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Review
. 2024 Feb 18;21(2):237.
doi: 10.3390/ijerph21020237.

The Association between Functional Dyspepsia and Metabolic Syndrome-The State of the Art

Mile Volarić  1   2 , Dunja Šojat  1 , Ljiljana Trtica Majnarić  1 , Domagoj Vučić  3
Affiliations
Review

The Association between Functional Dyspepsia and Metabolic Syndrome-The State of the Art

Mile Volarić et al. Int J Environ Res Public Health. .

Abstract

Functional dyspepsia is a common functional disorder of the gastrointestinal tract that is responsible for many primary care visits. No organic changes have been found to explain its symptoms. We hypothesize that modern lifestyles and environmental factors, especially psychological stress, play a crucial role in the high prevalence of functional dyspepsia and metabolic syndrome. While gastrointestinal tract diseases are rarely linked to metabolic disorders, chronic stress, obesity-related metabolic syndrome, chronic inflammation, intestinal dysbiosis, and functional dyspepsia have significant pathophysiological associations. Functional dyspepsia, often associated with anxiety and chronic psychological stress, can activate the neuroendocrine stress axis and immune system, leading to unhealthy habits that contribute to obesity. Additionally, intestinal dysbiosis, which is commonly present in functional dyspepsia, can exacerbate systemic inflammation and obesity, further promoting metabolic syndrome-related disorders. It is worth noting that the reverse is also true: obesity-related metabolic syndrome can worsen functional dyspepsia and its associated symptoms by triggering systemic inflammation and intestinal dysbiosis, as well as negative emotions (depression) through the brain-gut axis. To understand the pathophysiology and deliver an effective treatment strategy for these two difficult-to-cure disorders, which are challenging for both caregivers and patients, a psychosocial paradigm is essential.

Keywords: feeding behavior; gastrointestinal diseases; gastrointestinal microbiome; metabolic syndrome; psychological; stress.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The interaction between metabolic syndrome and functional dyspepsia involving the gut–brain axis; HPA—the hypothalamic–pituitary–adrenal axis; ANS—the autonomic nervous system; ENS—the enteric nervous system.
Figure 2
Figure 2
Crosstalk between obesity/metabolic syndrome and functional dyspepsia (FD).
Figure 3
Figure 3
Chronic psychological stress as the common denominator of metabolic syndrome and functional dyspepsia.
See this image and copyright information in PMC

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