Yang Y, Lin J-R, Li Y-Q, Wei Y-S, Duan Z-J
Department of Gastroenterology, The First Affiliated Hospital of Dalian Medical University, China.
Physiol Res. 2023 Aug 31;72(4):525-537. doi: 10.33549/physiolres.935067.
The incidence of obesity in the population is gradually increasing. Obesity can cause a variety of complications in the digestive system such as gastroesophageal reflux disease, and impacts the integrity of the esophageal mucosal barrier and esophageal motility. However, not many studies have focused on the effect of varying degrees of obesity on the esophagus. A total of 611 participants were included in this study. We divided them into three groups according to their body mass index (BMI): the normal weight group, the overweight group, and the obesity group. We performed a retrospective comparison between groups based on indicators from high resolution esophageal manometry (HREM) and 24-hour pH impedance monitoring, and did a correlation analysis on multiple indicators such as esophageal mucosal barrier, esophageal motility, and acid reflux. The mean nocturnal baseline impedance (MNBI) in the overweight and obesity groups was lower than that in the normal group. The MNBI of the subjects in Z5-Z6 channels in the overweight group was significantly lower than that in the normal group. With respect to Z3-Z6 channels, MNBI values in the obesity group were significantly lower than those in the normal group. 'The acid exposure time (AET), the DeMeester scores (DMS) and 24-hour total reflux episodes was significantly higher in the obesity group than those in the normal and overweight groups. The upper esophageal sphincter (UES) residual pressure, and intrabolus pressure (IBP) in the overweight and obesity groups were significantly higher than those in the normal group. In addition, lower esophageal sphincter (LES) resting pressure, and esophagogastric junction contractile integral (EGJ-CI) in the obesity group were significantly higher than those in the normal group. We found that increase in body weight affected the integrity of esophageal mucosa, and different degrees of increase associated with different degrees and different aspects of changes in esophageal motility.
人群中肥胖的发生率正在逐渐上升。肥胖会在消化系统引发多种并发症,如胃食管反流病,并影响食管黏膜屏障的完整性和食管动力。然而,针对不同程度肥胖对食管影响的研究并不多。本研究共纳入611名参与者。我们根据他们的体重指数(BMI)将其分为三组:正常体重组、超重组和肥胖组。我们基于高分辨率食管测压(HREM)和24小时pH阻抗监测的指标进行组间回顾性比较,并对食管黏膜屏障、食管动力和酸反流等多个指标进行相关性分析。超重组和肥胖组的夜间平均基线阻抗(MNBI)低于正常组。超重组Z5 - Z6通道受试者的MNBI显著低于正常组。对于Z3 - Z6通道,肥胖组的MNBI值显著低于正常组。肥胖组的酸暴露时间(AET)、DeMeester评分(DMS)和24小时总反流发作次数显著高于正常组和超重组。超重组和肥胖组的食管上括约肌(UES)残余压力和团注内压(IBP)显著高于正常组。此外,肥胖组的食管下括约肌(LES)静息压力和食管胃交界收缩积分(EGJ - CI)显著高于正常组。我们发现体重增加会影响食管黏膜的完整性,不同程度的体重增加与食管动力不同程度和不同方面的变化相关。