Abstract
Nearly 35 % of adults and 20 % of children in the USA are obese, defined as a body mass index (BMI) ≥30 kg/m2. Obesity, which is accompanied by metabolic dysregulation often manifesting in the metabolic syndrome, is an established risk factor for many cancers. Within the growth-promoting, proinflammatory environment of the obese state, crosstalk between adipocytes, macrophages, and epithelial cells occurs via obesity-associated hormones, cytokines, and other mediators that may enhance cancer risk and/or progression. This chapter synthesizes the evidence on key biological mechanisms underlying the obesity–cancer link, with particular emphasis on the relative contributions of increased adiposity per se versus the obesity-associated enhancements in growth factor signaling, inflammation, and vascular integrity processes resulting from adipose tissue dysfunction. These interrelated pathways represent possible mechanistic targets for disrupting the obesity–cancer link.
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Flegal KM, Carroll MD, et al. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307(5):491–7.
Grassi G, Seravalle G, et al. Structural and functional alterations of subcutaneous small resistance arteries in severe human obesity. Obesity (Silver Spring). 2010;18(1):92–8.
Gottschling-Zeller H, Birgel M, et al. Depot-specific release of leptin from subcutaneous and omental adipocytes in suspension culture: effect of tumor necrosis factor-alpha and transforming growth factor-beta1. Eur J Endocrinol. 1999;141(4):436–42.
Ford ES, Li C, et al. Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US. J Diabetes. 2010;2(3):180–93.
Carter JC, Church FC. Obesity and breast cancer: the roles of peroxisome proliferator-activated receptor-gamma and plasminogen activator inhibitor-1. PPAR Res. 2009;2009:345320.
Hursting SD, Berger NA. Energy balance, host-related factors, and cancer progression. J Clin Oncol. 2010;28(26):4058–65.
Poirier P, Giles TD, et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss. Arterioscler Thromb Vasc Biol. 2006;26(5):968–76.
Bluher M. Are there still healthy obese patients? Curr Opin Endocrinol Diabetes Obes. 2012;19(5):341–6.
Marques-Vidal P, Pecoud A, et al. Normal weight obesity: relationship with lipids, glycaemic status, liver enzymes and inflammation. Nutr Metab Cardiovasc Dis. 2010;20(9):669–75.
AICR. World Cancer Research Fund/American Institute for Cancer Research. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Washington, DC: AICR; 2007.
Calle EE, Rodriguez C, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625–38.
Stocks T, Borena W, et al. Cohort profile: the metabolic syndrome and cancer project (Me-Can). Int J Epidemiol. 2010;39(3):660–7.
Bjørndal B, Burri L, et al. Different adipose depots: their role in the development of metabolic syndrome and mitochondrial response to hypolipidemic agents. J Obes. 2011;2011:490650.
Sun K, Kusminski CM, et al. Adipose tissue remodeling and obesity. J Clin Invest. 2011;121(6):2094–101.
Wood IS, de Heredia FP, et al. Cellular hypoxia and adipose tissue dysfunction in obesity. Proc Nutr Soc. 2009;68(4):370–7.
Henry SL, Bensley JG, et al. White adipocytes: more than just fat depots. Int J Biochem Cell Biol. 2012;44(3):435–40.
Anderson N, Borlak J. Molecular mechanisms and therapeutic targets in steatosis and steatohepatitis. Pharmacol Rev. 2008;60(3):311–57.
Lee JS, Kim SH, et al. Clinical implications of fatty pancreas: correlations between fatty pancreas and metabolic syndrome. World J Gastroenterol. 2009;15(15):1869–75.
Kotronen A, Westerbacka J, et al. Liver fat in the metabolic syndrome. J Clin Endocrinol Metab. 2007;92(9):3490–7.
Neuschwander-Tetri BA, Caldwell SH. Nonalcoholic steatohepatitis: summary of an AASLD Single Topic Conference. Hepatology. 2003;37(5):1202–19.
Vanni E, Bugianesi E, et al. From the metabolic syndrome to NAFLD or vice versa? Dig Liver Dis. 2010;42(5):320–30.
