nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-180-8-34-38nogr-1422Research ArticleКЛИНИЧЕСКАЯ ГАСТРОЭНТЕРОЛОГИЯCLINICAL GASTROENTEROLOGYГастроэзофагеальная рефлюксная болезнь при неалкогольной жировой болезни печени и синдроме обструктивного апноэ снаGastroesophageal reflux disease in comorbidity with obstructive sleep apnea syndrome and non-alcoholic fatty liver diseaseДамбаеваБ. Б.DambaevaB. B.

Дамбаева Баирма Баировна - кафедра терапии, аспирант

Bairma B. Dambaeva - Department of Therapy, Postgraduate Student

ОнучинаЕ. В.OnuchinaE. V.

Онучина Елена Владимировна, кафедра терапии, профессор кафедры терапии, доктор медицинских наук

Elena V. Onuchina - Department of Therapy, Professor of the Department of Therapy, Doctor of Medical Sciences

elonu@mail.ruИркутская государственная медицинская академия последипломного образования — филиал ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской ФедерацииРоссияIrkutsk State Medical Academy of Postgraduate Education — Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education “Russian Medical Academy of Continuing Professional Education” of the Ministry of Healthcare of the Russian FederationRussian Federation202017102020083438Copyright © Дамбаева Б.Б., Онучина Е.В., 20202020Дамбаева Б.Б., Онучина Е.В.Dambaeva B.B., Onuchina E.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.nogr.org/jour/article/view/1422

Гастроэзофагеальная рефлюксная болезнь (ГЭРБ), неалкогольная жировая болезнь печени (НАЖБП) и синдром обструктивного апноэ сна (СОАС) высоко распространённые патологические состояния, ассоциированные с ожирением, абдоминальным ожирением и метаболическим синдромом. Каждое из заболеваний имеет негативный эффект на другие системы органов, обуславливающий, в том числе, сердечно-сосудистую заболеваемость и смертность. В связи с общностью этиопатогенетических механизмов, исследовательский интерес представляют вопросы взаимовлияния ГЭРБ, НАЖБП и СОАС. Большая часть выполненных работ по данной проблеме демонстрирует связь между ними, независящую от индекса массы тела, окружности талии, показателей липидного и углеводного обменов. При этом НАЖБП рассматривается в качестве самостоятельного предиктора симптомов ГЭРБ и эрозивного эзофагита. СОАС в значительной степени связан с повышенным риском появления стеатоза печени, его прогрессии до стеатогепатита и фиброза печени. ГЭРБ ассоциирована с более тяжелой формой СОАС, а СОАС — с развитием пищевода Барретта и аденокарциномы пищевода. Между тем, имеющиеся многочисленные публикации в современной литературе противоречивы. Вопросы сочетания ГЭРБ, НАЖБП и СОАС с позиций взаимной причинности и/или воздействия общих факторов риска до конца не решены. Остаются не ясными некоторые аспекты влияния ГЭРБ на возможное прогрессирование НАЖБП и СОАС.

Gastroesophageal reflux disease (GERD), non-alcoholic fatty liver disease (NAFLD) and obstructive sleep apnea syndrome (OSAS) are common diseases associated with obesity, abdominal obesity and metabolic syndrome. Each of the diseases has a negative effect on other organ systems, causing cardiovascular morbidity and mortality. Due to the commonality of etiopathogenetic mechanisms, the interrelationships of GERD, NAFLD, and OSAS are of research interest. Most of the work done on this issue demonstrates a relationship between them, independent of body mass index, waist circumference, lipid and carbohydrate metabolism. At the same time, NAFLD is considered as an independent predictor of symptoms of GERD and erosive esophagitis.  OSAS is signifi cantly associated with an increased risk of hepatic steatosis, its progression to steatohepatitis and liver fibrosis. GERD is associated with a more severe form of OSAS, and OSAS is associated with the development of Barrett’s esophagus and adenocarcinoma of the esophagus. Meanwhile, the numerous publications available in modern literature are controversial. The issues of combining GERD, NAFLD and OSAS from the standpoint of mutual causality and / or the impact of common risk factors have not been fully resolved. Some aspects of the influence of GERD on the possible progression of NAFLD and OSAS remain unclear.

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