高血糖相关的代谢和分子改变在癌症风险、进展、治疗及死亡率中的作用

Hyperglycemia Associated Metabolic and Molecular Alterations in Cancer Risk, Progression, Treatment, and Mortality.

作者信息

Ramteke Pranay, Deb Ankita, Shepal Varsha, Bhat Manoj Kumar

机构信息

National Centre for Cell Science, Savitribai Phule Pune University, Ganeshkhind, Pune-411 007, India.

出版信息

Cancers (Basel). 2019 Sep 19;11(9):1402. doi: 10.3390/cancers11091402.

Abstract

Cancer and diabetes are amongst the leading causes of deaths worldwide. There is an alarming rise in cancer incidences and mortality, with approximately 18.1 million new cases and 9.6 million deaths in 2018. A major contributory but neglected factor for risk of neoplastic transformation is hyperglycemia. Epidemiologically too, lifestyle patterns resulting in high blood glucose level, with or without the role of insulin, are more often correlated with cancer risk, progression, and mortality. The two conditions recurrently exist in comorbidity, and their interplay has rendered treatment regimens more challenging by restricting the choice of drugs, affecting surgical consequences, and having associated fatal complications. Limited comprehensive literature is available on their correlation, and a lack of clarity in understanding in such comorbid conditions contributes to higher mortality rates. Hence, a critical analysis of the elements responsible for enhanced mortality due to hyperglycemia-cancer concomitance is warranted. Given the lifestyle changes in the human population, increasing metabolic disorders, and glucose addiction of cancer cells, hyperglycemia related complications in cancer underline the necessity for further in-depth investigations. This review, therefore, attempts to shed light upon hyperglycemia associated factors in the risk, progression, mortality, and treatment of cancer to highlight important mechanisms and potential therapeutic targets.

摘要

癌症和糖尿病是全球主要的死亡原因。癌症的发病率和死亡率惊人地上升,2018年约有1810万新病例和960万人死亡。高血糖是肿瘤转化风险的一个主要促成因素,但却被忽视了。在流行病学上,导致血糖水平升高的生活方式模式,无论有无胰岛素的作用,都更常与癌症风险、进展和死亡率相关。这两种疾病经常合并存在,它们之间的相互作用通过限制药物选择、影响手术结果以及产生相关的致命并发症,使治疗方案更具挑战性。关于它们之间相关性的综合文献有限,对这种合并症的理解缺乏清晰度导致了更高的死亡率。因此,有必要对高血糖 - 癌症伴发导致死亡率增加的因素进行批判性分析。鉴于人类生活方式的改变、代谢紊乱的增加以及癌细胞对葡萄糖的依赖,癌症中与高血糖相关的并发症凸显了进一步深入研究的必要性。因此,本综述试图阐明癌症风险、进展、死亡率和治疗中与高血糖相关的因素,以突出重要机制和潜在的治疗靶点。

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