Adams LA, Lymp JF, et al. The natural history of nonalcoholic fatty liver disease: a population-based cohort study. Gastroenterology. 2005;129(1):113–21.
Bellentani S, Marino M. Epidemiology and natural history of non-alcoholic fatty liver disease (NAFLD). Ann Hepatol. 2009;8 Suppl 1:S4–8.
Browning JD, Szczepaniak LS, et al. Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity. Hepatology. 2004;40(6):1387–95.
Charlton M. Nonalcoholic fatty liver disease: a review of current understanding and future impact. Clin Gastroenterol Hepatol. 2004;2(12):1048–58.
Fraser A, Longnecker MP, et al. Prevalence of elevated alanine aminotransferase among US adolescents and associated factors: NHANES 1999-2004. Gastroenterology. 2007;133(6):1814–20.
Lam B, Younossi ZM. Treatment options for nonalcoholic fatty liver disease. Therap Adv Gastroenterol. 2010;3(2):121–37.
Amarapurkar D, Kamani P, et al. Prevalence of non-alcoholic fatty liver disease: population based study. Ann Hepatol. 2007;6(3):161–3.
Bedogni G, Miglioli L, et al. Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study. Hepatology. 2005;42(1):44–52.
Zhou Y, Zheng S, et al. The interruption of the PDGF and EGF signaling pathways by curcumin stimulates gene expression of PPARgamma in rat activated hepatic stellate cell in vitro. Lab Invest. 2007;87(5):488–98.
Zhou YJ, Li YY, et al. Prevalence of fatty liver disease and its risk factors in the population of South China. World J Gastroenterol. 2007;13(47):6419–24.
Higuchi H, Gores GJ. Mechanisms of liver injury: an overview. Curr Mol Med. 2003;3(6):483–90.
Day CP, James OF. Steatohepatitis: a tale of two “hits”? Gastroenterology. 1998;114(4):842–5.
Ip E, Farrell GC, et al. Central role of PPARalpha-dependent hepatic lipid turnover in dietary steatohepatitis in mice. Hepatology. 2003;38(1):123–32.
Reddy JK, Rao MS. Lipid metabolism and liver inflammation. II. Fatty liver disease and fatty acid oxidation. Am J Physiol Gastrointest Liver Physiol. 2006;290(5):G852–8.
Cai D, Yuan M, et al. Local and systemic insulin resistance resulting from hepatic activation of IKK-beta and NF-kappaB. Nat Med. 2005;11(2):183–90.
Braun S, Bitton-Worms K, et al. The link between the metabolic syndrome and cancer. Int J Biol Sci. 2011;7(7):1003–15.
Pollak M. Insulin and insulin-like growth factor signalling in neoplasia. Nat Rev Cancer. 2008;8(12):915–28.
Hursting SD, Smith SM, et al. Calories and cancer: the role of insulin-like growth factor-1. In: Leroith D, editor. The IGF system and cancer. New York: Springer; 2011. p. 231–43.
Wong KK, Engelman JA, et al. Targeting the PI3K signaling pathway in cancer. Curr Opin Genet Dev. 2010;20(1):87–90.
Memmott RM, Dennis PA. Akt-dependent and -independent mechanisms of mTOR regulation in cancer. Cell Signal. 2009;21(5):656–64.
Lindsley JE, Rutter J. Nutrient sensing and metabolic decisions. Comp Biochem Physiol B Biochem Mol Biol. 2004;139(4):543–59.
Moore T, Beltran L, et al. Dietary energy balance modulates signaling through the Akt/mammalian target of rapamycin pathways in multiple epithelial tissues. Cancer Prev Res (Phila). 2008;1(1):65–76.
De Angel RE, Conti CJ, et al. The enhancing effects of obesity on mammary tumor growth and Akt/mTOR pathway activation persist after weight loss and are reversed by RAD001. Mol Carcinog. 2013;52(6):446–58.
Nogueira LM, Dunlap SM, Ford NA, Hursting SD. Calorie restriction and rapamycin inhibit MMTV-Wnt-1 mammary tumor growth in a mouse model of postmenopausal obesity. Endocr Relat Cancer. 2012;19(1):57–68.
