Gastroesophageal reflux disease and diabetes mellitus: pathophysiological mechanisms of comorbidity

Cover Page

Cite item

Full Text

Abstract

This article covers a very important material about etiology and pathology of the gastroesophageal reflux disease with which most commonly suffer people with the diabetes mellitus type 2. It is well known fact that, on the one hand, hyperglycemia leads to the diabetic neuropathy. Neuropathy is the most common reason for motor disorders of the digestive system. On the other hand, patients who suffer from diabetes mellitus type 2 have an increased body mass index and obesity, which are associated with the increased abdominal pressure, the decreased lower esophageal sphincter pressure and increase of transient relaxation of the lower esophageal sphincter and lead to the pathophysiological reflux. In addition, such a decreased level of grelin in patients with obesity also leads to the pathophysiological reflux.

About the authors

Elena I. Kuznetsova

Yevdokimov Moscow State University of Medicine and Dentistry

Graduate Student Moscow, Russia

Ekaterina A. Rymareva

Main Clinical Hospital of Ministry of Internal Affairs of the Russian Federation

Cand. Sci. (Med.) Moscow, Russia

Diana T. Dicheva

Yevdokimov Moscow State University of Medicine and Dentistry

Cand. Sci. (Med.) Moscow, Russia

Dmitrii N. Andreev

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru
Cand. Sci. (Med.) Moscow, Russia

