MD Program, Weill Cornell Medicine, New York, New York.
Weill Cornell Medicine, New York, New York.
Cancer Prev Res (Phila). 2021 May;14(5):509-520. doi: 10.1158/1940-6207.CAPR-20-0633. Epub 2021 Feb 9.
Obesity represents one of the most significant public health challenges worldwide. Current clinical practice relies on body mass index (BMI) to define the obesity status of an individual, even though the index has long been recognized for its limitations as a measure of body fat. In normal BMI individuals, increased central adiposity has been associated with worse health outcomes, including increased risks of cardiovascular disease and metabolic disorders. The condition leading to these outcomes has been described as metabolic obesity in the normal weight (MONW). More recent evidence suggests that MONW is associated with increased risk of several obesity-related malignancies, including postmenopausal breast, endometrial, colorectal, and liver cancers. In MONW patients, the false reassurance of a normal range BMI can lead to lost opportunities for implementing preventive interventions that may benefit a substantial number of people. A growing body of literature has documented the increased risk profile of MONW individuals and demonstrated practical uses for body composition and biochemical analyses to identify this at-risk population. In this review, we survey the current literature on MONW and cancer, summarize pathophysiology and oncogenic mechanisms, highlight potential strategies for diagnosis and treatment, and suggest directions for future research.
肥胖是全球面临的最重大的公共健康挑战之一。目前的临床实践依赖于身体质量指数（BMI）来定义个体的肥胖状况，尽管该指数早已因其作为体脂测量方法的局限性而备受关注。在 BMI 正常的人群中，中心性肥胖的增加与更差的健康结果相关，包括心血管疾病和代谢紊乱风险的增加。导致这些结果的情况在正常体重的代谢性肥胖（MONW）中已有描述。最近的证据表明，MONW 与几种与肥胖相关的恶性肿瘤的风险增加有关，包括绝经后乳腺癌、子宫内膜癌、结直肠癌和肝癌。在 MONW 患者中，BMI 正常范围的虚假保证可能会错失实施预防干预的机会，而这些干预可能使相当数量的人受益。越来越多的文献记录了 MONW 个体的风险增加情况，并证明了身体成分和生化分析在识别这一高危人群方面的实际用途。在这篇综述中，我们调查了关于 MONW 和癌症的现有文献，总结了病理生理学和致癌机制，强调了诊断和治疗的潜在策略，并提出了未来研究的方向。