Anisimov VN. Metformin for aging and cancer prevention. Aging (Albany NY). 2010;2(11):760–74.
Athar M, Kopelovich L. Rapamycin and mTORC1 inhibition in the mouse: skin cancer prevention. Cancer Prev Res (Phila). 2011;4(7):957–61.
Chaudhary SC, Kurundkar D, et al. Metformin, an antidiabetic agent reduces growth of cutaneous squamous cell carcinoma by targeting mTOR signaling pathway. Photochem Photobiol. 2012;88(5):1149–56.
Checkley LA, Rho O, et al. Rapamycin is a potent inhibitor of skin tumor promotion by 12-O-tetradecanoylphorbol-13-acetate. Cancer Prev Res (Phila). 2011;4(7):1011–20.
Tomimoto A, Endo H, et al. Metformin suppresses intestinal polyp growth in ApcMin/+ mice. Cancer Sci. 2008;99(11):2136–41.
Gautron L, Elmquist JK. Sixteen years and counting: an update on leptin in energy balance. J Clin Invest. 2011;121(6):2087–93.
Villanueva EC, Myers Jr MG. Leptin receptor signaling and the regulation of mammalian physiology. Int J Obes (Lond). 2008;32 Suppl 7:S8–12.
Vaiopoulos AG, Marinou K, et al. The role of adiponectin in human vascular physiology. Int J Cardiol. 2012;155(2):188–93.
Barb D, Williams CJ, et al. Adiponectin in relation to malignancies: a review of existing basic research and clinical evidence. Am J Clin Nutr. 2007;86(3):s858–66.
Stofkova A. Leptin and adiponectin: from energy and metabolic dysbalance to inflammation and autoimmunity. Endocr Regul. 2009;43(4):157–68.
Fenton JI, Hord NG, et al. Leptin, insulin-like growth factor-1, and insulin-like growth factor-2 are mitogens in ApcMin/+ but not Apc+/+ colonic epithelial cell lines. Cancer Epidemiol Biomarkers Prev. 2005;14(7):1646–52.
Stattin P, Lukanova A, et al. Obesity and colon cancer: does leptin provide a link? Int J Cancer. 2004;109(1):149–52.
Wu MH, Chou YC, et al. Circulating levels of leptin, adiposity and breast cancer risk. Br J Cancer. 2009;100(4):578–82.
Grossmann ME, Nkhata KJ, et al. Effects of adiponectin on breast cancer cell growth and signaling. Br J Cancer. 2008;98(2):370–9.
Rzepka-Gorska I, Bedner R, et al. Serum adiponectin in relation to endometrial cancer and endometrial hyperplasia with atypia in obese women. Eur J Gynaecol Oncol. 2008;29(6):594–7.
Tian YF, Chu CH, et al. Anthropometric measures, plasma adiponectin, and breast cancer risk. Endocr Relat Cancer. 2007;14(3):669–77.
Jung CH, Rhee EJ, et al. The relationship of adiponectin/leptin ratio with homeostasis model assessment insulin resistance index and metabolic syndrome in apparently healthy korean male adults. Korean Diabetes J. 2010;34(4):237–43.
Labruna G, Pasanisi F, et al. High leptin/adiponectin ratio and serum triglycerides are associated with an “at-risk” phenotype in young severely obese patients. Obesity (Silver Spring). 2011;19(7):1492–6.
Mirza S, Qu HQ, et al. Adiponectin/leptin ratio and metabolic syndrome in a Mexican American population. Clin Invest Med. 2011;34(5):E290.
Ashizawa N, Yahata T, et al. Serum leptin-adiponectin ratio and endometrial cancer risk in postmenopausal female subjects. Gynecol Oncol. 2010;119(1):65–9.
Chen DC, Chung YF, et al. Serum adiponectin and leptin levels in Taiwanese breast cancer patients. Cancer Lett. 2006;237(1):109–14.
Cleary MP, Ray A, et al. Targeting the adiponectin:leptin ratio for postmenopausal breast cancer prevention. Front Biosci (Schol Ed). 2009;1:329–57.
