Scappaticcio Lorenzo, Maiorino Maria Ida, Bellastella Giuseppe, Giugliano Dario, Esposito Katherine
Division of Endocrinology and Metabolic Diseases, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, University of Campania "L. Vanvitelli", Piazza L. Miraglia n° 2, 80138, Naples, Italy.
Diabetes Unit, Department of Medical, Surgical, Neurological, Metabolic Sciences and Aging, University of Campania "L. Vanvitelli", Piazza L. Miraglia n° 2, 80138, Naples, Italy.
Endocrine. 2017 May;56(2):231-239. doi: 10.1007/s12020-016-1216-y. Epub 2016 Dec 31.
Diabetes mellitus and cancer are two growing health problems. They have in common many modifiable risk factors including sex, age, obesity, physical activity, diet, alcohol, and smoking, and have a long latency before overtly manifesting. Patients with diabetes experience a roughly 20-25% higher cancer incidence compared to individuals without diabetes, and it depends on cancer site. Moreover, patients with diabetes who further develop cancer have increased early and late mortality in comparison with cancer patients without diabetes. Prediabetes and metabolic syndrome are also related to an increased risk of developing and die from cancer. Possible mechanisms linking diabetes and prediabetes with cancer include hyperglycemia (endogenous or exogenous), hyperinsulinemia, and alterations of insulin-like growth factor system, chronic subclinical inflammation, abnormalities in sex hormone metabolism, and adipokines. It becomes crucial to define the right orientation of the associations between diabetes and cancer in order to identify the modifiable pathogenic mechanisms. The common soil hypothesis claims that prediabetes and diabetes, as well as metabolic syndrome, may be considered a surrogate sign for dietary risk factors of cancer. The clepsydra of foods may help choose foods associated with healthy benefit while avoiding foods associated with harm, including cancer.
糖尿病和癌症是两个日益严重的健康问题。它们有许多共同的可改变风险因素，包括性别、年龄、肥胖、身体活动、饮食、酒精和吸烟，并且在明显显现之前有很长的潜伏期。与没有糖尿病的个体相比，糖尿病患者的癌症发病率大约高20%-25%，这取决于癌症部位。此外，与没有糖尿病的癌症患者相比，进一步患癌的糖尿病患者的早期和晚期死亡率都有所增加。糖尿病前期和代谢综合征也与患癌风险增加以及死于癌症有关。将糖尿病和糖尿病前期与癌症联系起来的可能机制包括高血糖（内源性或外源性）、高胰岛素血症、胰岛素样生长因子系统的改变、慢性亚临床炎症、性激素代谢异常以及脂肪因子。确定糖尿病和癌症之间关联的正确方向以识别可改变的致病机制变得至关重要。共同土壤假说认为，糖尿病前期和糖尿病以及代谢综合征可能被视为癌症饮食风险因素的替代标志。食物的量杯可能有助于选择有益健康的食物，同时避免有害食物，包括致癌食物。
