№ 2 / 2016 / 79-85

The phenomenon of leptinresistance in patients with gastroesophageal reflux disease and different types of obesity

Author: Livzan M.A.¹, Lapteva I.V.², Krolevets T.S.³

Abstract

Aim: to determine the characteristics of the course of gastroesophageal reflux disease (GERD) based on the study of clinical and endoscopic manifestations of the disease, results of pH monitoring and the phenomenon of leptinresistance in patients with different types of obesity. Methods: 105 patients with GERD and obesity or overweight have been examined. We asked patients, assessed an anthropometric indices, did a biochemical analysis of blood, endoscope examination of the esophagus and stomach, pH monitoring, assessed levels leptin and its soluble receptor. We separated patients in two groups: the main group (n = 85) – patients with abdominal type of obesity, the comparison group (n = 20) – with normal volum of waist. Results: Weight, height, body mass index, level of glucose was higher in main group (p < 0.00003, p < 0.03, p < 0.(10)82, p < 0.02, respectively). Leptin levels in patients with abdominal type of obesity were significantly higher and the level of its receptors was significantly lower (mediana of leptin levels 36.93 (14.69–47.60) in main group versus 9.59 (7.66–19.48), mediana of leptin’s receptors 18.25 (14.69–24.26) versus 23.78 (18.83–32.67), respectively). Between these indicators in main group was revealed negative correlation of mild strength (r_s = –0.424), p < 0.002). In group with abdominal type of obesity pH cardia and body of stomach was higher (p < 0.04, p < 0.02, respectively), but time of refluxate’s contact with low pH (pH < 4) in these departments was longer in the comparison group (p < 0.05). Positive relationship was found between leptin’s receptors and contact’s time in the range of pH from 3 till 6 in the stomach (r_s = (0.645), p < 0.03), in the range from 4 till 7 and less than 4 in the esophagus (r_s = (0.645), p < 0.03, r_s = (0.600), p < 0.05, respectively), the longest gastroesophageal (r_s = (0.624), p < 0.03) and alkaline refluxes (r_s = (0.640), p < 0.03). Conclusions: the formation of leptinresistance in individuals with overweight and obesity based on the type of fat distribution is associated with course of the GERD.

Key words

abdominal type of obesity, gastroesophageal refluxed disease, leptin, leptinresistance

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About Authors (Correspondence):

Livzan M.A. – doctor of medical sciences, head of the chair for faculty therapy with the course of occupational diseases, prorector on scientific work

Lapteva I.V. – postgraduate student of the chair for faculty therapy

Krolevets T.S. – postgraduate student of the chair for faculty therapy, e-mail: mts-8-90@mail.ru

Full Text

13-2-2016.pdf

Received: 19/05/2016