Nature Reviews:一文读懂肥胖与胃肠道癌症(综述)

过多脂肪是胃肠肿瘤的危险因素,全球胃肠肿瘤的发病和分布与肥胖流行趋势相关,例如结直肠、肝脏、食管腺和胰腺肿瘤;
脂肪组织通过改变胰岛素信号传导、脂肪组织源的炎性介质分泌、性激素代谢等途径介导胃肠肿瘤发生;
肠道菌群、肠道激素和非酒精性脂肪性肝病也可能介导胃肠肿瘤发生;
应用MRI准确测量脂肪、以及大规模高质量的分子流行病学证据、组学技术、孟德尔随机化等,有助于揭示肥胖和胃肠肿瘤的关系。
延伸阅读

Adiposity and gastrointestinal cancers: epidemiology, mechanisms and future directions

肥胖和胃肠道癌症: 流行病学、机制和展望

2018-07-03, Review, 10.1038/s41575-018-0038-1more

Abstract:
Excess adiposity is a risk factor for several cancers of the gastrointestinal system, specifically oesophageal adenocarcinoma and colorectal, small intestine, pancreatic, liver, gallbladder and stomach cancers. With the increasing prevalence of obesity in nearly all regions of the world, this relationship could represent a growing source of cancers of the digestive system. Experimental and molecular epidemiological studies indicate important roles for alterations in insulin signalling, adipose tissue-derived inflammation and sex hormone pathways in mediating the association between adiposity and gastrointestinal cancer. The intestinal microbiome, gut hormones and non alcoholic fatty liver disease (NAFLD) also have possible roles. However, important gaps remain in our knowledge. For instance, our understanding of how adiposity throughout the life course is related to the risk of gastrointestinal cancer development and of how obesity influences gastrointestinal cancer prognosis and survival is limited. Nonetheless, the increasing use of state-of-the-art analytical methods (such as omics technologies, Mendelian randomization and MRI) in large-scale epidemiological studies offers exciting opportunities to advance our understanding of the complex relationship between adiposity and gastrointestinal cancers. Here, we examine the epidemiology of associations between obesity and gastrointestinal cancer, explore potential mechanisms underlying these relationships and highlight important unanswered research questions.

First Authors:
Neil Murphy

Correspondence Authors:
Marc J Gunter

All Authors:
Neil Murphy,Mazda Jenab,Marc J Gunter