Tumorrisiko antiarteriosklerotischer Maßnahmen

  • G. Middelhoff
Conference paper

Zusammenfassung

Eine krebserzeugende oder -fördernde Wirkung von lipidsenkenden Pharmaka konnte in keiner der bis jetzt bekannten großen klinischen Studien nachgewiesen werden.

Die epidemiologisch beschriebenen Zusammenhänge zwischen einem erniedrigten Plasmacholesterinspiegel und einer erhöhten Krebsinzidenz sind allenfalls schwach, zudem widersprüchlich und in großen prospektiven, klinisch orientierten Studien am Modellbeispiel des Kolonkarzinoms nicht nachvollziehbar. Zudem ist kein adäquates Modell zur Erklärung dieser Zusammenhänge sichtbar.

Die Zusammenhänge zwischen den Bestandteilen der menschlichen Nahrung und der Karzinogenese sind ausgesprochen komplex und bedürfen einer weiteren intensiven Abklärung. Die pathogenetische Bedeutung der sogenannten Transfettsäuren erscheint (noch) nicht hinreichend abgesichert.

Die vorgelegten Befunde erlauben nicht die Schlußfolgerung, daß eine wie immer zu erreichende Senkung des Plasmacholesterinspiegels in den für die Vermeidung bzw. Verzögerung der Atherogenese sinnvollen Bereich zwischen 180 und 200 mg/dl das Krebsrisiko dieser großen Gruppe von Patienten erhöht.

Die vorgelegten Befunde lassen an der Realisierung von Studien zur Krebsprävention mit diätetischen Maßnahmen, wie sie jetzt konzipiert bzw. bereits durchgeführt werden, Zweifel aufkommen.

Summary

A cancer-producing or -promoting effect of lipid-lowering drugs could not be detected in any of the large clinical trials reported so far. The epidemiologically described connections between a lowered plasma cholesterol level and an increased incidence of cancer are at best sparse, besides being contradictory and nonreproduciable in extensive clinically oriented studies using colon carcinoma as a model. In addition, there is no adequate theory for the explanation of these correlations. The connections between constituents of the human diet and carcinogenesis are extremely complex and must continue to be examined intensively. The present results do not permit the conclusion that a lowering of plasma cholesterol between 180 and 200 mg/dl, which is regarded as appropriate for preventing or decelerating atherogenesis, increases the cancer risk in this large group of patients, by whatever means this reduction is achieved.

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© Springer-Verlag Berlin Heidelberg 1989

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  • G. Middelhoff

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