Joshi Rakhi Kumari, Lee Sang-Ah
Department of Preventive Medicine, Kangwon National University School of Medicine, Chuncheon-si, Gangwon-do, South Korea E-mail :
Asian Pac J Cancer Prev. 2014;15(1):397-405. doi: 10.7314/apjcp.2014.15.1.397.
Obesity has been considered as an important risk factor for the development of colorectal cancer (CRC), but the association has not been fully elucidated. Obesity is linked significantly to adipose tissue dysfunction and to alteration of adipokines in blood; in particular, obesity-induced inflammation is thought to be an important link between obesity and colorectal cancer. Based on epidemiological studies, we undertook a systematic review to understand the association of circulating levels of selected adipokines, including adiponectin, leptin, resistin, IL-6 and TNF-α, with the level of CRC risk. Most prospective studies suggested protective effects of adiponectin, but these were attenuated by body mass index (BMI) and waist circumference (WC) data in our meta-analysis. On the other hand, meta-analyses for leptin and CRC did not demonstrate any association, similar to the results of systematic review. Although it proved difficult to determine whether other selected adipokines (resistin, IL-6 and TNF-α) were related to CRC risk due to small number of reports, the present systematic review suggested a positive association with elevated resistin levels but null associations with IL-6 and TNF-α.
肥胖被认为是结直肠癌(CRC)发生发展的重要危险因素,但这种关联尚未完全阐明。肥胖与脂肪组织功能障碍以及血液中脂肪因子的改变密切相关;特别是,肥胖诱导的炎症被认为是肥胖与结直肠癌之间的重要联系。基于流行病学研究,我们进行了一项系统综述,以了解包括脂联素、瘦素、抵抗素、白细胞介素-6和肿瘤坏死因子-α在内的选定脂肪因子的循环水平与结直肠癌风险水平之间的关联。大多数前瞻性研究表明脂联素有保护作用,但在我们的荟萃分析中,这些作用因体重指数(BMI)和腰围(WC)数据而减弱。另一方面,瘦素与结直肠癌的荟萃分析未显示任何关联,这与系统综述的结果相似。尽管由于报告数量较少,难以确定其他选定的脂肪因子(抵抗素、白细胞介素-6和肿瘤坏死因子-α)是否与结直肠癌风险相关,但本系统综述表明抵抗素水平升高呈正相关,而与白细胞介素-6和肿瘤坏死因子-α无关联。