Palabras clave
Complicaciones gastrointestinales
Enfermedad del hígado graso no alcohólico
Cómo citar
Copyright © | Todos los derechos reservados.
La revista posee los derechos de autor exclusivos para la publicación de este artículo en los términos de la ley brasileña 9610/98.
Reproducción parcial
El uso de partes de los textos, figuras y cuestionario del artículo es libre, siendo obligatoria la citación de los autores y revista.
Reproducción total
Está expresamente prohibido y debe ser autorizado por la revista.
Resumen
Objetivo: Identificar y correlacionar los principales impactos moleculares, fisiológicos y tisulares de la obesidad sobre los trastornos gastrointestinales y hepáticos. Revisión bibliográfica: La obesidad es un problema de salud pública mundial, en Brasil, según la Encuesta Nacional de Salud (PNS, 2020), actualmente más de la mitad de los adultos tienen sobrepeso (60,3%, lo que representa 96 millones de personas), con mayor prevalencia entre mujeres (62,6%) que hombres (57,5%). La obesidad está directamente relacionada con problemas como resistencia a la insulina, diabetes mellitus, hipertensión y riesgo de enfermedades cardiovasculares, sin embargo, varias enfermedades pueden subyacer a estas condiciones, principalmente enfermedades gastrointestinales y hepáticas, por lo que comprender sus mecanismos fisiopatológicos se vuelve esencial para posibles intervenciones médicas. Consideraciones finales: Las complicaciones y enfermedades gastrointestinales y hepáticas se vuelven más pronunciadas en la obesidad, con alta prevalencia de reflujo gastroesofágico, esofagitis erosiva, esófago de Barrett, gastritis erosiva, disbiosis, diarrea, enfermedad del hígado graso no alcohólico e incluso cáncer gástrico. Además, las intervenciones y el diagnóstico precoz se reflejan positivamente en la supervivencia de estos pacientes, en este sentido, el gastroenterólogo junto con el equipo multidisciplinario es de suma importancia en el manejo clínico de la obesidad y sus complicaciones.
Referencias
ALEMAN R, et al. De novo gastroesophageal reflux disease esophageal surgery in bariatrics: a literature review and analysis of the current treatment options. Annals of Translational Medicine, 2021; 9(10).
ARAÚJO MC, et al. An overview of the TRP-oxidative stress axis in metabolic syndrome: Insights for novel therapeutic approaches. Cells, 2022; 11(8): 1292.
ARON-WISNEWSKY J, et al. Metabolism and Metabolic Disorders and the Microbiome: The Intestinal Microbiota Associated With Obesity, Lipid Metabolism, and Metabolic Health-Pathophysiology and Therapeutic Strategies. Gastroenterology, 2021; 160(2): 573-599.
BALLESTRI S, et al. The role of nuclear receptors in the pathophysiology, natural course, and drug treatment of NAFLD in humans. Adv Ther, 2016; 33(3): 291-319.
BARROSO I, et al. The Genetic Basis of Metabolic Disease. Cell, 2019; 177: 146-161.
BARROSO WA, et al. High-fat diet inhibits PGC-1α suppressive effect on NFκB signaling in hepatocytes. Eur J Nutr, 2017; 57(5): 1891-1900.
BEDRIKOVETSKI S, et al. Artificial intelligence for body composition and sarcopenia evaluation on computed tomography: A systematic review and meta-analysis. European journal of radiology, 2022; 149: 110218.
BOURAS E, et al. Diet and Risk of Gastric Cancer: An Umbrella Review. Nutrients, 2022; 14(9): 1764.
CHAIT A, LAURA JD. Adipose Tissue Distribution, Inflammation and Its Metabolic Consequences, Including Diabetes and Cardiovascular Disease. Frontiers in cardiovascular medicine, 2020; 7(22).
CHEN J, et al. Gastrointestinal Consequences of Type 2 Diabetes Mellitus and Impaired Glycemic Homeostasis: A Mendelian Randomization Study. Diabetes Care, 2023; 46(4): 828-835.
CROOKS B, et al. Appetite, the enteroendocrine system, gastrointestinal disease and obesity. Proc Nutr Soc, 2021; 80(1) :50-58.
DONG Y, et al. Abdominal obesity and colorectal cancer risk: systematic review and meta-analysis of prospective studies. Bioscience reports, 2017; 37(6): BSR20170945.
FRANÇA LM, et al. post-weaning exposure to high-sucrose diet induces early non-alcoholic fatty liver disease onset and progression in male mice: role of dysfunctional white adipose tissue. Journal of developmental origins of health and disease, 2020; 11(5): 509-520.