References

  1. Whiting D.R, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabet Res Clin Pract 2011; 94 (3): 311-21.
  2. Маев И.В., Бусарова Г.А., Андреев Д.Н. Болезни пищевода. М.: ГЭОТАР-Медиа, 2019. [Maev I.V., Busarova G.A., Andreev D.N. Esophagus. Moscow: GEOTAR-Media, 2019 (in Russian)
  3. El-Serag H.B, Sweet S, Winchester C.C, Dent J. Update on the epidemiology of gastro-esophageal reflux disease: a systematic review. Gut 2013; 5.
  4. Bonatti H, Achem S.R, Hinder R.A. Impact of changing epidemiology of gastroesophageal reflux disease on its diagnosis and treatment. J Gastrointestinal Surg 2008; 12 (2): 373-81.
  5. Bor S, Lazebnik L.B, Kitapcioglu G et al. Prevalence of gastroesophageal reflux disease in Moscow. Dis Esophagus 2016; 29 (2): 159-65.
  6. Маев И.В., Юренев Г.Л., Вьючнова Е.С. и др. Гастроэзофагеальная рефлюксная болезнь. М.: ГЭОТАР-Медиа, 2019. @@ Maev I.V., Iurenev G.L., V'iuchnova E.S. et al. Gastroesophageal Reflux Disease. Moscow: GEOTAR-Media, 2019 (in Russian).]
  7. Nishida T, Tsuji S, Tsujii M et al. Gastroesophageal reflux disease related to diabetes: analysis of 241 cases with type 2 diabetes mellitus. J Gastroenterol Hepatol 2004; 19 (3): 258-65.
  8. Sun X.M, Tan J.C, Zhu Y, Lin L. Association between diabetes mellitus and gastroesophageal reflux disease: A meta-analysis. World J Gastroenterol 2015; 21 (10): 3085-92.
  9. Iyer P.G, Borah B.J, Heien H.C et al. Association o fBarrett's esophagus with type II Diabetes Mellitus: results from a large population-based case-control study. Clin Gastroenterol Hepatol 2013; 11 (9): 1108-14e5.
  10. Schwab A, Siddiqui A et al. Polyol pathway links glucose metabolism to the aggressivness of cancer cells. Cancer Res 2018.
  11. Paawan Punjabi, Angela Hira Do , Shanti Prasad et al. Review of gastroesophageal reflux disease (GERD) in the diabetic patient. J Diabetes 2015; 7 (5): 599-609.
  12. Wang X, Pitchumoni C.S, Chandrarana K, Shah N. Increased prevalence of symptoms of gastroesophageal reflux diseases in type 2 diabetics with neuropathy. World J Gastroenterol 2008; 14 (5): 709-12.
  13. Kinekawa F, Kubo F, Matsuda K et al. Esophageal function worsens with long duration of diabetes. J Gastroenterol 2008; 43 (5): 338-44.
  14. Jorge J.X, Panão E.A, Simões M.A et al. Esophageal body motility in people with diabetes: comparison with non-diabetic healthy individuals. Diabet Res Clin Pract 2012; 97 (1): 77-81.
  15. Ahmed W, Vohra E.A. Esophageal motility disorders in diabetics. J Pak Med Assoc 2004; 54 (12): 597-601.
  16. Kinekawa F, Kubo F, Matsuda K et al. Relationship between esophageal dysfunction and neuropathy in diabetic patients. Am J Gastroenterol 2001; 96 (7): 2026-32.
  17. Fass R, McCallum R.W, Parkman H.P. Treatment Challenges in the Management of Gastroparesis-Related GERD. Gastroenterol Hepatol 2009; 5 (10; Suppl. 18): 4-16.
  18. Sellin J.H, Chang E.B. Therapy Insight: gastrointestinal complications of diabetes-pathophysiology and management. Nature clinical practice. Gastroenterol Hepatol 2008; 5 (3): 162-71.
  19. Promberger R, Spitzer A, Ott J et al. Quality of life in type 2 diabetics with gastroesophageal reflux disease: a case control study. Eur Surg 2013: 1-6.
  20. Hampel H, Abraham N.S, El-Serag H.B. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med 2005; 143 (3): 199-211.
  21. Peeters A, Barendregt J.J, Willekens F et al. Obesity in adulthood and its consequences for life expectancy: a life-table analysis. Ann Internal Med 2003; 138 (1): 24-32.
  22. Singh S, Sharma A.N, Murad MH et al. Central Adiposity Is Associated With Increased Risk of Esophageal Inflammation, Metaplasia, and Adenocarcinoma: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol 2013; 11: 1399-1412.e7.
  23. El-Serag H.B, Graham D.Y, Satia J.A et al. Obesity is an independent risk factor for GERD symptoms and erosive esophagitis. Am J Gastroenterol 2005; 100 (6): 1243-50.
  24. Kubo A, Corley D.A. Body mass index and adenocarcinomas of the esophagus or gastric cardia: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 2006; 15 (5): 872-8.
  25. Hajar N, Castell D.O, Ghomrawi H et al. Impedance pH confirms the relationship between GERD and BMI. Dig Dis Sci 2012; 57: 1875-9.
  26. Nadaleto B.F, Herbella F.A, Patti M.G. Gastroesophageal reflux disease in the obese: Pathophysiology and treatment. Surgery 2016; 159 (2): 475-86.
  27. Alberti K, Zimmet P, Shaw J. Metabolic syndrome - a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabetic Med 2006; 23 (5): 469-80.
  28. Niigaki M, Adachi K, Hirakawa K et al. Association between metabolic syndrome and prevalence of gastroesophageal reflux disease in a health screening facility in Japan. J Gastroenterol 2012: 1-10.
  29. Chung S.J, Kim D, Park M.J et al. Metabolic syndrome and visceral obesity as risk factors for reflux oesophagitis: a cross-sectional case-control study of 7078 Koreans undergoing health check-ups. Gut 2008; 57 (10): 1360-5.
  30. Moki F, Kusano M, Mizuide M et al. Association between reflux oesophagitis and features of the metabolic syndrome in Japan. Aliment Pharmacol Ther 2007; 26 (7): 1069-75.
  31. Hirata A, Kishida K, Nakatsuji H et al. High prevalence of gastroesophageal reflux symptoms in type 2 diabetics with hypoadiponectinemia and metabolic syndrome. Nutr Metab 2012; 9 (1): 4.
  32. Cummings D.E, Purnell J.Q, Frayo R.S et al. A preprandial rise in plasma ghrelin levels suggests a role in meal initiation in humans. Diabetes 2001; 50 (8): 1714-9.
