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Mahamat-Saleh Y, Aune D, Freisling H, Hardikar S, Jaafar R, Rinaldi S, Gunter MJ, Dossus L. Association of metabolic obesity phenotypes with risk of overall and site-specific cancers: a systematic review and meta-analysis of cohort studies. Br J Cancer 2024:10.1038/s41416-024-02857-7. [PMID: 39317703 DOI: 10.1038/s41416-024-02857-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 09/05/2024] [Accepted: 09/13/2024] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND Adiposity is a known risk factor for certain cancers; however, it is not clear whether the risk of cancer differs between individuals with high adiposity but different metabolic health status. The aim of this systematic literature review and meta-analysis of cohort studies was to evaluate associations between metabolic obesity phenotypes and overall and site-specific cancer risk. METHODS PubMed and Embase databases were used to identify relevant cohort studies up to the 6th of June 2023. Random-effects models were used to estimate summary relative risks (SRRs) and 95% confidence intervals (CIs) for the association between metabolic obesity phenotypes and cancer risk. Certainty of evidence was assessed using the Cochrane methods and the GRADE tool. This study is registered with PROSPERO, number CRD42024549511. RESULTS A total of 15,556 records were screened, and 31 publications covering 15 unique cohort studies were included in this analysis. Of these studies, 22 were evaluated as being at low risk of bias and 9 at moderate risk of bias. Compared to metabolically healthy normal-weight individuals (MHNW), metabolically unhealthy overweight/obese (MUOW/OB) individuals had a higher risk of overall (SRR = 1.21, 95% CI = 1.02-1.44, n = 3 studies, high certainty) and obesity-related cancers (SRR = 1.42, 95% CI = 1.15-1.74, n = 3, very low certainty). Specifically, MUOW/OB individuals were at higher risk of cancers of the postmenopausal breast (SRR = 1.32, 95% CI = 1.17-1.48, n = 7, low certainty), colorectum (SRR = 1.24, 95% CI = 1.16-1.31, n = 6, moderate certainty), endometrium (SRR = 2.31, 95% CI = 2.08-2.57, n = 4, high certainty), thyroid (SRR = 1.42, 95% CI = 1.29-1.57, n = 4, moderate certainty), kidney (SRR = 1.71, 95% CI = 1.40-2.10, n = 3, low certainty), pancreas (SRR = 1.35, 95% CI = 1.24-1.47, n = 3, high certainty), liver (SRR = 1.81, 95% CI = 1.36-2.42, n = 2, moderate certainty), gallbladder (SRR = 1.42, 95% CI = 1.17-1.73, n = 2, high certainty), bladder (SRR = 1.36, 95% CI = 1.19-1.56, n = 2, moderate certainty), and stomach (SRR = 1.50, 95% CI = 1.12-2.01, n = 2, high certainty). In addition, we found elevated risks of most of these cancers among individuals classified as MUNW and MHOW/OB phenotypes compared to those with MHNW phenotype. Our stratified analyses according to metabolic obesity phenotypes suggested that the elevated risks of some cancers were stronger in individuals with MUOW/OB versus those with MHOW/OB or MUNW phenotypes. CONCLUSION These findings suggest that both higher adiposity and metabolic dysfunction were independently associated with increased risk of several cancers, with the strongest associations generally observed among those with both metabolic dysfunction and obesity.
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Affiliation(s)
- Yahya Mahamat-Saleh
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France.
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Research, Cancer Registry of Norway, Norwegian Institute of Public Health, Oslo, Norway
- Department of Nutrition, Oslo New University College, Oslo, Norway
| | - Heinz Freisling
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Sheetal Hardikar
- Department of Population Health Sciences, University of Utah, Salt Lake City, Utah, USA
- Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA
| | - Rola Jaafar
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Sabina Rinaldi
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
| | - Marc J Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Laure Dossus
- Nutrition and Metabolism Branch, International Agency for Research on Cancer, Lyon, France
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Jo J, Ha N, Ji Y, Do A, Seo JH, Oh B, Choi S, Choe EK, Lee W, Son JW, Won S. Genetic determinants of obesity in Korean populations: exploring genome-wide associations and polygenic risk scores. Brief Bioinform 2024; 25:bbae389. [PMID: 39207728 PMCID: PMC11359806 DOI: 10.1093/bib/bbae389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 06/24/2024] [Indexed: 09/04/2024] Open
Abstract
East Asian populations exhibit a genetic predisposition to obesity, yet comprehensive research on these traits is limited. We conducted a genome-wide association study (GWAS) with 93,673 Korean subjects to uncover novel genetic loci linked to obesity, examining metrics such as body mass index, waist circumference, body fat ratio, and abdominal fat ratio. Participants were categorized into non-obese, metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO) groups. Using advanced computational methods, we developed a multifaceted polygenic risk scores (PRS) model to predict obesity. Our GWAS identified significant genetic effects with distinct sizes and directions within the MHO and MUO groups compared with the non-obese group. Gene-based and gene-set analyses, along with cluster analysis, revealed heterogeneous patterns of significant genes on chromosomes 3 (MUO group) and 11 (MHO group). In analyses targeting genetic predisposition differences based on metabolic health, odds ratios of high PRS compared with medium PRS showed significant differences between non-obese and MUO, and non-obese and MHO. Similar patterns were seen for low PRS compared with medium PRS. These findings were supported by the estimated genetic correlation (0.89 from bivariate GREML). Regional analyses highlighted significant local genetic correlations on chromosome 11, while single variant approaches suggested widespread pleiotropic effects, especially on chromosome 11. In conclusion, our study identifies specific genetic loci and risks associated with obesity in the Korean population, emphasizing the heterogeneous genetic factors contributing to MHO and MUO.
