Department of Internal Medicine, 1st Faculty of Medicine, Charles University, Military University Hospital in Prague, Czech Republic.
Physiol Res. 2021 Aug 31;70(4):509-522. doi: 10.33549/physiolres.934631. Epub 2021 Jun 1.
A substantial body of literature has provided evidence that type 2 diabetes mellitus (T2DM) and colorectal neoplasia share several common factors. Both diseases are among the leading causes of death worldwide and have an increasing incidence. In addition to usual risk factors such as sedentary lifestyle, obesity, and family history, common pathophysiological mechanisms involved in the development of these diseases have been identified. These include changes in glucose metabolism associated with adipose tissue dysfunction including insulin resistance resulting to hyperinsulinemia and chronic hyperglycemia. In addition to altered glucose metabolism, abdominal obesity has been associated with accented carcinogenesis with chronic subclinical inflammation. An increasing number of studies have recently described the role of the gut microbiota in metabolic diseases including T2DM and the development of colorectal cancer (CRC). Due to the interconnectedness of different pathophysiological processes, it is not entirely clear which factor is crucial in the development of carcinogenesis in patients with T2DM. The aim of this work is to review the current knowledge on the pathophysiological mechanisms of colorectal neoplasia development in individuals with T2DM. Here, we review the potential pathophysiological processes involved in the onset and progression of colorectal neoplasia in patients with T2DM. Uncovering common pathophysiological characteristics is essential for understanding the nature of these diseases and may lead to effective treatment and prevention.
大量文献提供的证据表明,2 型糖尿病(T2DM)和结直肠肿瘤具有一些共同的因素。这两种疾病均是全球主要致死病因之一,且发病率呈上升趋势。除了久坐不动的生活方式、肥胖和家族史等常见的危险因素外,还确定了这些疾病发展过程中涉及的一些常见的病理生理机制。这些机制包括与脂肪组织功能障碍相关的葡萄糖代谢改变,包括导致高胰岛素血症和慢性高血糖的胰岛素抵抗。除了葡萄糖代谢改变外,腹型肥胖与慢性亚临床炎症引起的促癌作用有关。最近越来越多的研究描述了肠道微生物群在包括 T2DM 和结直肠癌(CRC)在内的代谢性疾病中的作用。由于不同病理生理过程的相互关联性,尚不完全清楚在 T2DM 患者的癌变发展过程中哪个因素是至关重要的。本研究旨在综述 T2DM 患者结直肠肿瘤发生发展的病理生理机制的现有知识。在这里,我们回顾了 T2DM 患者结直肠肿瘤发生和进展中涉及的潜在病理生理过程。揭示共同的病理生理特征对于理解这些疾病的本质至关重要,并且可能会导致有效的治疗和预防。