Faculty of Medicine, University of Nottingham, UK.
J Gastroenterol Hepatol. 2013 Dec;28 Suppl 4:54-8. doi: 10.1111/jgh.12293.
Obesity is major health problem in the Asia-Pacific region. The proportion of people who are overweight and obese in the region has increased dramatically and is closely linked to the increasing affluence in the region. While the body mass index has been used as a yardstick in many published studies, it has been noted that Asian patients have a greater percentage body fat for a given body mass index and especially abdominal or visceral obesity. The association of obesity and cancers is intriguing and worrisome at the same time, as obesity is rising exponentially throughout the world especially in the Asia-Pacific region. Evidence of its association with gastrointestinal cancers is well documented and is reported with cardioesophageal, colorectal, liver, pancreatic, and gallbladder cancers. The strength of association varies between individual cancers but is of particular concern with colorectal cancer, which is perhaps the fastest emerging cancer in this region. Biological mechanisms for obesity-related carcinogenesis have been described, which includes insulin resistance and secretion of adipokines and chronic inflammation. A "dose-response" relationship between severity of excess body weight and risks of cancer has been reported. However, there is a paucity of data looking at a decrease in incidence of these cancers with a decrease in body weight with treatment, for example, bariatric surgery. Such studies will be difficult to perform and which would require a long period of longitudinal follow-up.
肥胖是亚太地区的一个主要健康问题。该地区超重和肥胖人群的比例显著增加，这与该地区日益富裕密切相关。虽然体重指数已被许多已发表的研究用作标准，但人们注意到，亚洲患者的体脂百分比对于给定的体重指数更高，尤其是腹部或内脏肥胖。肥胖与癌症的关联既有趣又令人担忧，因为肥胖在全球范围内呈指数级增长，尤其是在亚太地区。肥胖与胃肠道癌症的关联已有充分的证据，并与食道癌、结直肠癌、肝癌、胰腺癌和胆囊癌有关。关联的强度因个别癌症而异，但与结直肠癌尤其相关，结直肠癌可能是该地区发展最快的癌症。已经描述了肥胖相关致癌作用的生物学机制，其中包括胰岛素抵抗和脂肪因子的分泌以及慢性炎症。据报道，超重程度与癌症风险之间存在“剂量反应”关系。然而，关于随着体重减轻，例如通过减肥手术，这些癌症的发病率降低的数据很少。这样的研究将很难进行，并且需要进行长期的纵向随访。