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Affiliation(s)
- Jinyeon Jo
- Department of Public Health Sciences, Graduate school of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, South Korea
| | - Nayoung Ha
- Department of Public Health Sciences, Graduate school of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, South Korea
| | - Yunmi Ji
- Interdisciplinary Program in Bioinformatics, College of Natural Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, South Korea
| | - Ahra Do
- Interdisciplinary Program in Bioinformatics, College of Natural Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, South Korea
| | - Je Hyun Seo
- Veterans Health Service Medical Center, Veterans Medical Research Institute, 53, Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul, 05368, South Korea
| | - Bumjo Oh
- Department of Family Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061, South Korea
| | - Sungkyoung Choi
- Department of Applied Mathematics, Hanyang University (ERICA), 55, Hanyang-deahak-ro, Sangnok-gu, Ansan, Gyeonggi-do, 15588, South Korea
| | - Eun Kyung Choe
- Division of Colorectal Surgery, Department of Surgery, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea
- Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, 39FL, 152, Teheran-ro, Gangnam-gu, Seoul, 06236, South Korea
| | - Woojoo Lee
- Department of Public Health Sciences, Graduate school of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, South Korea
- Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, South Korea
| | - Jang Won Son
- Division of Endocrinology, Department of Internal Medicine, Bucheon St. Mary's hospital, The Catholic University of Korea, 327, Sosa-ro, Bucheon-si, Gyeonggi-do, Bucheon, 14647, South Korea
| | - Sungho Won
- Department of Public Health Sciences, Graduate school of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, South Korea
- Interdisciplinary Program in Bioinformatics, College of Natural Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, South Korea
- Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, South Korea
- RexSoft Corps, Seoul National University Administration Building, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, South Korea
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Mahamat‐Saleh Y, Rinaldi S, Kaaks R, Biessy C, Gonzalez‐Gil EM, Murphy N, Le Cornet C, Huerta JM, Sieri S, Tjønneland A, Mellemkjær L, Guevara M, Overvad K, Perez‐Cornago A, Tin Tin S, Padroni L, Simeon V, Masala G, May A, Monninkhof E, Christakoudi S, Heath AK, Tsilidis K, Agudo A, Schulze MB, Rothwell J, Cadeau C, Severi S, Weiderpass E, Gunter MJ, Dossus L. Metabolically defined body size and body shape phenotypes and risk of postmenopausal breast cancer in the European Prospective Investigation into Cancer and Nutrition. Cancer Med 2023; 12:12668-12682. [PMID: 37096432 PMCID: PMC10278526 DOI: 10.1002/cam4.5896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/06/2023] [Accepted: 03/23/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Excess body fatness and hyperinsulinemia are both associated with an increased risk of postmenopausal breast cancer. However, whether women with high body fatness but normal insulin levels or those with normal body fatness and high levels of insulin are at elevated risk of breast cancer is not known. We investigated the associations of metabolically defined body size and shape phenotypes with the risk of postmenopausal breast cancer in a nested case-control study within the European Prospective Investigation into Cancer and Nutrition. METHODS Concentrations of C-peptide-a marker for insulin secretion-were measured at inclusion prior to cancer diagnosis in serum from 610 incident postmenopausal breast cancer cases and 1130 matched controls. C-peptide concentrations among the control participants were used to define metabolically healthy (MH; in first tertile) and metabolically unhealthy (MU; >1st tertile) status. We created four metabolic health/body size phenotype categories by combining the metabolic health definitions with normal weight (NW; BMI < 25 kg/m2 , or WC < 80 cm, or WHR < 0.8) and overweight or obese (OW/OB; BMI ≥ 25 kg/m2 , or WC ≥ 80 cm, or WHR ≥ 0.8) status for each of the three anthropometric measures separately: (1) MHNW, (2) MHOW/OB, (3) MUNW, and (4) MUOW/OB. Conditional logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Women classified as MUOW/OB were at higher risk of postmenopausal breast cancer compared to MHNW women considering BMI (OR = 1.58, 95% CI = 1.14-2.19) and WC (OR = 1.51, 95% CI = 1.09-2.08) cut points and there was also a suggestive increased risk for the WHR (OR = 1.29, 95% CI = 0.94-1.77) definition. Conversely, women with the MHOW/OB and MUNW were not at statistically significant elevated risk of postmenopausal breast cancer risk compared to MHNW women. CONCLUSION These findings suggest that being overweight or obese and metabolically unhealthy raises risk of postmenopausal breast cancer while overweight or obese women with normal insulin levels are not at higher risk. Additional research should consider the combined utility of anthropometric measures with metabolic parameters in predicting breast cancer risk.
