Adipositas - Ursachen, Folgeerkrankungen, Therapie 2014; 08(03): 151-156
DOI: 10.1055/s-0037-1618849
Übersichtsarbeit
Schattauer GmbH

Adipositas und Krebs

Obesity and risk of cancer
K. Nimptsch
1   Max-Delbrück-Centrum für Molekulare Medizin (MDC) Berlin-Buch, Arbeitsgruppe Molekulare Epidemiologie
,
T. Pischon
1   Max-Delbrück-Centrum für Molekulare Medizin (MDC) Berlin-Buch, Arbeitsgruppe Molekulare Epidemiologie
› Author Affiliations
Further Information

Publication History

Publication Date:
21 December 2017 (online)

Zusammenfassung

Wachsende wissenschaftliche Evidenz zeigt einen Zusammenhang von Übergewicht und Adipositas mit dem Krebsrisiko auf. Bisher besteht überzeugende Evidenz dafür, dass Adipositas das Risiko für kolorektale Karzinome, postmenopausale Mammakarzinome, Endometriumkarzinome, Nierenzellkarzinome, Adenokarzinome der Speiseröhre sowie Pankreaskarzinome erhöht. Dabei steigt das Erkrankungsrisiko pro Zunahme des Body-Mass-Index um 5 kg/m2 zwischen 12 % und 51 % an. Neben der allgemeinen übt die abdominelle Adipositas einen zusätzlichen risikoerhöhenden Effekt bei Adenokarzinomen des Ösophagus und kolorektalen Karzinomen aus. Adipositas ist auch mit einem höheren Risiko für Karzinome der Leber und des Ovars assoziiert, wenngleich die Datenlage hier weniger umfangreich ist. Die Mechanismen, die diese Zusammenhänge erklären könnten, sind nicht eindeutig geklärt und unterscheiden sich je nach Krebsentität. Zu den wichtigsten möglichen erklärenden Mechanismen gehören Komponenten des metabolischen Syndroms, insbesondere Insulinresistenz und die daraus folgende Hyperinsulinämie, chronisch entzündliche Veränderungen, Steroidhormone sowie vom Fettgewebe sezernierte Zytokine, wie Leptin und Adiponectin.

Summary

There is growing scientific evidence that overweight and obesity are associated with increased risk of cancer. So far, there is convincing evidence from epidemiological studies that obesity is associated with a higher risk of colorectal cancer, postmenopausal breast cancer, endometrial cancer, renal cell cancer, esophageal adenocarcinoma and pancreatic cancer. A 5 unit increase in body mass index is associated with a 12 % to 51 % higher risk. Abdominal obesity is associated with esophageal adenocarcinoma and colorectal cancer beyond body mass index. Obesity has also been associated with a higher risk of liver and ovarian cancer, although supporting data is less abundant. The mechanisms underlying the positive association between obesity and risk of certain cancers have not been fully elucidated and differ by cancer site. Among the most important potential mechanisms are components of the metabolic syndrome, in particular insulin resistance and hyperinsulinemia, chronic inflammatory processes, sex steroid hormones as well as cytokines secreted by adipose tissue, including leptin and adiponectin.

 
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