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肥胖女性的代谢失调与妇科肿瘤的发生:综述。

Metabolic dysregulation in obese women and the carcinogenesis of gynecological tumors: A review.

机构信息

University of Novi Sad, Faculty of Medicine in Novi Sad, Novi Sad, Serbia; Diabetes and Metabolic Disorders, Clinic for Endocrinology, Clinical Center of Vojvodina, Novi Sad, Serbia.

University of Novi Sad, Faculty of Medicine in Novi Sad, Novi Sad, Serbia; Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia.

出版信息

Biomol Biomed. 2024 May 19;24(4):787-797. doi: 10.17305/bb.2024.10508.

Abstract

Obesity is a significant health issue associated with increased cancer risks, including gynecological malignancies. The worldwide rise in obesity rates is significantly impacting both cancer development and treatment outcomes. Adipose tissue plays a crucial role in metabolism, secreting various substances that can influence cancer formation. In obese individuals, dysfunctional adipose tissue can contribute to cancer development through inflammation, insulin resistance, hormonal changes, and abnormal cholesterol metabolism. Studies have shown a strong correlation between obesity and gynecological cancers, particularly endometrial and breast cancers. Obesity not only increases the risk of developing these cancers but is also associated with poorer outcomes. Additionally, obesity affects the perioperative management of gynecological cancers, requiring specialized care due to increased complications and resistance to therapy. Treatment strategies for managing metabolic dysregulation in patients with gynecological cancers include weight management, statin therapy, and insulin-sensitizing medications. Emerging studies suggest that interventions like intermittent fasting and caloric restriction may enhance the effectiveness of cancer treatments. Furthermore, targeting cholesterol metabolism, such as with statins or proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, shows potential in cancer therapy. In conclusion, addressing metabolic issues, particularly obesity, is crucial in preventing and treating gynecological malignancies. Personalized approaches focusing on weight management and metabolic reprogramming may improve outcomes in these patients.

摘要

肥胖是一个与癌症风险增加相关的重大健康问题,包括妇科恶性肿瘤。全球肥胖率的上升对癌症的发展和治疗结果都有重大影响。脂肪组织在代谢中起着至关重要的作用,分泌各种物质,这些物质可以影响癌症的形成。在肥胖个体中,功能失调的脂肪组织可通过炎症、胰岛素抵抗、激素变化和异常胆固醇代谢促进癌症的发展。研究表明肥胖与妇科癌症之间存在很强的相关性,尤其是子宫内膜癌和乳腺癌。肥胖不仅增加了这些癌症的发病风险,还与较差的预后相关。此外,肥胖还影响妇科癌症的围手术期管理,由于并发症增加和对治疗的抵抗力,需要特殊的护理。管理妇科癌症患者代谢失调的治疗策略包括体重管理、他汀类药物治疗和胰岛素增敏药物。新出现的研究表明,间歇性禁食和热量限制等干预措施可能会增强癌症治疗的效果。此外,靶向胆固醇代谢,如使用他汀类药物或前蛋白转化酶枯草溶菌素 9(PCSK9)抑制剂,在癌症治疗中显示出潜力。总之,解决代谢问题,特别是肥胖问题,对于预防和治疗妇科恶性肿瘤至关重要。针对体重管理和代谢重编程的个性化方法可能会改善这些患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d28d/11293241/246201f954f5/bb-2024-10508f1.jpg

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