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Affiliation(s)
| | - S. Rinaldi
- International Agency for Research on CancerLyonFrance
| | - R. Kaaks
- Division of Cancer EpidemiologyGerman Cancer Research Center (DFKZ)HeidelbergGermany
| | - C. Biessy
- International Agency for Research on CancerLyonFrance
| | | | - N. Murphy
- International Agency for Research on CancerLyonFrance
| | - C. Le Cornet
- Division of Cancer EpidemiologyGerman Cancer Research Center (DFKZ)HeidelbergGermany
| | - J. M. Huerta
- Department of EpidemiologyMurcia Regional Health CouncilMurciaSpain
- CIBER Epidemiología y Salud Pública (CIBERESP)MadridSpain
| | - S. Sieri
- Epidemiology and Prevention UnitFondazione IRCCS Istituto Nazionale dei Tumori20133MilanItaly
| | - A. Tjønneland
- Danish Cancer Society Research CenterCopenhagenDenmark
- Department of Public HealthUniversity of CopenhagenCopenhagenDenmark
| | - L. Mellemkjær
- Danish Cancer Society Research CenterCopenhagenDenmark
| | - M. Guevara
- Navarra Public Health Institute31003PamplonaSpain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)28029MadridSpain
- Navarra Institute for Health Research (IdiSNA)31008PamplonaSpain
| | - K. Overvad
- Department of Public Health, Section for EpidemiologyAarhus UniversityAarhusDenmark
| | - A. Perez‐Cornago
- Cancer Epidemiology UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - S. Tin Tin
- Cancer Epidemiology UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - L. Padroni
- Department of Clinical and Biological SciencesUniversity of TurinTurinItaly
| | - V. Simeon
- Dipartimento di Salute Mentale e Fisica e Medicina PreventivaUniversità degli Studi della Campania 'Luigi Vanvitelli'80121NaplesItaly
| | - G. Masala
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO)FlorenceItaly
| | - A. May
- Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - E. Monninkhof
- Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - S. Christakoudi
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
- Department of Inflammation BiologySchool of Immunology and Microbial SciencesKing's College LondonLondonUK
| | - A. K. Heath
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - K. Tsilidis
- Department of Epidemiology and BiostatisticsSchool of Public Health, Imperial College LondonLondonUK
| | - A. Agudo
- Unit of Nutrition and CancerCatalan Institute of Oncology – ICOL'Hospitalet de LlobregatSpain
- Nutrition and Cancer Group; Epidemiology, Public Health, Cancer Prevention and Palliative Care ProgramBellvitge Biomedical Research Institute – IDIBELLL'Hospitalet de LlobregatSpain
| | - M. B. Schulze
- Department of Molecular EpidemiologyGerman Institute of Human Nutrition Potsdam‐RehbrueckeNuthetalGermany
- Institute of Nutritional ScienceUniversity of PotsdamNuthetalGermany
| | - J. Rothwell
- Paris‐Saclay UniversityUVSQ, Inserm, Gustave Roussy, “Exposome and Heredity” team, CESPVillejuifFrance
| | - C. Cadeau
- Paris‐Saclay UniversityUVSQ, Inserm, Gustave Roussy, “Exposome and Heredity” team, CESPVillejuifFrance
| | - S. Severi
- Paris‐Saclay UniversityUVSQ, Inserm, Gustave Roussy, “Exposome and Heredity” team, CESPVillejuifFrance
| | - E. Weiderpass
- International Agency for Research on CancerLyonFrance
| | - M. J. Gunter
- International Agency for Research on CancerLyonFrance
| | - L. Dossus
- International Agency for Research on CancerLyonFrance
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4
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Choi HG, Kim HJ. Association between metabolically obese but normal weight and cardiovascular diseases in Korean menopausal women. Menopause 2023; 30:506-511. [PMID: 36730719 DOI: 10.1097/gme.0000000000002092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The aim of this study was to present useful data for developing effective health management strategies for cardiovascular disease (CVD) prevention in postmenopausal women by investigating health-related behaviors and the prevalence of CVD for different types of obesity classified according to metabolic health status and body mass index criteria. METHODS Using the 2016 Korean National Health and Nutrition Examination Survey VII-1 data, 1,190 menopausal women aged 50 years or older were analyzed in this cross-sectional study. The participants were divided into four groups as follows: metabolically healthy and normal weight (MHNW), metabolically obese but normal weight (MONW), metabolically healthy but obese, and metabolically obese and obese. Complex-samples general linear analysis, t tests, and logistic regression analysis were used to compare the differences in health-related behaviors and the risk of CVD among the four groups. RESULTS The risk for stroke was 3.61 times higher (95% CI, 1.18-11.03) in the MONW group than in the MHNW group. CONCLUSIONS We found a strong association between the MONW group of obesity and the risk for CVD, particularly stroke, in postmenopausal women. These findings would serve as valuable evidence for developing and implementing interventions to prevent stroke in postmenopausal women in the MONW group.