  33. Kawahara H, Kubota A, Hasegawa T et al. Effects of rikkunshito on the clinical symptoms and esophageal acid exposure in children with symptomatic gastroesophageal reflux. Pediatr Surg Int 2007; 23 (10): 1001-5.
  34. Rubenstein J.H, Morgenstern H, McConell D et al. Associations of Diabetes Mellitus, Insulin, Leptin, and Ghrelin With Gastroesophageal Reflux and Barrett's Esophagus. Gastroenterology 2013; 145 (6): 1237-44.e5.
  35. Ohno T, Mochiki E, Kuwano H. The roles of motilin and ghrelin in gastrointestinal motility. Int J Pept 2010.
  36. Perdikis G, Wilson P, Hinder R.A et al. Gastroesophageal reflux disease is associated with enteric hormone abnormalities. Am J Surg 1994; 167 (1): 186-91; discussion 91-2.
  37. Schmid R, Schusdziarra V, Allescher H.D et al. Effect of motilin on gastric emptying in patients with diabetic gastroparesis. Diabetes Care 1991; 14 (1): 65-8.
  38. McCallum R.W, Cynshi O, TEAM U.I. Efficacy of mitemcinal, a motilin agonist, on gastrointestinal symptoms in patients with symptoms suggesting diabetic gastropathy: a randomized, multi-center, placebo-controlled trial. Aliment Pharmacol Ther 2007; 26 (1): 107-16.
  39. Okano H, Inui A, Ueno N et al. EM523L, a nonpeptide motilin agonist, stimulates gastric emptying and pancreatic polypeptide secretion. Peptides 1996; 17 (6): 895-900.
  40. Nakanome C, Akai H, Hongo M et al. Disturbances of the alimentary tract motility and hypermotilinemia in the patients with diabetes mellitus. Tohoku J Exp Med 1983; 139 (2): 205-15.
  41. Pendleton H, Ekman R, Olsson R et al. Motilin concentrations in relation to gastro intestinal dysmotility in diabetes mellitus. Eur J Intern Med 2009; 20 (6): 654-9.
  42. Nies A.T, Hofmann U, Resch C et al. Proton pump inhibitors inhibit metformin uptake by organic cation transporters (OCTs). PloS one 2011; 6 (7): e22163.
  43. Cummings D.E, Overduin J. Gastrointestinal regulation of food intake. J Clin Invest 2007; 117 (1): 13-23.
  44. Dent J. Editorial: Better ammunition for use of weight loss in managing gastroesophageal reflux disease. Am J Gastroenterol 2013; 108 (3): 383-5.
  45. Маев И.В., Кучерявый Ю.А., Андреев Д.Н. Ожирение и коморбидность: пособие для врачей. М.: Прима Принт, 2016. @@ Maev I.V., Kucheriavyi Iu.A., Andreev D.N. Obesity and comorbidity: a guide for doctors. Moscow: Prima Print, 2016 (In Russian)
  46. Юренев Г.Л., Миронова Е.М., Андреев Д.Н., Юренева-Тхоржевская Т.В. Клинические и патогенетические параллели гастроэзофагеальной рефлюксной болезни и ожирения. Фарматека. 2017; 13: 30-9. @@ Iurenev G.L., Mironova E.M., Andreev D.N., Iureneva-Tkhorzhevskaia T.V. Klinicheskie i patogeneticheskie paralleli gastroezofageal'noi refliuksnoi bolezni i ozhireniia. Farmateka. 2017; 13: 30-9 (In Russian).]
  47. Ивашкин В.Т., Маев И.В., Трухманов А.С. и др. Клинические рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению гастроэзофагеальной рефлюксной болезни. РЖГГК. 2017; 27 (4): 75-95. @@ Ivashkin V.T., Maev I.V., Trukhmanov A.S. i dr. Klinicheskie rekomendatsii Rossiiskoi gastroenterologicheskoi assotsiatsii po diagnostike i lecheniiu gastroezofageal'noi refliuksnoi bolezni. RZhGGK. 2017; 27 (4): 75-95 (In Russian).
  48. Crouch M.A, Mefford I.N, Wade E.U. Proton pump inhibitor therapy associated with lower glycosylated hemoglobin levels in type 2 diabetes. J Am Board Family Med 2012; 25 (1): 50-4.
  49. Mefford I.N, Wade E.U. Proton pump inhibitors as a treatment method for type II diabetes. Medical Hypotheses 2009; 73 (1): 29-32.
  50. Bodvarsdottir T.B, Hove K.D, Gotfredsen C.F et al. Treatment with a proton pump inhibitor improves glycaemic control in Psam-momys obesus, a model of type 2 diabetes. Diabetologia 2010; 53 (10): 2220-3.
  51. Маев И.В., Баркалова Е.В., Овсепян М.А. и др. Возможности рн-импедансометрии и манометрии высокого разрешения при ведении пациентов с рефрактерной гастроэзофагеальной рефлюксной болезнью. Терапевтический архив. 2017; 89 (2): 76-83. @@ Maev I.V., Barkalova E.V., Ovsepian M.A. et al. Vozmozhnosti rn-impedansometrii i manometrii vysokogo razresheniia pri vedenii patsientov s refrakternoi gastroezofageal'noi refliuksnoi bolezn'iu. Therapeutic Archive. 2017; 89 (2): 76-83. (in Russian)
  52. Маев И.В., Баркалова Е.В., Овсепян М.А и др. Достижения современной гастроэнтерологии в оценке нарушений тонуса и моторики пищевода. Consilium Medicum. 2018; 20 (8): 8-13. doi: 10.26442/2075-1753_2018.8.8-13 @@ Maev I.V., Barkalova E.V., Ovsepyan M.A. et al. Modern gastroenterology advances in esophageal tonus and motility disorders assessment. Consilium Medicum. 2018; 20 (8): 8-13. doi: 10.26442/2075-1753_2018.8.8-13 (in Russian).]
  53. Маев И.В., Дичева Д.Т., Андреев Д.Н. и др. Терапевтическая роль прокинетических препаратов в лечении гастроэзофагеальной рефлюксной болезни. Мед. совет. 2014; 4: 66-70. @@ aev I.V., Dicheva D.T., Andreev D.N. et al. Terapevticheskaia rol' prokineticheskikh preparatov v lechenii gastroezofageal'noi refliuksnoi bolezni. Med. sovet. 2014; 4: 66-70 (in Russian).]
  54. Holtmann G, Talley N.J, Liebregts T et al. A placebo-controlled trial of itopride in functional dyspepsia. N Engl J Med 2006; 354 (8): 832-40.
  55. Дедов И.И. Эндокринология. Национальное руководство. М.: ГЭОТАР-Медиа, 2016. @@ Dedov I.I. Endocrinology. National leadership. Moscow: GEOTAR-Media, 2016 (in Russian).

Copyright (c) 2019 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies