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[肥胖与结直肠癌]

[Obesity and colorectal cancer].

作者信息

Na Soo-Young, Myung Seung-Jae

机构信息

Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Korean J Gastroenterol. 2012 Jan;59(1):16-26. doi: 10.4166/kjg.2012.59.1.16.

Abstract

Obesity worldwide is constantly increasing. Obesity acts as an independent significant risk factor for malignant tumors of various organs including colorectal cancer. Visceral adipose tissue is physiologically more important than subcutaneous adipose tissue. The relative risk of colorectal cancer of obese patients is about 1.5 times higher than the normal-weight individuals, and obesity is also associated with premalignant colorectal adenoma. The colorectal cancer incidence of obese patients has gender-specific and site-specific characteristics that it is higher in men than women and in the colon than rectum. Obesity acts as a risk factor of colorectal carcinogenesis by several mechanisms. Isulin, insulin-like growth factor, leptin, adiponectin, microbiome, and cytokines of chronic inflammation etc. have been understood as its potential mechanisms. In addition, obesity in patients with colorectal cancer negatively affects the disease progression and response of chemotherapy. Although the evidence is not clear yet, there are some reports that weight loss as well as life-modification such as dietary change and physical activity can reduce the risk of colorectal cancer. It is very important knowledge in the point that obesity is a potentially modifiable risk factor that can alter the incidence and outcome of the colorectal cancer.

摘要

全球肥胖率持续上升。肥胖是包括结直肠癌在内的各种器官恶性肿瘤的独立重要危险因素。内脏脂肪组织在生理上比皮下脂肪组织更重要。肥胖患者患结直肠癌的相对风险比正常体重者高约1.5倍,肥胖还与结直肠癌前腺瘤有关。肥胖患者的结直肠癌发病率具有性别特异性和部位特异性特征,即男性高于女性,结肠高于直肠。肥胖通过多种机制成为结直肠癌发生的危险因素。胰岛素、胰岛素样生长因子、瘦素、脂联素、微生物群以及慢性炎症细胞因子等已被视为其潜在机制。此外,结直肠癌患者的肥胖会对疾病进展和化疗反应产生负面影响。尽管证据尚不明确,但有一些报告表明,减肥以及饮食改变和体育活动等生活方式的改变可以降低患结直肠癌的风险。肥胖是一个潜在的可改变的危险因素,可改变结直肠癌的发病率和预后,这是非常重要的知识。

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