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Affiliation(s)
- Han-Gyo Choi
- From the Digestive Disease Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Hye-Jin Kim
- Department of Nursing, University of Ulsan, Ulsan, Republic of Korea
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5
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Ho J, Kim E, Lee M, Jung I, Jo YS, Lee J. Impact of thyroid cancer on the cancer risk in patients with non-alcoholic fatty liver disease or dyslipidemia. Sci Rep 2023; 13:1076. [PMID: 36658156 PMCID: PMC9852577 DOI: 10.1038/s41598-023-28112-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/12/2023] [Indexed: 01/20/2023] Open
Abstract
The raised prevalence of obesity has increased the incidence of obesity-related metabolic diseases such as dyslipidemia (DL) and non-alcoholic fatty liver disease (NAFLD), along with the development and progression of various types of cancer, including thyroid cancer. In this study, we investigated whether thyroid cancer in patients with DL and NAFLD could be a risk factor for other cancers. To achieve our goal, we generated two independent cohorts from our institution and from the National Health Insurance System in South Korea. Based on the ICD-10 code, we conducted exact matching (1:5 matching) and estimated the overall risk of thyroid cancer for other cancers in patients with DL or NAFLD. Univariate and multivariate analyses showed that the hazard ratio (HR) of thyroid cancer was 2.007 (95% Confidence Interval [CI], 1.597-2.522) and 2.092 (95% CI, 1.546-2.829), respectively in the institutional cohort and 1.329 (95% CI, 1.153-1.533) and 1.301 (95% CI, 1.115-1.517), respectively in the nationwide cohort. Risk analysis revealed a significant increase in the HR in lip, tongue, mouth, lung, bone, joint, soft tissue, skin, brain, male cancers and lymphoma after thyroid cancer occurred. Thyroid cancer in patients with DL or NAFLD might be a valuable factor for predicting the development of other cancers.
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Affiliation(s)
- Joon Ho
- Open NBI Convergence Technology Research Laboratory, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Eunhwa Kim
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Myeongjee Lee
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Inkyung Jung
- Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea.
| | - Young Suk Jo
- Open NBI Convergence Technology Research Laboratory, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
| | - Jandee Lee
- Open NBI Convergence Technology Research Laboratory, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
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Torres-Roman JS, Quispe-Vicuña C, Arce-Huamani MA, Dávila-Hernandez CA, Valcarcel B, Martinez-Herrera JF. Prostate Cancer Mortality in Peru: An Update from 2003 to 2017. Asian Pac J Cancer Prev 2022; 23:3623-3628. [PMID: 36444573 PMCID: PMC9930958 DOI: 10.31557/apjcp.2022.23.11.3623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE We estimated the mortality trends for prostate cancer in Peru and its geographical areas between 2003 and 2017. MATERIAL AND METHODS We obtained recorded prostate cancer deaths from the Peruvian Ministry of Health Database between 2003 and 2017. Age-adjusted mortality rates per 100,000 men-year were computed with the direct method using the world standard SEGI population. We estimated the annual percent change (APC) using the Joinpoint regression program. RESULTS A total of 38,617 prostate cancer deaths were reported between 2003 and 2017, with a mortality rate ranging from 18.21 to 19.94 deaths per 100,000 men-year. Since 2006, Peru has experienced a decrease of 2.2 deaths per year, whereas the mortality rate in the coastal region has declined by 2.9% per year. The highlands and rainforest regions showed stable trends throughout the entire study period. According to provinces, only Moquegua had a significant decrease (APC: -6.0, 95%CI: -11.4, -0.2, p<0.05) from 2003 to 2017. CONCLUSIONS Although mortality rates are decreasing, there is a high mortality burden by prostate cancer in Peru and by geographical regions, being mostly concentrated in the coastal region. The rainforest provinces deserve the most attention. Our findings suggest wide health care disparities among the different regions of Peru that need greater public health attention to reduce the burden of mortality by prostate cancer.
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Affiliation(s)
- J Smith Torres-Roman
- Cancer Research Networking, Scientific University of the South, Lima, Peru. ,Latin American Network for Cancer Research (LAN–CANCER), Lima, Peru. ,Professional School of Human Medicine, San Juan Bautista Private University, Chincha Branch, Ica, Peru. ,For Correspondence:
| | | | - Miguel A Arce-Huamani
- Cancer Research Networking, Scientific University of the South, Lima, Peru. ,Latin American Network for Cancer Research (LAN–CANCER), Lima, Peru.
| | - Carlos A Dávila-Hernandez
- Latin American Network for Cancer Research (LAN–CANCER), Lima, Peru. ,Professional School of Human Medicine, San Juan Bautista Private University, Chincha Branch, Ica, Peru.
| | - Bryan Valcarcel
- Latin American Network for Cancer Research (LAN–CANCER), Lima, Peru.
| | - José Fabián Martinez-Herrera
- Latin American Network for Cancer Research (LAN–CANCER), Lima, Peru. ,Cancer Center, Medical Center American British Cowdray, Mexico City, Mexico.
