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It has been proven that obesity is associated with several gastroenterological diseases, while the mechanisms of these associations are extremely heterogeneous and multifactorial. Hypertrophy and hyperplasia of adipocytes in obesity lead to a change in the profile of adipokine production (a decrease in adiponectin, an increase in leptin), an increase in the production of pro-inflammatory cytokines (interleukin-1, 6, 8, tumor necrosis factor ), C-reactive protein, free fatty acids, as well as active forms of oxygen (superoxide radicals, H2O2). All the above induces the development of chronic slowly progressive inflammation, oxidative stress, and insulin resistance. In addition, peptides secreted by adipocytes (adiponectin, leptin, nesfatin-1 and apelin) can modulate gastrointestinal motility, acting both centrally and peripherally. The qualitative and quantitative changes in the intestinal microbiota observed in obese patients (increased Firmicutes and decreased Bacteroidetes) lead to a decrease in the production of short-chain fatty acids and an increase in the intestinal permeability due to disruption of intercellular tight junctions, which leads to increased translocation of bacteria and endotoxins into the systemic circulation. Numerous studies have demonstrated the association of obesity with diseases of the esophagus (gastroesophageal reflux disease, Barretts esophagus, esophageal adenocarcinoma, esophageal motility disorders), stomach (functional dyspepsia, stomach cancer), gallbladder (cholelithiasis, gallbladder cancer), pancreas (acute pancreatitis, pancreatic cancer), liver (non-alcoholic fatty liver disease, hepatocellular carcinoma), intestine (diverticular disease, irritable bowel syndrome, colorectal cancer).<\/jats:p>","DOI":"10.26442\/00403660.2021.08.200983","type":"journal-article","created":{"date-parts":[[2021,9,8]],"date-time":"2021-09-08T07:37:07Z","timestamp":1631086627000},"page":"954-962","source":"Crossref","is-referenced-by-count":28,"title":["Obesity as a risk factor for diseases of the digestive system"],"prefix":"10.26442","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4007-7112","authenticated-orcid":false,"given":"Dmitry N.","family":"Andreev","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7760-2091","authenticated-orcid":false,"given":"Yury A.","family":"Kucheryavyy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"18344","published-online":{"date-parts":[[2021,8,15]]},"reference":[{"key":"ref1","unstructured":"\u0410\u043c\u0435\u0442\u043e\u0432 \u0410.\u0421. \u041e\u0436\u0438\u0440\u0435\u043d\u0438\u0435. \u0421\u043e\u0432\u0440\u0435\u043c\u0435\u043d\u043d\u044b\u0439 \u0432\u0437\u0433\u043b\u044f\u0434 \u043d\u0430 \u043f\u0430\u0442\u043e\u0433\u0435\u043d\u0435\u0437 \u0438 \u0442\u0435\u0440\u0430\u043f\u0438\u044e. \u041c.: \u0413\u042d\u041e\u0422\u0410\u0420-\u041c\u0435\u0434\u0438\u0430, 2021 [Ametov AS. 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Obesity: clinical guidelines. Moscow, 2020 (in Russian)]."},{"key":"ref75","doi-asserted-by":"publisher","DOI":"10.14341\/OMET2018153-70"},{"key":"ref76","unstructured":"\u0414\u0435\u043c\u0438\u0434\u043e\u0432\u0430 \u0422.\u042e., \u0413\u0440\u0438\u0446\u043a\u0435\u0432\u0438\u0447 \u0415.