Internal Medicine, G. D'Annunzio University Foundation, Chieti, Italy.
Curr Med Chem. 2012;19(34):5837-53. doi: 10.2174/092986712804143349.
Visceral obesity is characterized by increased risk of cardiovascular disease as well as higher incidence of malignancies, including colorectal cancer (CRC), although the mechanisms linking excess adiposity with cancer are only partly characterized. Visceral obesity is currently acknowledged as a chronic inflammatory disorder and a growing body of evidence demonstrates the interconnections between obesity-related secretion pattern of adipo/cytokines and CRC. Specific molecules derived from the visceral adipose tissue (VAT), including adiponectin, leptin and resistin, are able to establish a positive feedback loop, thus increasing the proinflammatory and insulin resistant state and promoting tumorigenesis. Interestingly, these molecules have emerged as novel prognostic factors and therapeutic targets. This review will focus on current molecular and clinical evidence linking VAT-related inflammation to CRC initiation and progression, and summarize the role of dietary factors and lifestyle interventions aimed at promoting weight control and physical activity on CRC prevention and prognosis.
内脏型肥胖的特点是心血管疾病风险增加,以及包括结直肠癌(CRC)在内的恶性肿瘤发病率更高,尽管将肥胖与癌症联系起来的机制仅部分得到了描述。目前,内脏型肥胖被认为是一种慢性炎症性疾病,越来越多的证据表明肥胖相关的脂肪/细胞因子分泌模式与 CRC 之间存在关联。源自内脏脂肪组织(VAT)的特定分子,包括脂联素、瘦素和抵抗素,能够建立正反馈回路,从而增加促炎和胰岛素抵抗状态,并促进肿瘤发生。有趣的是,这些分子已成为新的预后因素和治疗靶点。这篇综述将重点关注目前将 VAT 相关炎症与 CRC 发生和进展联系起来的分子和临床证据,并总结饮食因素和生活方式干预在促进体重控制和体力活动以预防和改善 CRC 预后方面的作用。