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Kliemann N, Ould Ammar R, Biessy C, Gicquiau A, Katzke V, Kaaks R, Tjønneland A, Olsen A, Sánchez MJ, Crous-Bou M, Pasanisi F, Tin Tin S, Perez-Cornago A, Aune D, Christakoudi S, Heath AK, Colorado-Yohar SM, Grioni S, Skeie G, Sartor H, Idahl A, Rylander C, May AM, Weiderpass E, Freisling H, Playdon MC, Rinaldi S, Murphy N, Huybrechts I, Dossus L, Gunter MJ. Metabolically Defined Body Size Phenotypes and Risk of Endometrial Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). Cancer Epidemiol Biomarkers Prev 2022; 31:1359-1367. [PMID: 35437568 PMCID: PMC9355542 DOI: 10.1158/1055-9965.epi-22-0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/17/2022] [Accepted: 04/13/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Obesity is a risk factor for endometrial cancer but whether metabolic dysfunction is associated with endometrial cancer independent of body size is not known. METHODS The association of metabolically defined body size phenotypes with endometrial cancer risk was investigated in a nested case-control study (817 cases/ 817 controls) within the European Prospective Investigation into Cancer and Nutrition (EPIC). Concentrations of C-peptide were used to define metabolically healthy (MH; <1st tertile) and metabolically unhealthy (MU; ≥1st tertile) status among the control participants. These metabolic health definitions were combined with normal weight (NW); body mass index (BMI)<25 kg/m2 or waist circumference (WC)<80 cm or waist-to-hip ratio (WHR)<0.8) and overweight (OW; BMI≥25 kg/m2 or WC≥80 cm or WHR≥0.8) status, generating four phenotype groups for each anthropometric measure: (i) MH/NW, (ii) MH/OW, (iii) MU/NW, and (iv) MU/OW. RESULTS In a multivariable-adjusted conditional logistic regression model, compared with MH/NW individuals, endometrial cancer risk was higher among those classified as MU/NW [ORWC, 1.48; 95% confidence interval (CI), 1.05-2.10 and ORWHR, 1.68; 95% CI, 1.21-2.35] and MU/OW (ORBMI, 2.38; 95% CI, 1.73-3.27; ORWC, 2.69; 95% CI, 1.92-3.77 and ORWHR, 1.83; 95% CI, 1.32-2.54). MH/OW individuals were also at increased endometrial cancer risk compared with MH/NW individuals (ORWC, 1.94; 95% CI, 1.24-3.04). CONCLUSIONS Women with metabolic dysfunction appear to have higher risk of endometrial cancer regardless of their body size. However, OW status raises endometrial cancer risk even among women with lower insulin levels, suggesting that obesity-related pathways are relevant for the development of this cancer beyond insulin. IMPACT Classifying women by metabolic health may be of greater utility in identifying those at higher risk for endometrial cancer than anthropometry per se.
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Affiliation(s)
| | | | - Carine Biessy
- International Agency for Research on Cancer, Lyon, France
| | | | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anja Olsen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Maria-Jose Sánchez
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs, GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Marta Crous-Bou
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO)—Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Fabrizio Pasanisi
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Sandar Tin Tin
- Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, Oxford, England
| | - Aurora Perez-Cornago
- Nuffield Department of Population Health, Cancer Epidemiology Unit, University of Oxford, Oxford, England
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Nutrition, Oslo New University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Sofia Christakoudi
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- Department of Inflammation Biology, King's College London, London, United Kingdom
| | - Alicia K. Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | - Sandra M. Colorado-Yohar
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - Sara Grioni
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Guri Skeie
- Department of Community Medicine, UIT—The Arctic University of Norway, Tromsø, Norway
| | - Hanna Sartor
- Diagnostic Radiology, Lund University, Lund, Sweden
| | - Annika Idahl
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Charlotta Rylander
- Department of Community Medicine, UIT—The Arctic University of Norway, Tromsø, Norway
| | - Anne M. May
- Julius Center for Health Sciences and Primary care, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | | | - Mary C. Playdon
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, Utah
- Cancer Control and Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Sabina Rinaldi
- International Agency for Research on Cancer, Lyon, France
| | - Neil Murphy
- International Agency for Research on Cancer, Lyon, France
| | | | - Laure Dossus
- International Agency for Research on Cancer, Lyon, France
| | - Marc J. Gunter
- International Agency for Research on Cancer, Lyon, France
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8
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Metabolic Syndrome and Prostate Cancer Risk in Mexican Men: A Population Case-control Study. Arch Med Res 2022; 53:594-602. [DOI: 10.1016/j.arcmed.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/06/2022] [Accepted: 07/15/2022] [Indexed: 11/20/2022]
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9
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Zheng X, Peng R, Xu H, Lin T, Qiu S, Wei Q, Yang L, Ai J. The Association Between Metabolic Status and Risk of Cancer Among Patients With Obesity: Metabolically Healthy Obesity vs. Metabolically Unhealthy Obesity. Front Nutr 2022; 9:783660. [PMID: 35284439 PMCID: PMC8914254 DOI: 10.3389/fnut.2022.783660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background Controversial evidence about the association between cancer risk and metabolic status among individuals with obesity has been reported, but pooled data remain absent. This study aims to present pooled data comparing cancer risk between patients with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO). Methods The current study systematically searched pieces of literature on January 4, 2021, of prospective cohorts that compare the incidence of cancer between MHO and MUO. The quality of included studies was assessed using Newcastle-Ottawa scale, and publication bias was evaluated using funnel plots. Results Eleven high-quality studies were eventually selected. Quantitative analysis indicates that a lower cancer incidence exists for MHO phenotype than that for MUO (odds ratio [OR], 0.71; 95% confidential interval [CI], 0.61-0.84). Consistent outcomes are presented by subgroup analyses, which are grouped by cohort region (western population: [OR, 0.84; 95% CI, 0.75-0.93]; Asian population: [OR, 0.64; 95% CI, 0.54-0.77]); definition of metabolic unhealthiness (≥3 metabolic abnormalities: [OR, 0.62; 95% CI, 0.54-0.71]; ≥1 metabolic abnormality: [OR, 0.76; 95% CI, 0.62-0.94]); and definition of obesity (body mass index (BMI), ≥30 kg/m2: [OR, 0.84; 95% CI, 0.73-0.98]; BMI, ≥25 kg/m2: [OR, 0.53; 95% CI, 0.52-0.55]). Conclusion In conclusion, this study suggests a reduced cancer risk for MHO compared to MUO regardless of population heterogeneity, or the definitions of obesity and metabolic status.
