Obesity, Diabetes, the Cardiorenal Syndrome, and Risk for Cancer

Abstract

Numerous epidemiological studies confirm that the prevalence of obesity and the cardiorenal metabolic syndrome (CRS) is extraordinarily high and that the rates have increased dramatically in the last three decades. In addition, epidemiological data demonstrate that obesity, the CRS, and diabetes are inextricably linked and are all associated with an increased incidence of a number of solid tissue cancers. The mechanisms for this association have been examined, including, but not limited to, higher levels of insulin and free levels of insulin-like growth factor and insulin resistance in obesity and the CRS. Mortality, morbidity, and the associated health care costs which are the link between obesity, the CRS, and diabetes are just beginning to be examined. In addition, we review the advantages of implementing lifestyle and surgical changes to modify obesity, lessening the development of the CRS, diabetes, and associated cancers. Epidemiological data regarding the general mechanisms of the pathogenesis of cancers associated with obesity, the CRS, and diabetes (specifically colon, pancreas, esophageal, liver, breast, prostate, thyroid, and renal carcinomas) are reviewed. The mechanisms by which obesity and other components of the CRS contribute to the pathogenesis of these cancers, such as hormone alterations and insulin-and insulin-like growth factor-dependent pathways of tumor pathogenesis, include the attending roles of inflammation and oxidative stress. Emphasis has been placed

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“…GH therapy increases insulin resistance. Obesity and insulin resistance are found to be associated with an increased incidence of solid tissue cancers (colorectal, endometrium, kidney, pancreas, esophagus, postmenopausal breast cancer, and gall bladder) (79). It has been estimated that 15-20% of all cancer deaths in the United States can be attributed to overweight or obesity (80).…”

“…Hyperinsulinemia, elevated IGF1 level, increased production of estrogens by adipose tissue (due to increased aromatase activity in adipose tissue), decrease of sex steroid-binding globulin (due to reduction in the hepatic synthesis by hyperinsulinemia), altered circulating levels of adipocytokines (TNF-a, IL6, IL1, VEGF, leptin, heparin-binding epidermal growth factor-like growth factor (HB-EGF), adiponectin), inflammation and oxidative stress are possibly involved (79).…”

<i>In vitro</i> evaluation of mutagenicity and genotoxicity of sitagliptin alone and in combination with artificial sweeteners

“…Significant association is seen between diabetes, diabetes therapies, and cancer [3]. In fact metabolic dysfunction influences tumorigenesis because of which obese and diabetic patients are at greater risk of cancer [4].…”

Obesity and Related Chronic Health Conditions as Predictors of Motivation to Engage in Healthy Eating Behaviors Among Black Adults

“…The chronic health conditions associated with obesity include conditions such as cardiovascular disease, stroke, hypertension, type 2 diabetes, and certain forms of cancer [7]. These health conditions represent four of the six leading causes of death in the USA [8].…”