Visceral Adiposity and Cancer: Role in Pathogenesis and Prognosis

Abstract

The prevalence of being overweight and obese has been expanded dramatically in recent years worldwide. Obesity usually occurs when the energetic introit overtakes energy expenditure from metabolic and physical activity, leading to fat accumulation mainly in the visceral depots. Excessive fat accumulation represents a risk factor for many chronic diseases, including cancer. Adiposity, chronic low-grade inflammation, and hyperinsulinemia are essential factors of obesity that also play a crucial role in tumor onset. In recent years, several strategies have been pointed toward boundary fat accumulation, thus limiting the burden of cancer attributable to obesity. While remodeling fat via adipocytes browning seems a tempting prospect, lifestyle interventions still represent the main pathway to prevent cancer and enhance the efficacy of treatments. Specifically, the Mediterranean Diet stands out as one of the best dietary approaches to curtail visceral adiposity and, therefore, cancer risk. In this Review, the close relationship between obesity and cancer has been investigated, highlighting the biological mechanisms at the basis of this link. Finally, strategies to remodel fat, including browning and lifestyle interventions, have been taken into consideration as a major perspective to limit excess body weight and tumor onset.

Obesity and Its Relationship With Cancer: Part I Obesity

“…However, it appears to be more prominent in white men, African American women, and Asian Indian and Japanese men and women (Hamdy et al, 2006). Visceral fat is also closely related to tumorigenesis and the progression of tumors (Crudele et al, 2021).…”

The obesity-breast cancer link: a multidisciplinary perspective

“…The WAT secretome is an important mediator of tumor exacerbation by obesity [81]. Adipokines, secreted by WAT, constitute a class of biologically active polypeptides with a broad range of endocrine, metabolic, and inflammatory functions [89]. Given the extensive interaction between adipocytes and tumor cells in the breast TME, adipokines play a critical role in the proliferative and invasive capacities of breast cancer [90].…”

Using adipose‐derived mesenchymal stem cells to fight the metabolic complications of obesity: Where do we stand?

“…The current most widely used criteria for classifying obesity is the body mass index (BMI), which ranges from class 1 of obesity (BMI ≥ 30.0 kg/m 2 ) to severe or morbid obesity (BMI ≥ 40 kg/m 2 ). Obesity can progressively cause and/or exacerbate a wide spectrum of metabolic comorbidities, including type 2 diabetes mellitus (T2DM), hypertension, dyslipidemia, cardiovascular disease (CVD), nonalcoholic fatty liver disease (NAFLD), and fertility problems 5,6 . The severity and duration of obesity are associated with the metabolic syndrome (MS), which occurs in 4.9% of nonobese patients to 35.3% in patients with obesity 7 .…”

“…Obesity can progressively cause and/or exacerbate a wide spectrum of metabolic comorbidities, including type 2 diabetes mellitus (T2DM), hypertension, dyslipidemia, cardiovascular disease (CVD), nonalcoholic fatty liver disease (NAFLD), and fertility problems. 5,6 The severity and duration of obesity are associated with the metabolic syndrome (MS), which occurs in 4.9% of nonobese patients to 35.3% in patients with obesity. 7 According to the National Institutes of Health, a subject has MS if it satisfies three or more of the following traits: large waist circumference (≥89 cm for women and ≥102 cm for men), hypertriglyceridemia (≥1.7 mmol/L), reduced highdensity lipoprotein cholesterol (HDL-C) (<1.04 mmol/L in men or <1.3 mmol/L in women), hypertension (≥130/≥85 mm Hg), and elevated fasting blood glucose (≥5.6 mmol/L).…”