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Affiliation(s)
- Xiaonan Zheng
- Department of Urology and Institute of Urology of West China Hospital, Sichuan University, Chengdu, China
- Frontiers Science Center for Disease-Related Molecular Network, Institutes for Systems Genetics, West China Hospital, Sichuan University, Chengdu, China
| | - Ruilin Peng
- Department of Radiation Oncology, West China Hospital, Sichuan University, Chengdu, China
| | - Hang Xu
- Department of Urology and Institute of Urology of West China Hospital, Sichuan University, Chengdu, China
| | - Tianhai Lin
- Department of Urology and Institute of Urology of West China Hospital, Sichuan University, Chengdu, China
| | - Shi Qiu
- Department of Urology and Institute of Urology of West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Wei
- Department of Urology and Institute of Urology of West China Hospital, Sichuan University, Chengdu, China
| | - Lu Yang
- Department of Urology and Institute of Urology of West China Hospital, Sichuan University, Chengdu, China
| | - Jianzhong Ai
- Department of Urology and Institute of Urology of West China Hospital, Sichuan University, Chengdu, China
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10
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Lin CJ, Chang YC, Hsu HY, Tsai MC, Hsu LY, Hwang LC, Chien KL, Yeh TL. Metabolically healthy overweight/obesity and cancer risk: A representative cohort study in Taiwan. Obes Res Clin Pract 2021; 15:564-569. [PMID: 34782258 DOI: 10.1016/j.orcp.2021.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 10/05/2021] [Accepted: 10/21/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Many cancers are caused by overweight; however, cancer risk varies among individuals with obesity. Few studies are addressing the relationship between metabolic obesity phenotypes and cancer. This study investigates the association between metabolically healthy overweight (MHOW) or metabolically healthy obesity (MHO) and cancer incidence. METHODS In a nationwide, representative community-based prospective cohort study, 5734 Taiwanese adults were classified into eight phenotypes according to body mass index (underweight <18.5; normal weight 18.5-23.9; overweight 24-26.9; and obese ≥27 kg/m2) and metabolic status (healthy/unhealthy). Participants with healthy cardiometabolic blood profiles included in the metabolic syndrome criteria and an absence of hypertension, diabetes, and hyperlipidemia were considered metabolically healthy. We used the Cox proportional hazards models to estimate the adjusted hazard ratio (HR) and 95% confidence intervals (95% CI). RESULTS During 73,389 person-years of follow-up, 428 incident cancers were identified. Compared to the participants with metabolically healthy normal weight, participants with MHOW (adjusted HR 1.39, 95% CI, 0.90-2.13) or MHO (adjusted HR 1.07, 95% CI, 0.51-2.22) had a tendency toward a higher risk of cancer. These associations were stronger in MHOW (adjusted HR 1.77, 95% CI, 1.09-2.86) or MHO (adjusted HR 1.39, 95% CI, 0.66-2.93) participants younger than 65 years. CONCLUSIONS This study was the first to investigate the impact of metabolic obesity phenotype on the incidence of cancer in the Taiwanese population. Even in the absence of metabolic abnormalities, overweight, and obesity may cause a modest increase in the risk of developing cancer.
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Affiliation(s)
- Chien-Ju Lin
- Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan
| | - Yu-Chen Chang
- Department of Family Medicine, MacKay Memorial Hospital, Taipei City, Taiwan
| | - Hsin-Yin Hsu
- Department of Family Medicine, MacKay Memorial Hospital, Taipei City, Taiwan
| | - Ming-Chieh Tsai
- Department of Endocrinology, Department of Internal Medicine, MacKay Memorial Hospital, Tamsui Branch, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan
| | - Le-Yin Hsu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan
| | - Lee-Ching Hwang
- Department of Family Medicine, MacKay Memorial Hospital, Taipei City, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei City, Taiwan
| | - Kuo-Liong Chien
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan
| | - Tzu-Lin Yeh
- Department of Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu City, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan.
