Role of Obesity in the Pathogenesis and Progression of Barrett's Esophagus.

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Role of Obesity in the Pathogenesis and Progression of Barrett's Esophagus.

Gastroenterol Clin North Am. 2015 Jun;44(2):249-64

Authors: Chandar AK, Iyer PG

Abstract
Central obesity is involved in the pathogenesis and progression of Barrett's esophagus to esophageal adenocarcinoma. Involved are likely both mechanical and nonmechanical effects. Mechanical effects of increased abdominal fat cause disruption of the gastroesophageal reflux barrier leading to increased reflux events. Nonmechanical effects may be mediated by inflammation, via classically activated macrophages, pro-inflammatory cytokines, and adipokines such as Leptin, all of which likely potentiate reflux-mediated inflammation. Insulin resistance, associated with central obesity, is also associated with both Barrett's pathogenesis and progression to adenocarcinoma. Molecular pathways activated in obesity, inflammation and insulin resistance overlap with those involved in Barrett's pathogenesis and progression.

PMID: 26021193 [PubMed - indexed for MEDLINE]

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