Table 2

Quantified risk ratios and physiological mechanisms of selected gastrointestinal diseases associated with obesity in adults

Gastrointestinal diseaseObesity as a risk factorPhysiological mechanism by which obesity is associated with gastrointestinal disease
Risk expressed as OR or RR95% CI
Oesophagus
Gastro-oesophageal reflux diseaseOR, 1.941.46–2.57↑ intra-abdominal pressure, ↓ Oesophageal pressure.
↑ Oestrogen
Erosive oesophagitisOR, 1.871.51–2.31Abdominal adiposity
Barrett’s oesophagusOR, 4.01.4–11.1Abdominal adiposity,
↓ Adiponectin, ↑Leptin
Oesophageal adenocarcinomaMen: OR, 2.41.9–3.2Abdominal adiposity, ↓ Adiponectin,
Women: OR, 2.11.4–3.2↑ Leptin, Insulin-like growth factor
RR, 4.83.0–7.7
Stomach
GastritisOR, 2.231.59–3.11↓ Adiponectin
Gastric cancerOR, 1.551.31–1.84Proinflammatory, adipokines, Insulin-like growth factor
RR (Cardia), 1.81.3–2.5
Hepatobiliary
Non-alcoholic fatty liver diseaseRR, 4.62.5–11.0Abdominal obesity, ↑ serum free fatty acids, ↑ hepatic triglycerides, hepatic de novo lipogenesis
Liver cirrhosisRR, 4.11.4–11.4Non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, proinflammatory
Hepatocellular carcinomaRR, 1.81.6–2.1Non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, proinflammatory
Gallstone disease (gallstones, cholecystitis)Men: RR 2.512.16–2.91Abdominal obesity, ↑ Insulin, ↑ leptin, ↑ lipids, insulin resistance, dysmotility
Women: RR, 2.321.17–4.57
Gallbladder cancerRR, 1.31.2–1.4↑ risk of gallstones, chronic inflammation
Pancreas
Acute pancreatitisRR, 2.201.82–2.66Hyperlipidaemia, chronic inflammation
Pancreatic cancerMen: RR, 1.101.04–1.22Insulin-like growth factor binding protein-1
Women: RR, 1.131.05–1.18
RR, 1.51.2–1.8
Intestinal
DiarrhoeaOR, 2.71.10–6.8↑ Bile acids, accelerated colonic transit,
Diverticular diseaseRR, 1.781.08–2.94Chronic inflammation, alteration in gut microbiota
PolypsOR, 1.441.23–1.70Chronic inflammation
Colorectal cancerMen: RR, 1.951.59–2.39Chronic inflammation, ↑ adipokines, bile acids, insulin resistance, gut microbiota
Women: RR, 1.151.06–1.24
RR, 1.31.3–1.4
  • Adapted from Camilleri et al. 7

  • CI, confidence interval; OR, odds ratio; RR, relative risk.