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11
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Liu B, Giffney HE, Arthur RS, Rohan TE, Dannenberg AJ. Cancer Risk in Normal Weight Individuals with Metabolic Obesity: A Narrative Review. Cancer Prev Res (Phila) 2021; 14:509-520. [PMID: 33563604 PMCID: PMC8102335 DOI: 10.1158/1940-6207.capr-20-0633] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/25/2021] [Accepted: 02/03/2021] [Indexed: 11/16/2022]
Abstract
Obesity represents one of the most significant public health challenges worldwide. Current clinical practice relies on body mass index (BMI) to define the obesity status of an individual, even though the index has long been recognized for its limitations as a measure of body fat. In normal BMI individuals, increased central adiposity has been associated with worse health outcomes, including increased risks of cardiovascular disease and metabolic disorders. The condition leading to these outcomes has been described as metabolic obesity in the normal weight (MONW). More recent evidence suggests that MONW is associated with increased risk of several obesity-related malignancies, including postmenopausal breast, endometrial, colorectal, and liver cancers. In MONW patients, the false reassurance of a normal range BMI can lead to lost opportunities for implementing preventive interventions that may benefit a substantial number of people. A growing body of literature has documented the increased risk profile of MONW individuals and demonstrated practical uses for body composition and biochemical analyses to identify this at-risk population. In this review, we survey the current literature on MONW and cancer, summarize pathophysiology and oncogenic mechanisms, highlight potential strategies for diagnosis and treatment, and suggest directions for future research.
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Affiliation(s)
- Bethina Liu
- MD Program, Weill Cornell Medicine, New York, New York
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12
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Lee J, Yang SW, Jin L, Lee CL, Lee JY, Shin JH, Lim JS, Song KH. Is PSA density of the peripheral zone as a useful predictor for prostate cancer in patients with gray zone PSA levels? BMC Cancer 2021; 21:472. [PMID: 33910525 PMCID: PMC8082970 DOI: 10.1186/s12885-021-08216-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 04/19/2021] [Indexed: 11/10/2022] Open
Abstract
Background Serum prostate-specific antigen (PSA) is widely used in screening tests for prostate cancer. As the low specificity of PSA results in unnecessary and invasive prostate biopsies, we evaluated the clinical significance of various PSAs and PSA density (PSAD) related to peripheral zones in patients with gray zone PSA level (4–10 ng/mL). Methods A total of 1300 patients underwent transrectal ultrasonography-guided prostate biopsy from 2014 to 2019. Among them, 545 patients in the gray zone were divided into the prostate cancer diagnosis group and the non-prostate cancer diagnosis group, and PSA, relative extra transitional zone PSA (RETzPSA), estimated post holmium laser enucleation of the prostate PSA (EPHPSA), PSAD, peripheral zone PSA density (PZPSAD) and extra-transitional zone density (ETzD) were compared and analyzed using receiver-operating characteristics (ROC) analysis after 1:1 matching using propensity score. Results Area under the ROC curve values of PSA, EPHPSA, RETzPSA, PSA density, ETzD, and PZPSAD were 0.553 (95% CI: 0.495–0.610), 0.611 (95% CI: 0.554–0.666), 0.673 (95% CI: 0.617–0.725), 0.745 (95% CI: 0.693–0.793), 0.731 (95% CI: 0.677–0.780) and 0.677 (95% CI: 0.611–0.719), respectively. PSAD had 67.11% sensitivity, 71.71% specificity, and 70.34% positive predictive rate at 0.18 ng/mL/cc. ETzD had 69.08% sensitivity, 64.47% specificity, and 66.04% positive predictive rate at 0.04 ng/mL/cc. When the cut-off value of PSAD was increased to 0.18 ng/mL/cc, the best results were obtained with an odds ratio of 5.171 (95% CI: 3.171–8.432), followed by ETzD with 4.054 (95% CI: 2.513–6.540). Conclusions These results suggested that volume-adjusted parameters (ETzD and PSAD) might be more sensitive and accurate than various PSA in gray zone patients who required prostate biopsy to reduce unnecessary biopsy.
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Affiliation(s)
- Jaegeun Lee
- Department of Urology, Chungnam National University College of Medicine, 282 Monwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Seung Woo Yang
- Department of Urology, Chungnam National University College of Medicine, 282 Monwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Long Jin
- Department of Urology, Chungnam National University College of Medicine, 282 Monwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Chung Lyul Lee
- Department of Urology, Chungnam National University College of Medicine, 282 Monwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Ji Yong Lee
- Department of Urology, Chungnam National University College of Medicine, 282 Monwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Ju Hyun Shin
- Department of Urology, Chungnam National University College of Medicine, 282 Monwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Jae Sung Lim
- Department of Urology, Chungnam National University College of Medicine, 282 Monwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Ki Hak Song
- Department of Urology, Chungnam National University College of Medicine, 282 Monwha-ro, Jung-gu, Daejeon, 35015, Republic of Korea.
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13
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Garay-Sevilla ME, Gomez-Ojeda A, González I, Luévano-Contreras C, Rojas A. Contribution of RAGE axis activation to the association between metabolic syndrome and cancer. Mol Cell Biochem 2021; 476:1555-1573. [PMID: 33398664 DOI: 10.1007/s11010-020-04022-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/11/2020] [Indexed: 02/07/2023]
Abstract
Far beyond the compelling proofs supporting that the metabolic syndrome represents a risk factor for diabetes and cardiovascular diseases, a growing body of evidence suggests that it is also a risk factor for different types of cancer. However, the involved molecular mechanisms underlying this association are not fully understood, and they have been mainly focused on the individual contributions of each component of the metabolic syndrome such as obesity, hyperglycemia, and high blood pressure to the development of cancer. The Receptor for Advanced Glycation End-products (RAGE) axis activation has emerged as an important contributor to the pathophysiology of many clinical entities, by fueling a chronic inflammatory milieu, and thus supporting an optimal microenvironment to promote tumor growth and progression. In the present review, we intend to highlight that RAGE axis activation is a crosswise element on the potential mechanistic contributions of some relevant components of metabolic syndrome into the association with cancer.
