Energy balance and gastrointestinal cancer: risk, interventions, outcomes and mechanisms.
Energy balance and gastrointestinal cancer: risk, interventions, outcomes and mechanisms.
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能量平衡和胃肠癌：风险，干预措施，结果和机制。
DOI：
10.1038/s41575-018-0053-2
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发表时间：
2018-11
期刊：
影响因子：
--
通讯作者：
Hursting SD
中科院分区：
文献类型：
--
作者：
Ulrich CM;Himbert C;Holowatyj AN;Hursting SD
肥胖会增加多种胃肠道癌症和胰腺癌的风险。相反，体力活动与结肠癌和可能的其他胃肠道恶性肿瘤之间出现了强烈的负相关。减肥干预措施的效果-如饮食和/或身体活动或减肥手术的修改-仍然不清楚肥胖和胃肠道癌症患者，尽管大型临床试验正在进行中。人类干预研究已经揭示了能量平衡与癌症关系的潜在机制，临床前模型支持新兴的途径效应。减少肥胖或增加体力活动的干预措施的核心是多能癌症预防作用（包括减少全身和脂肪组织炎症和血管生成，改变脂肪因子水平和改善胰岛素抵抗），这些作用与癌症的特征直接相关。其他机制，如DNA修复、氧化应激和端粒长度、免疫功能、对癌症干细胞和微生物组的影响，也可能有助于对胃肠道癌症的能量平衡效应。虽然一些机制已经很好地理解（例如，对炎症和胰岛素信号的全身影响），但其他领域仍不清楚。目前的知识水平支持需要更好地将机制方法与临床前和人体研究相结合，以开发有效的个性化饮食和运动干预措施，以减轻肥胖对胃肠道癌症的负担。
Obesity increases the risk of multiple gastrointestinal cancers and worsens disease outcomes. Conversely, strong inverse associations have emerged between physical activity and colon cancer and possibly other gastrointestinal malignancies. The effect of weight loss interventions — such as modifications of diet and/or physical activity or bariatric surgery — remains unclear in patients who are obese and have gastrointestinal cancer, although large clinical trials are underway. Human intervention studies have already shed light on potential mechanisms underlying the energy balance-cancer relationship, with preclinical models supporting emerging pathway effects. Central to interventions that reduce obesity or increase physical activity are pluripotent cancer-preventive effects (including reduced systemic and adipose tissue inflammation and angiogenesis, altered adipokine levels and improved insulin resistance) that directly interface with the hallmarks of cancer. Other mechanisms, such as DNA repair, oxidative stress and telomere length, immune function, effects on cancer stem cells and the microbiome, could also contribute to energy balance effects on gastrointestinal cancers. Although some mechanisms are well understood (for instance, systemic effects on inflammation and insulin signalling), other areas remain unclear. The current state of knowledge supports the need to better integrate mechanistic approaches with preclinical and human studies to develop effective, personalized diet and exercise interventions to reduce the burden of obesity on gastrointestinal cancer.
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影响因子：
3.3
作者：
Campbell, Peter T.;Wener, Mark H.;Ulrich, Cornelia M.
通讯作者：
Ulrich, Cornelia M.
影响因子：
3.3
作者：
Campbell, Kristin L.;Foster-Schubert, Karen E.;Ulrich, Cornelia M.
通讯作者：
Ulrich, Cornelia M.
影响因子：
3.4
作者：
Brown JC;Troxel AB;Ky B;Damjanov N;Zemel BS;Rickels MR;Rhim AD;Rustgi AK;Courneya KS;Schmitz KH
通讯作者：
Schmitz KH
DOI：
10.1152/ajpendo.00661.2010
发表时间：
2011-04-01
影响因子：
5.1
作者：
Bruss, Matthew D.;Thompson, Airlia C. S.;Hellerstein, Marc K.
通讯作者：
Hellerstein, Marc K.
影响因子：
2.8
作者：
Ahn, Ki-Yong;Hur, Hyuk;Kim, Nam Kyu
通讯作者：
Kim, Nam Kyu