\u042e. \u041e\u0436\u0438\u0440\u0435\u043d\u0438\u0435 \u0438 \u043a\u043e\u043c\u043e\u0440\u0431\u0438\u0434\u043d\u044b\u0435 \u0441\u043e\u0441\u0442\u043e\u044f\u043d\u0438\u044f. \u0421\u043e\u0432\u0440\u0435\u043c\u0435\u043d\u043d\u044b\u0435 \u043f\u0440\u0438\u043d\u0446\u0438\u043f\u044b \u0443\u043f\u0440\u0430\u0432\u043b\u0435\u043d\u0438\u044f \u0438 \u043e\u0436\u0438\u0434\u0430\u0435\u043c\u044b\u0435 \u043f\u0435\u0440\u0441\u043f\u0435\u043a\u0442\u0438\u0432\u044b. \u041c., 2018 [Demidova TYu, Gritskevich EYu. Obesity and comorbid conditions. Modern management principles and expected prospects. Moscow, 2018 (in Russian)]."},{"key":"ref77","unstructured":"\u0410\u043d\u0434\u0440\u0435\u0435\u0432 \u0414., \u041c\u0430\u0435\u0432\u0441\u043a\u0430\u044f \u0415., \u0414\u0438\u0447\u0435\u0432\u0430 \u0414., \u041a\u0443\u0437\u043d\u0435\u0446\u043e\u0432\u0430 \u0415. \u0414\u0438\u0435\u0442\u043e\u0442\u0435\u0440\u0430\u043f\u0438\u044f \u043a\u0430\u043a \u043f\u0440\u0438\u043e\u0440\u0438\u0442\u0435\u0442\u043d\u0430\u044f \u0442\u0430\u043a\u0442\u0438\u043a\u0430 \u043b\u0435\u0447\u0435\u043d\u0438\u044f \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u0432 \u0441 \u043d\u0435\u0430\u043b\u043a\u043e\u0433\u043e\u043b\u044c\u043d\u043e\u0439 \u0436\u0438\u0440\u043e\u0432\u043e\u0439 \u0431\u043e\u043b\u0435\u0437\u043d\u044c\u044e \u043f\u0435\u0447\u0435\u043d\u0438. \u0412\u0440\u0430\u0447. 2017;7:2-6 [Andreev D, Maevskaya E, Dicheva D, Kuznetsova E. Dietotherapy as a priority treatment policy for patients with nonalcoholic fatty liver disease. Vrach (The Doctor). 2017;7:2-6 (in Russian)]."},{"key":"ref78","unstructured":"\u0413\u0438\u043d\u0437\u0431\u0443\u0440\u0433 \u041c.\u041c. \u041e\u0442\u0447\u0435\u0442 \u00ab\u041e\u043f\u044b\u0442 \u043f\u0440\u0438\u043c\u0435\u043d\u0435\u043d\u0438\u044f \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442\u0430 \u041c\u0443\u043a\u043e\u0444\u0430\u043b\u044c\u043a \u0432 \u043a\u043e\u043c\u043f\u043b\u0435\u043a\u0441\u043d\u043e\u0439 \u0442\u0435\u0440\u0430\u043f\u0438\u0438 \u0443 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u0432 \u0441 \u043e\u0436\u0438\u0440\u0435\u043d\u0438\u0435\u043c \u0438 \u043c\u0435\u0442\u0430\u0431\u043e\u043b\u0438\u0447\u0435\u0441\u043a\u0438\u043c \u0441\u0438\u043d\u0434\u0440\u043e\u043c\u043e\u043c\u00bb. \u041d\u0418\u0418 \u0414\u0438\u0435\u0442\u043e\u043b\u043e\u0433\u0438\u0438 \u0438 \u0414\u0438\u0435\u0442\u043e\u0442\u0435\u0440\u0430\u043f\u0438\u0438. \u0421\u0430\u043c\u0430\u0440\u0430, 2010 [Ginzburg MM. Report \u201cExperience of using the drug Mucofalk in complex therapy in patients with obesity and metabolic syndrome\u201d. Research Institute of Dietetics and Nutritional Therapy. Samara, 2010 (in Russian)]."},{"key":"ref79","unstructured":"\u041a\u043e\u043c\u0438\u0441\u0441\u0430\u0440\u0435\u043d\u043a\u043e \u0418.\u0410., \u041b\u0435\u0432\u0447\u0435\u043d\u043a\u043e \u0421.\u0412., \u0413\u0443\u0434\u043a\u043e\u0432\u0430 \u0420.\u0411., \u0421\u0438\u043b\u044c\u0432\u0435\u0441\u0442\u0440\u043e\u0432\u0430 \u0421.