ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet12706ometendo-12706Research ArticleНаучные обзорыReviewsОжирение и функциональные заболевания кишечника: существует ли связь?Obesity and functional bowel disorders: are they linked?https://orcid.org/0000-0001-8533-3119ПогодинаА. А.PogodinaA. V.

Погодина Анна Валерьевна - доктор медицинских наук, Researcher ID: O-6248-2015; Scopus Author ID: 56347569400; eLibrary SPIN: 6059-0340.

664003, Иркутск, ул. Тимирязева, д. 16

Anna V. Pogodina, MD, PhD, Researcher ID: O-6248-2015; Scopus Author ID: 56347569400; eLibrary SPIN: 6059-0340

16 Timiryazeva Street, 664003 Irkutsk

pogodina_av@inbox.ruhttps://orcid.org/0000-0001-5294-6808РоманицаА. И.RomanitsaA. I.

Романица Анастасия Игоревна - eLibrary SPIN: 7676-0301.

Иркутск

Anastasya I. Romanitsa, MD; eLibrary SPIN: 7676-0301.

Irkutsk

ranzypel93@gmail.comhttps://orcid.org/0000-0003-2910-0737РычковаЛ. В.RychkovaL. V.

Рычкова Любовь Владимировна - доктор медицинских наук, профессор, Researcher ID: AAH-9714-2020; Scopus Author ID: 57208523079; eLibrary SPIN: 6059-03401369-6575.

Иркутск

Scientific Center for Family Health and Human Reproduction Problems

iphr@sbamsr.irk.ruНаучный центр проблем здоровья семьи и репродукции человекаРоссияScientific Center for Family Health and Human Reproduction ProblemsRussian Federation202123072021182132141Copyright © Погодина А.А., Романица А.И., Рычкова Л.В., 20212021Погодина А.А., Романица А.И., Рычкова Л.В.Pogodina A.V., Romanitsa A.I., Rychkova L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/12706

Ожирение и функциональные заболевания кишечника (ФЗК) широко распространены в человеческой популяции и сопряжены с психосоциальными проблемами и увеличением нагрузки на здравоохранение. Целью настоящего обзора было всестороннее изучение взаимосвязей ожирения и ФЗК, а также механизмов, объясняющих эту связь. Анализ литературы предоставляет весомые доказательства связи ожирения с диареей, но к настоящему моменту недостаточно данных для того, чтобы уверенно говорить о связи ожирения с синдромом раздраженного кишечника. Большинство исследований свидетельствует о том, что ожирение во взрослой популяции не связано или отрицательно связано с запорами.

Ассоциация ожирения с диареей наиболее убедительно объясняется через особенности диеты, пищевого поведения, изменения в метаболизме желчных кислот, ускоренный транзит по толстой кишке, измененную кишечную микробиоту и связанные с этим воспаление и повышенную проницаемость кишечника. Собственную роль могут играть принимаемые больными лекарственные препараты, а также коморбидная неалкогольная жировая болезнь печени.

Планирование и проведение исследований, в том числе продольных, основанных на валидных диагностических критериях и учитывающих максимально широкий спектр вмешивающихся факторов, позволит глубже исследовать проблему коморбидности ожирения и ФЗК, что будет способствовать оптимизации подходов к лечению этих широко распространенных и социально значимых заболеваний.

Obesity and functional bowel disease (FBD) are affecting a large number of people worldwide. They have psychosocial consequences and associated with considerable healthcare resource use. The purpose of this review was a comprehensive study of the relationship between obesity and FBD, as well as mechanisms to explain this relationship. An analysis of the literature provides strong evidence of a link between obesity and diarrhea, but there is currently insufficient data to speak confidently about the link between obesity and irritable bowel syndrome. Most studies suggest that adult obesity is not associated or negatively associated with constipation. The association of obesity with diarrhea is most convincingly explained through diet, eating behavior, changes in the metabolism of bile acids, accelerated colonic transit, altered intestinal microbiota and associated inflammation and increased intestinal permeability. Medicines taken by patients, as well as non-alcoholic fatty liver disease, can play their own role.

Planning and conducting studies, including longitudinal ones, based on valid diagnostic criteria and taking into account the widest possible range of confounders, will allow a deeper study of the problem of comorbidity of obesity and FBD. This will help optimize the treatment of these diseases.

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The authors declare that there are no conflicts of interest present.