Renehan Andrew G, Frystyk Jan, Flyvbjerg Allan
Department of Surgery, Christie Hospital NHS Trust, Wilmslow Road, Manchester M20 4BX, UK.
Trends Endocrinol Metab. 2006 Oct;17(8):328-36. doi: 10.1016/j.tem.2006.08.006. Epub 2006 Sep 7.
Accumulating epidemiological evidence shows that being either overweight or obese, in other words having excess body weight (EBW), is associated with an increased risk of several, common, adult cancers. The molecular mechanisms that underlie these associations are not understood fully, but insulin resistance is likely to be important. The insulin-cancer hypothesis postulates that chronic hyperinsulinemia is associated with decreased concentrations of insulin-like growth factor binding protein1 (IGFBP-1) and IGFBP-2, leading to increased availability of IGF-I and concomitant changes in the cellular environment that favor tumor formation. However, the situation is likely to be more complex because hyperinsulinemia is also associated with alterations in related molecular systems (e.g. sex steroids and adipocytokines). As the prevalence of EBW increases to epidemic proportions, untangling the links between EBW and the insulin-IGF axis and its wider molecular interactions will become increasingly important in the development of preventive strategies.
越来越多的流行病学证据表明，超重或肥胖，即体重超标（EBW），与几种常见的成人癌症风险增加有关。这些关联背后的分子机制尚未完全明确，但胰岛素抵抗可能起重要作用。胰岛素-癌症假说假定，慢性高胰岛素血症与胰岛素样生长因子结合蛋白1（IGFBP-1）和IGFBP-2浓度降低有关，导致IGF-I的可用性增加以及有利于肿瘤形成的细胞环境随之改变。然而，情况可能更为复杂，因为高胰岛素血症还与相关分子系统（如性激素和脂肪细胞因子）的改变有关。随着EBW的患病率上升到流行程度，理清EBW与胰岛素-IGF轴及其更广泛分子相互作用之间的联系，在预防策略的制定中将变得越来越重要。