GAO W-Y, et al. Tanshinone IIA Downregulates Lipogenic Gene Expression and Attenuates Lipid Accumulation through the Modulation of LXRα/SREBP1 Pathway in HepG2 Cells. Biomedicines. 2021; 9(3): 326.
IATCU CO, et al. Gut Microbiota and Complications of Type-2 Diabetes. Nutrients, 2021; 14(1): 166.
KARASKOVA E, et al. Role of Adipose Tissue in Inflammatory Bowel Disease. International journal of molecular sciences, 2021; 22(8): 4226.
KAWAI T, et al. Adipose tissue inflammation and metabolic dysfunction in obesity. Am J Physiol Cell Physiol, 2021; 320(3): C375-C391.
KHALAFI, M, et al. The impact of exercise and dietary interventions on circulating leptin and adiponectin in individuals who are overweight and those with obesity: A systematic review and meta-analysis. Advances in Nutrition, 2023; 14(1): 128.
KIM H, et al. Targeting Liver X Receptors for the Treatment of Non-Alcoholic Fatty Liver Disease. Cells, 2023; 12(9): 1292.
KUMAR V, et al. Biogenic phytochemicals modulating obesity: From molecular mechanism to preventive and therapeutic approaches. Evidence-Based Complementary and Alternative Medicine, 2022; 1.
LAUBY-SECRETAN B, et al. Obésité et cancer [Obesity and Cancer]. Bull Cancer, 2019; 106(7-8): 635-646.
LI X, et al. New insights into the role of dietary triglyceride absorption in obesity and metabolic diseases. Frontiers in Pharmacology, 2023; 14: 1097835.
LINGHU E. Obesity and chronic diarrhea: a new syndrome?. Chinese Medical Journal, 2022; 135(15): 1806-1807.
LIU BING-NAN, et al. Gut microbiota in obesity. World journal of gastroenterology, 2021; 27: 3837-3850.
MARCUS C, et al. Pediatric obesity-Long-term consequences and effect of weight loss. J Intern Med. 2022; 292(6): 870-891.
MASSIRONI S, et al. Inflammation and malnutrition in inflammatory bowel disease. Lancet Gastroenterol Hepatol. 2023; 8(6): 579-590.
MORSALI M, et al. Diet Therapeutics Interventions for Obesity: A Systematic Review and Network Meta-Analysis. J Res Health Sci. 2021; 21(3): e00521.
PARIS S, et al. Obesity and its effects on the esophageal mucosal barrier. Am J Physiol Gastrointest Liver Physiol. 2021; 321(3): G335-G343.
PATHAK P, et al. Farnesoid X receptor induces Takeda G-protein receptor 5 Crosstalk to regulate Bile Acid Synthesis and Hepatic Metabolism. J Biol Chem:jbc, 2017; M117: 784322.
QIU Y-Y, et al. Roles of the peroxisome proliferator-activated receptors (PPARs) in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). Pharmacol Res. 2023; 192: 106786.
RODRIGUES MC, et al. Prevalência e fatores associados à síndrome metabólica em população vulnerável do norte do Brasil: um estudo transversal. Journal of Human Growth and Development, 2021; 31(2): 291.
SCHLOTTMANN F, et al. Obesity and esophageal cancer: GERD, Barrett´s esophagus, and molecular carcinogenic pathways. Expert Rev Gastroenterol Hepatol. 2020; 14(6): 425-433.
SHIN J-H, et al. Amelioration of obesity-related characteristics by a probiotic formulation in a high-fat diet-induced obese rat model. Eur J Nutr, 2017; 1-10.
SOHN W, et al. Obesity and the risk of primary liver cancer: A systematic review and meta-analysis. Clin Mol Hepatol. 2021; 27(1): 157-174.
STOPA SR, et al. Pesquisa Nacional de Saúde 2019: histórico, métodos e perspectivas. Epidemiologia e Serviços de Saúde, 2020; 29: e2020315.
WANG Q e WU H. T cells in adipose tissue: critical players in immunometabolism. Frontiers in immunology, 2018; 9: 2509.
YE Q, et al. “Global prevalence, incidence, and outcomes of non-obese or lean non-alcoholic fatty liver disease: a systematic review and meta-analysis.” The lancet. Gastroenterology & hepatology, 2020; 5(8): 739-752.
YUAN S e SUSANNA CL. Adiposity, diabetes, lifestyle factors and risk of gastroesophageal reflux disease: a Mendelian randomization study. European journal of epidemiology, 2022; 37(7): 747-754.
ZHAN J, et al. Abdominal obesity increases the risk of reflux esophagitis: a systematic review and meta-analysis. Scand J Gastroenterol. 2022; 57(2): 131-142.