Adipositas erhöht nicht nur das Risiko für Typ-2-Diabetes und Herz-Kreislauf-Komplikationen,
auch Tumorerkrankungen sind eine mögliche Folge von Adipositas. Adipositas ist mit
einem erhöhten Risiko assoziiert, an bestimmten Krebsarten zu erkranken, wobei das
Krebsspektrum geschlechtsspezifische Unterschiede aufweist. Die Tatsache, dass in
Deutschland zwei Drittel der Männer und die Hälfte der Frauen adipös sind, unterstreicht
die gesundheitspolitische, ökonomische und gesellschaftliche Relevanz des Volksleidens
Adipositas.
Abstract
The incidence of obesity in the western world has grown dramatically during the recent
decades. Epidemiological data suggest that obesity is associated with an increased
risk of several, but not all types of cancer, with marked gender-specific differences.
The underlying mechanisms are still a matter of debate. This review focuses on the
potential factors linking obesity to cancer. Current experimental evidence suggests
that insulin resistance and a chronic, subclinical inflammation in the visceral fat
are the major metabolic events causing alterations in the levels of insulin, glucose,
free fatty acids, insulin-like growth factors, adipose tissue-derived proinflammatory
cytokines and other bioactive molecules such as adipokines, vascular endothelial growth
factor (VEGF), sex hormones, gut microbiota, and secondary bile acids. All these factors
may act directly or indirectly on the tumor microenvironment to drive tumor progression
via stimulation of cell survival/antiapoptosis, cell proliferation, angiogenesis,
and invasion/metastasis of the cancer cells. A therapeutic strategy that targets dysfunctional
and/or inflamed fat and that has been shown to benefit patients is mainly represented
by bariatric surgery, while other cell or hormone-directed interventions such as the
pharmacological modulation of serum adipokine levels are still theoretical and need
to be evaluated for their ability to successfully treat or prevent obesity-related
cancers.
Schlüsselwörter
Krebs - Adipositas - Entzündung - Adipokine - viszerales Fettgewebe
Keywords
cancer - obesity - inflammation - adipokines - visceral fat
