Grigor'eva I N, Efimova O V, Suvorova T S, Tov N L
Eksp Klin Gastroenterol. 2014(9):4-10.
THE PURPOSE OF THE REVIEW: Analyze the basic data on the role of obesity in the pathogenesis of pancreatic cancer (PC) and the modern mechanisms of this association.
In the European Union and in Russia incidence of pancreatic diseases increases, such pancreatic cancer (PC) ranks 10th among cancer diseases. Obesity is a risk factor for not only of severe acute pancreatitis, but also PC at that independently of diabetes. In a meta-analysis the PC risk in obese increased by 47%, while the person with a central obesity have a higher PC risk compared to those with a peripheral type of obesity (odds ratio = 1,45, 95% CI: 1,02-2,07), but association between BMI and PC risk in this Japanese population may be different from that in Western populations, sometimes inversely. The link between obesity and PC is explained by insulin resistance and hyperinsulinemia: was proved a direct correlation between the level of circulating C-peptide and PC, low levels of serum adiponektin and leptin increase the PC risk. There are also genetic risk factors for PC: a statistically significant interaction between IVS1-27777C> and IVS1-23525A>T genotypes of the FTO gene with obesity and the PC risk: AA genotype in patients with BMI < 25 kg/m2 reduced PC risk by 22%-28% (p < 0,0001), and with BMI ≥ 25 kg/m2 was associated with 54%-60% increased PC risk (p < 0,0015). Lifestyle factors (smoking, consumption of saturated fats, etc.) increase the PC risk.
综述目的：分析肥胖在胰腺癌（PC）发病机制中的基础数据以及这种关联的现代机制。
在欧盟和俄罗斯，胰腺疾病的发病率在上升，胰腺癌（PC）在癌症疾病中排名第10。肥胖不仅是重症急性胰腺炎的危险因素，也是胰腺癌的危险因素，且与糖尿病无关。在一项荟萃分析中，肥胖者患胰腺癌的风险增加了47%，而中心性肥胖者患胰腺癌的风险高于外周型肥胖者（优势比=1.45，95%可信区间：1.02 - 2.07），但在日本人群中，体重指数（BMI）与胰腺癌风险之间的关联可能与西方人群不同，有时呈负相关。肥胖与胰腺癌之间的联系可通过胰岛素抵抗和高胰岛素血症来解释：已证实循环C肽水平与胰腺癌之间存在直接关联，血清脂联素和瘦素水平低会增加患胰腺癌的风险。胰腺癌也存在遗传风险因素：FTO基因的IVS1 - 27777C>和IVS1 - 23525A>T基因型与肥胖和胰腺癌风险之间存在统计学上的显著相互作用：体重指数（BMI）<25 kg/m²的患者中，AA基因型使患胰腺癌的风险降低22% - 28%（p<0.0001），而BMI≥25 kg/m²时，与患胰腺癌的风险增加54% - 60%相关（p<0.0015）。生活方式因素（吸烟、食用饱和脂肪等）会增加患胰腺癌的风险。
