, 2012, https://doi.org/10.7314/apjcp.2015.16.5.1913
  2. Gastrointestinal Gas and Abdominal Fat Quantity Measured by Three-Dimensional Abdominal Computed Tomography in Patients with Functional Bloating vol.71, pp.6, 2012, https://doi.org/10.4166/kjg.2018.71.6.324
  3. Obesity and Functional Gastrointestinal Disorders vol.94, pp.5, 2012, https://doi.org/10.3904/kjm.2019.94.5.425