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代谢综合征对胃肠道恶性肿瘤发生发展的影响——综述

The Influence of Metabolic Syndrome on the Development of Gastrointestinal Malignant Tumors-A Review.

作者信息

Brzački Vesna, Rančić Andrija, Tešić Rajković Snežana, Nagorni Ivan, Stamenković Marko, Stanković Elena, Milutinović Nikola, Vukadinović Aleksandar

机构信息

Clinic for Gastroenterohepatology, University Clinical Center of Niš, 18000 Niš, Serbia.

Clinic for Abdominal Surgery, University Clinical Center of Niš, 18000 Niš, Serbia.

出版信息

Medicina (Kaunas). 2025 May 31;61(6):1025. doi: 10.3390/medicina61061025.

Abstract

: Metabolic syndrome (MetS) is characterized by a cluster of metabolic abnormalities, including abdominal obesity, hyperglycemia, insulin resistance, dyslipidemia, and hypertension. Growing evidence suggests that these components may contribute to the development of gastrointestinal (GI) malignancies. This review aims to explore the association between MetS and GI cancers, including esophageal, gastric, pancreatic, and colorectal cancers. : A narrative literature review was conducted using PubMed, incorporating 22 sources published between 1991 and 2024. Search terms included "gastrointestinal malignant tumors", "metabolic syndrome", "diabetes mellitus", and "obesity". Priority was given to large-scale studies from Europe, America, and Asia. Case reports, commentaries, and conference abstracts were excluded. : By analyzing the available literature data, this study determined that hyperinsulinemia (IGF-1 pathway), hyperglycemia, and obesity (>102 cm in men and >88 cm in women) are highly associated with the development of esophageal cancer (primarily with Barret's long and short segment as precancerosis), gastric cancer (through reactive oxygen species), and both pancreatic (1.5-2.4 higher risk) and colorectal cancer (30% higher risk). Patients with a high BMI (>40 kg/m) show a 20%- or 1.18-times greater risk of developing colorectal cancer and a 1.72-times higher risk of developing pancreatic cancer. There is not enough evidence on the specific influence of hypertriglyceridemia, low HDL cholesterol, and high blood pressure on the development of gastrointestinal malignancy. However, those three conditions have shown a low to moderate association (from 6% to 12%) with the development of colorectal cancer. : Metabolic syndrome (MetS) is increasingly being recognized as a significant risk factor for the development and progression of gastrointestinal cancers. Key components such as obesity, hyperglycemia, insulin resistance, and type 2 diabetes mellitus appear to contribute to carcinogenesis through mechanisms involving chronic inflammation, oxidative stress, and immune dysregulation. Further research is needed to clarify the biological pathways linking MetS to gastrointestinal malignancies and to inform effective prevention strategies.

摘要

代谢综合征(MetS)的特征是一系列代谢异常,包括腹部肥胖、高血糖、胰岛素抵抗、血脂异常和高血压。越来越多的证据表明,这些因素可能促使胃肠道(GI)恶性肿瘤的发生。本综述旨在探讨代谢综合征与胃肠道癌症之间的关联,包括食管癌、胃癌、胰腺癌和结直肠癌。

使用PubMed进行了叙述性文献综述,纳入了1991年至2024年间发表的22篇文献。检索词包括“胃肠道恶性肿瘤”、“代谢综合征”、“糖尿病”和“肥胖”。优先选择来自欧洲、美洲和亚洲的大规模研究。排除病例报告、评论和会议摘要。

通过分析现有文献数据,本研究确定高胰岛素血症(IGF-1途径)、高血糖和肥胖(男性>102cm,女性>88cm)与食管癌(主要与巴雷特长短段癌前病变相关)、胃癌(通过活性氧)以及胰腺癌(风险高1.5 - 2.4倍)和结直肠癌(风险高30%)的发生高度相关。BMI高(>40kg/m)的患者患结直肠癌的风险高20%或1.18倍,患胰腺癌的风险高1.72倍。关于高甘油三酯血症、低高密度脂蛋白胆固醇和高血压对胃肠道恶性肿瘤发生的具体影响,证据不足。然而,这三种情况与结直肠癌的发生显示出低至中度的关联(6%至12%)。

代谢综合征(MetS)越来越被认为是胃肠道癌症发生和进展的重要危险因素。肥胖、高血糖、胰岛素抵抗和2型糖尿病等关键因素似乎通过涉及慢性炎症、氧化应激和免疫失调的机制促进致癌作用。需要进一步研究以阐明将代谢综合征与胃肠道恶性肿瘤联系起来的生物学途径,并为有效的预防策略提供依据。

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