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Adipositas, metabolisches Syndrom und Krebsentstehung

Epidemiologie und mögliche Ursachen

Obesity, metabolic syndrome and cancer genesis

Epidemiology and possible causes

  • Leitthema
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Der Diabetologe Aims and scope

Zusammenfassung

Typ-2-Diabetes und Adipositas sind pathophysiologisch eng verknüpft. Dies spiegelt sich im Begriff des metabolischen Syndroms wider, mit dem das gemeinsame Vorliegen von Glukoseintoleranz, stammbetonter Adipositas, arterieller Hypertonie und Dyslipidämie beschrieben wird. Patienten mit Typ-2-Diabetes entwickeln häufiger bösartige Tumoren von Kolon/Rektum, Pankreas, Leber, Mamma und Endometrium. Unabhängig von einer Diabetesmanifestation sind Übergewicht und Adipositas ebenfalls mit einer Häufung von Krebserkrankungen assoziiert. Auch die Mortalität durch Krebs ist erhöht. Die zugrunde liegenden Pathomechanismen, die das erhöhte Krebsrisiko erklären könnten, sind Gegenstand aktueller Forschung. Als mögliche Faktoren werden Hyperinsulinämie, Mediatoren aus Fettzellen wie Adipokine, Sexualhormone, chronische Inflammation und oxidativer Stress diskutiert. In Anbetracht der enormen und weiterhin steigenden Prävalenz von Typ-2-Diabetes und Übergewicht/Adipositas muss das potenziell erhöhte Krebsrisiko intensiv in den Fokus von Forschung und Klinik gerückt werden.

Abstract

Type 2 diabetes mellitus and obesity are pathophysiologically closely related. This is revealed in the complex entity of metabolic syndrome, which describes the simultaneous occurence of glucose intolerance, obesity, arterial hypertension, and dyslipidemia. Patients with type 2 diabetes mellitus show an increased frequency of colorectal, pancreatic, liver, breast and endometrial cancer. Independent of diabetes manifestation, an increase of malignancies has been reported in obesity, and also mortality due to cancer is increased. The underlying pathophysiology is currently under investigation and potential factors under study include hyperinsulinemia, adipokines, sex hormones, chronic inflammation and oxidative stress. Considering the enormous and further accelerating increase of type 2 diabetes mellitus and overweight the potential enhanced risk of cancer needs to be carefully addressed in research and clinical aspects.

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  1. Medizinische Klinik und Poliklinik II, Ludwig-Maximilians-Universität, Campus Großhadern, Marchioninistr. 15, 81377, München, Deutschland

    J. de Heer

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de Heer, J. Adipositas, metabolisches Syndrom und Krebsentstehung. Diabetologe 8, 455–462 (2012). https://doi.org/10.1007/s11428-012-0864-7

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