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Affiliation(s)
- Ma Eugenia Garay-Sevilla
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, Guanajuato, Mexico
| | - Armando Gomez-Ojeda
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, Guanajuato, Mexico
| | - Ileana González
- Biomedical Research Labs, Medicine Faculty, Catholic University of Maule, Talca, Chile
| | - Claudia Luévano-Contreras
- Department of Medical Science, Division of Health Science, University of Guanajuato, Campus León, Guanajuato, Mexico
| | - Armando Rojas
- Biomedical Research Labs, Medicine Faculty, Catholic University of Maule, Talca, Chile.
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14
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Lin CJ, Chang YC, Cheng TY, Lo K, Liu SJ, Yeh TL. The association between metabolically healthy obesity and risk of cancer: A systematic review and meta-analysis of prospective cohort studies. Obes Rev 2020; 21:e13049. [PMID: 32476278 DOI: 10.1111/obr.13049] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 04/26/2020] [Accepted: 04/28/2020] [Indexed: 12/24/2022]
Abstract
The risk of cancer among adults with metabolically healthy obesity (MHO) has not yet been established. We systematically searched from inception to 15 March 2020. We included prospective cohort studies that compared participants with MHO and participants with metabolically healthy non-obesity (MHNO) for incidence of any type of cancer. Benign tumors, cancer mortality or cancer prognosis were not in the scope of our analysis. The Newcastle-Ottawa Scale was used for quality assessment. Ultimately, eight studies with a total of 12 542 390 participants were included. The pooled meta-analysis using random effect model showed participants with MHO demonstrated a significantly increased risk of developing cancer (odds ratio [OR], 1.14; 95% confidence interval [CI], 1.05 to 1.23; and I2 = 39%) than those with MHNO. The subgroup analysis revealed a higher pooled estimate (OR, 1.17; 95% CI, 1.01-1.35; and I2 = 56%) in comparison with metabolically healthy normal weight. No evidence of effect modification by age, sex, ethnicity, smoking, sample size or length of follow-up was found. In conclusion, the present study reports a positive association between MHO and cancer incidence. All individuals with obesity, even in the absence of metabolic dysfunction, should be encouraged to lose weight.
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Affiliation(s)
- Chien-Ju Lin
- Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan
| | - Yu-Chen Chang
- Family Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Ting-Yao Cheng
- Post Graduate Year, MacKay Memorial Hospital, Taipei, Taiwan
| | - Kai Lo
- Post Graduate Year, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shu-Jung Liu
- Medical Library, MacKay Memorial Hospital, Tamsui Branch, New Taipei City, Taiwan
| | - Tzu Lin Yeh
- Family Medicine, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan.,Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
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15
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Liu W, Li W, Wang Z, Zhu Y, Ye D, Zhang G. Metabolically Abnormal Obesity Increases the Risk of Advanced Prostate Cancer in Chinese Patients Undergoing Radical Prostatectomy. Cancer Manag Res 2020; 12:1779-1787. [PMID: 32210619 PMCID: PMC7071860 DOI: 10.2147/cmar.s242193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/27/2020] [Indexed: 12/19/2022] Open
Abstract
Background To investigate the pathological risk of prostate cancer (PCa) according to the obesity and metabolic status of Chinese patients undergoing radical prostatectomy. Materials and Methods We performed a retrospective cross-sectional study of 1016 patients with PCa who underwent radical prostatectomy and whose metabolic status and body mass index were examined. Multivariate logistic regression analysis was performed to examine the relationship between different metabolic obesity phenotypes and the pathological outcomes of PCa. Results Among 1016 men, 551 (54.2%), 106 (10.4%), 238 (23.4%), and 121 (11.9%) were assigned to the metabolically healthy and normal weight (MHNW) group, metabolically abnormal but normal weight (MANW) group, metabolically healthy but overweight or obese (MHO) group, and metabolically abnormal and overweight or obese (MAO) group, respectively. Compared with the MHNW group, the MAO group had a significantly greater risk of a higher prostatectomy Gleason score [odds ratio (OR), 1.907; 95% confidence interval (95% CI), 1.144–3.182], pathological stage (OR, 1.606; 95% CI, 1.035–2.493), and seminal vesicle invasion (OR, 1.673; 95% CI, 1.041–2.687). In contrast, the ORs were not increased in the MHO or MANW group. In the context of normal weight, metabolic disorders were associated with lymph node involvement. The metabolic status and body mass index were not associated with extracapsular extension or surgical margins in any of the four groups. Conclusion The MAO phenotype is associated with aggressive PCa, including a higher prostatectomy Gleason score, pathological stage, and seminal vesicle invasion and might also be associated with disease progression. Obesity and metabolic disorders act synergistically to increase the pathological risk of PCa.
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Affiliation(s)
- Wen Liu
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Wenxian Li
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
| | - Zhankun Wang
- Department of Urology, Qingdao Eighth People's Hospital, Qingdao, People's Republic of China
| | - Yao Zhu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
| | - Dingwei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
| | - Guiming Zhang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, People's Republic of China
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