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肥胖与结直肠癌:一篇叙述性综述。

Obesity and Colorectal Cancer: A Narrative Review.

机构信息

Department of Surgery, Instituto de Assistência Médica ao Servidor Público Estadual-IAMSPE, Sao Paulo 04029-000, SP, Brazil.

Department of Surgery, Faculdade de Medicina do ABC-FMABC, Santo Andre 09060-870, SP, Brazil.

出版信息

Medicina (Kaunas). 2024 Jul 27;60(8):1218. doi: 10.3390/medicina60081218.

Abstract

: Cancer is a multicausal disease, and environmental, cultural, socioeconomic, lifestyle, and genetic factors can influence the risk of developing cancer. Colorectal cancer (CRC) stands as the third most common cancer globally. Some countries have observed a rise in the incidence of CRC, especially among young people. This increase is associated with lifestyle changes over the last few decades, including changes in diet patterns, a sedentary lifestyle, and obesity. Currently, obesity and overweight account for approximately 39% of the world's population and increase the risk of overall mortality of certain cancer types. This study aims to conduct a literature review examining the association between obesity and CRC. : This narrative review explored the pathophysiological mechanisms, treatment strategies, and challenges related to obesity and CRC. : Several studies have established a clear causal relationship between obesity and CRC, showing that individuals with morbid obesity are at a higher risk of developing colorectal cancer. The adipose tissue, particularly the visceral, secretes proinflammatory cytokines, such as TNF-alpha, interleukin-6, and C-reactive protein. Chronic inflammation is closely linked to cancer initiation and progression, with a complex interplay of molecular mechanisms underlying this association. Obesity can complicate the treatment of CRC due to several factors, reducing the therapeutic effectiveness and increasing the risk for adverse events during treatment. Dietary modification, calorie restriction, and other types of weight-control strategies can reduce the risk of CRC development and improve treatment outcomes. : Obesity is intricately linked to CRC development and progression, making it a crucial target for intervention, whether through diet therapy, physical exercises, medical therapy, or bariatric surgery.

摘要

癌症是一种多因素疾病,环境、文化、社会经济、生活方式和遗传因素都可能影响癌症的发病风险。结直肠癌(CRC)是全球第三大常见癌症。一些国家观察到 CRC 的发病率上升,尤其是在年轻人中。这种增加与过去几十年生活方式的改变有关,包括饮食模式、久坐的生活方式和肥胖的改变。目前,肥胖和超重约占世界人口的 39%,增加了某些癌症类型的总体死亡率风险。本研究旨在对肥胖与 CRC 之间的关系进行文献综述。

本叙述性综述探讨了肥胖与 CRC 之间的病理生理机制、治疗策略和相关挑战。

多项研究已经确立了肥胖与 CRC 之间的明确因果关系,表明病态肥胖的个体发生结直肠癌的风险更高。脂肪组织,特别是内脏,会分泌促炎细胞因子,如 TNF-α、白细胞介素-6 和 C 反应蛋白。慢性炎症与癌症的发生和进展密切相关,其关联的分子机制非常复杂。肥胖会因多种因素使 CRC 的治疗变得复杂,降低治疗效果,并增加治疗过程中发生不良事件的风险。饮食改变、热量限制和其他类型的体重控制策略可以降低 CRC 发生的风险,并改善治疗结果。

肥胖与 CRC 的发生和发展密切相关,因此肥胖是干预的关键目标,无论是通过饮食疗法、体育锻炼、医学治疗还是减肥手术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bc2/11355959/6edf481b111a/medicina-60-01218-g001.jpg

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