Harvey AE, Lashinger LM, et al. The growing challenge of obesity and cancer: an inflammatory issue. Ann N Y Acad Sci. 2011;1229:45–52.
Olefsky JM, Glass CK. Macrophages, inflammation, and insulin resistance. Annu Rev Physiol. 2010;72:219–46.
Subbaramaiah K, Howe LR, et al. Obesity is associated with inflammation and elevated aromatase expression in the mouse mammary gland. Cancer Prev Res (Phila). 2011;4(3):329–46.
O’Rourke RW. Inflammation in obesity-related diseases. Surgery. 2009;145(3):255–9.
Karin M. Nuclear factor-kappaB in cancer development and progression. Nature. 2006;441(7092):431–6.
Renehan AG, Roberts DL, et al. Obesity and cancer: pathophysiological and biological mechanisms. Arch Physiol Biochem. 2008;114(1):71–83.
Virchow R. Die Krankenhasften Geschwulste; Berlin, Germany. Aetologie der neoplastichen Geschwelste/Pathogenie der neoplastischen Geschwulste. 1863;58.
Aggarwal BB, Gehlot P. Inflammation and cancer: how friendly is the relationship for cancer patients? Curr Opin Pharmacol. 2009;9(4):351–69.
Del Prete A, Allavena P, et al. Molecular pathways in cancer-related inflammation. Biochem Med (Zagreb). 2011;21(3):264–75.
Ono M. Molecular links between tumor angiogenesis and inflammation: inflammatory stimuli of macrophages and cancer cells as targets for therapeutic strategy. Cancer Sci. 2008;99(8):1501–6.
Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002;420(6917):860–7.
Foltz CJ, Fox JG, et al. Spontaneous inflammatory bowel disease in multiple mutant mouse lines: association with colonization by Helicobacter hepaticus. Helicobacter. 1998;3(2):69–78.
Allavena P, Sica A, Garlanda C, Mantovani A. The Yin-Yang of tumor-associated macrophages in neoplastic progression and immune surveillance. Immunol Rev. 2008;222:155–61.
Koki A, Khan NK, et al. Cyclooxygenase-2 in human pathological disease. Adv Exp Med Biol. 2002;507:177–84.
Kundu JK, Surh YJ. Inflammation: gearing the journey to cancer. Mutat Res. 2008;659(1–2):15–30.
Byrne AM, Bouchier-Hayes DJ, et al. Angiogenic and cell survival functions of vascular endothelial growth factor (VEGF). J Cell Mol Med. 2005;9(4):777–94.
Liu Y, Tamimi RM, et al. The association between vascular endothelial growth factor expression in invasive breast cancer and survival varies with intrinsic subtypes and use of adjuvant systemic therapy: results from the Nurses’ Health Study. Breast Cancer Res Treat. 2011;129(1):175–84.
Cao Y. Angiogenesis modulates adipogenesis and obesity. J Clin Invest. 2007;117(9):2362–8.
Renehan AG. Body fatness and bevacizumab-based therapy in metastatic colorectal cancer. Gut. 2010;59(3):289–90.
Simkens LH, Koopman M, et al. Influence of body mass index on outcome in advanced colorectal cancer patients receiving chemotherapy with or without targeted therapy. Eur J Cancer. 2011;47(17):2560–7.
Iwaki T, Urano T, et al. PAI-1, progress in understanding the clinical problem and its aetiology. Br J Haematol. 2012;157(3):291–8.
Muldowney 3rd JA, Chen Q, et al. Pentoxifylline lowers plasminogen activator inhibitor 1 levels in obese individuals: a pilot study. Angiology. 2012;63(6):429–34.
Skurk T, Hauner H. Obesity and impaired fibrinolysis: role of adipose production of plasminogen activator inhibitor-1. Int J Obes Relat Metab Disord. 2004;28(11):1357–64.
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Ford, N.A., DiGiovanni, J., Hursting, S.D. (2013). Metabolic Perturbations Associated with Adipose Tissue Dysfunction and the Obesity–Cancer Link. In: Kolonin, M. (eds) Adipose Tissue and Cancer. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7660-3_1
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DOI: https://doi.org/10.1007/978-1-4614-7660-3_1
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