\u042e. \u042d\u0444\u0444\u0435\u043a\u0442\u044b \u0434\u043b\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u0433\u043e \u043f\u0440\u0438\u043c\u0435\u043d\u0435\u043d\u0438\u044f \u043f\u0441\u0438\u043b\u043b\u0438\u0443\u043c\u0430 \u043f\u0440\u0438 \u043b\u0435\u0447\u0435\u043d\u0438\u0438 \u0431\u043e\u043b\u044c\u043d\u044b\u0445 \u0441 \u0434\u0438\u0432\u0435\u0440\u0442\u0438\u043a\u0443\u043b\u044f\u0440\u043d\u043e\u0439 \u0431\u043e\u043b\u0435\u0437\u043d\u044c\u044e \u0442\u043e\u043b\u0441\u0442\u043e\u0439 \u043a\u0438\u0448\u043a\u0438. \u041a\u043b\u0438\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u0435 \u043f\u0435\u0440\u0441\u043f\u0435\u043a\u0442\u0438\u0432\u044b \u0432 \u0433\u0430\u0441\u0442\u0440\u043e\u044d\u043d\u0442\u0435\u0440\u043e\u043b\u043e\u0433\u0438\u0438, \u0433\u0435\u043f\u0430\u0442\u043e\u043b\u043e\u0433\u0438\u0438. 2014;3:29-36 [Komissarenko IA, Levchenko SV, Gudkova RB, Sil\u2019vestrova SIu. Effekty dlitel\u2019nogo primeneniia psilliuma pri lechenii bol\u2019nykh s divertikuliarnoi bolezn\u2019iu tolstoi kishki. Klinicheskie perspektivy v gastroenterologii, gepatologii. 2014;3:29-36 (in Russian)]."},{"key":"ref80","unstructured":"\u041c\u0430\u0435\u0432\u0441\u043a\u0430\u044f \u0415.\u0410., \u041c\u0430\u0435\u0432 \u0418.\u0412., \u041a\u0443\u0447\u0435\u0440\u044f\u0432\u044b\u0439 \u042e.\u0410., \u0438 \u0434\u0440. \u041e\u0446\u0435\u043d\u043a\u0430 \u0432\u043b\u0438\u044f\u043d\u0438\u044f \u043b\u0430\u043a\u0442\u0443\u043b\u043e\u0437\u044b \u0438\u043b\u0438 \u043f\u0438\u0449\u0435\u0432\u044b\u0445 \u0432\u043e\u043b\u043e\u043a\u043e\u043d \u043d\u0430 \u0434\u0438\u043d\u0430\u043c\u0438\u043a\u0443 \u043f\u043e\u043a\u0430\u0437\u0430\u0442\u0435\u043b\u0435\u0439 \u043b\u0438\u043f\u0438\u0434\u043d\u043e\u0433\u043e \u043f\u0440\u043e\u0444\u0438\u043b\u044f \u0443 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u0432 \u0441 \u0444\u0443\u043d\u043a\u0446\u0438\u043e\u043d\u0430\u043b\u044c\u043d\u044b\u043c \u0437\u0430\u043f\u043e\u0440\u043e\u043c \u0438 \u043d\u0435\u0430\u043b\u043a\u043e\u0433\u043e\u043b\u044c\u043d\u044b\u043c \u0441\u0442\u0435\u0430\u0442\u043e\u0433\u0435\u043f\u0430\u0442\u0438\u0442\u043e\u043c. \u041b\u0435\u0447\u0430\u0449\u0438\u0439 \u0432\u0440\u0430\u0447. 2016;4:117-23 [Maevskaya EA, Maev IV, Kucheryavyy YuA, et al. Evaluation of influence of lactulose or dietary fibers on dynamics of lipid profile indices in patients with functional constipation and non-alcoholic steatohepatitis. Lechashchii vrach. 2016;4:117-23 (in Russian)]."},{"key":"ref81","doi-asserted-by":"publisher","DOI":"10.3945\/ajcn.115.106989"},{"key":"ref82","doi-asserted-by":"publisher","DOI":"10.1093\/nutrit\/nuab018"}],"container-title":["Terapevticheskii arkhiv"],"original-title":[],"link":[{"URL":"https:\/\/ter-arkhiv.ru\/0040-3660\/article\/viewFile\/79590\/60206","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ter-arkhiv.ru\/0040-3660\/article\/viewFile\/79590\/60206","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T15:39:02Z","timestamp":1634139542000},"score":1,"resource":{"primary":{"URL":"https:\/\/ter-arkhiv.ru\/0040-3660\/article\/view\/79590"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,15]]},"references-count":82,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,8,15]]}},"URL":"https:\/\/doi.org\/10.26442\/00403660.2021.08.200983","relation":{},"ISSN":["2309-5342","0040-3660"],"issn-type":[{"value":"2309-5342","type":"electronic"},{"value":"0040-3660","type":"print"}],"subject":[],"published":{"date-parts":[[2021,8,15]]}}}