厄瓜多尔Laron综合征(ELS)患者的癌症。

IF 4.1 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Endocrine-related cancer Pub Date : 2023-06-01 DOI:10.1530/ERC-22-0389
Jaime Guevara-Aguirre, Gabriela Peña, Gabriel Pazmiño, William Acosta, Jannette Saavedra, Daniela Lescano, Alexandra Guevara, Antonio W D Gavilanes
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引用次数: 0

摘要

2018-2022年的荟萃分析显示,肥胖会增加各种癌症的风险,如急性髓性淋巴瘤、慢性髓性淋巴瘤、弥漫性β细胞淋巴瘤、霍奇金淋巴瘤、白血病、多发性骨髓瘤、非霍奇金淋巴瘤、膀胱癌、乳腺癌、胆管癌、结直肠癌、卵巢癌、食道癌、肾癌、肝癌、前列腺癌、甲状腺癌和子宫癌。就具体情况而言,肥胖及其合并症是人类历史上规模最大、最致命的流行病;因此,需要确定基本机制,以充分应对这一全球健康威胁。在此,我们提出了与肥胖相关的代谢和激素机制,这些机制可能在病因上导致肿瘤,包括高胰岛素血症和胰岛素信号通路中的假定位置。过量的胰岛素,作为一种生长因子,可能有助于肿瘤的发生,而丰富的ATP和GDP提供了快速分裂细胞增殖所需的额外能量。我们对厄瓜多尔Laron综合征(ELS)患者队列的观察证明,肥胖并不总是与癌症风险增加相关。事实上,尽管这些人从出生到死亡都有多余的脂肪,但与年龄和性别匹配的亲属相比,他们的癌症发病率降低了。此外,在暴露于强氧化剂的细胞培养中,添加ELS血清诱导较少的DNA损伤和增加的细胞凋亡。由于生长激素受体缺陷,ELS个体在碳水化合物代谢中缺乏生长激素(GH)的反调节作用。相应的生化表型包括极低的胰岛素和胰岛素样生长因子- 1的基础血清浓度,较低的基础葡萄糖和甘油三酯(TG)水平,以及口服葡萄糖或混合膳食对葡萄糖、TG和胰岛素的反应降低。
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Cancer in Ecuadorian subjects with Laron syndrome (ELS).

Meta-analyses from 2018-2022 have shown that obesity increases the risk of various cancers such as acute myeloid lymphoma, chronic myeloid lymphoma, diffuse beta cell lymphoma, Hodgkin's lymphoma, leukemia, multiple myeloma, non-Hodgkin's lymphoma, bladder, breast, cholangiocarcinoma, colorectal, ovarian, esophageal, kidney, liver, prostate, thyroid, and uterus. Contextually, obesity, and its comorbidities, is the largest, most lethal pandemics in the history of mankind; hence, identification of underlying mechanisms is needed to adequately address this global health threat. Herein, we present the metabolic and hormonal mechanisms linked to obesity that might etiologically contribute to neoplasia, including hyperinsulinemia and putative places in the insulin-signaling pathway. Excess insulin, acting as a growth factor, might contribute to tumorigenesis, while abundant ATP and GDP supply the additional energy needed for proliferation of rapidly dividing cells. Our observations in the Ecuadorian cohort of subjects with Laron syndrome (ELS) prove that obesity does not always associate with increased cancer risk. Indeed, despite excess body fat from birth to death, these individuals display a diminished incidence of cancer when compared to their age- and sex-matched relatives. Furthermore, in cell cultures exposed to potent oxidizing agents, addition of ELS serum induces less DNA damage as well as increased apoptosis. ELS individuals have absent growth hormone (GH) counter-regulatory effects in carbohydrate metabolism due to a defective GH receptor. The corresponding biochemical phenotype includes extremely low basal serum concentrations of insulin and insulin-like growth factor-I, lower basal glucose and triglyceride (TG) levels, and diminished glucose, TG, and insulin responses to orally administered glucose or to a mixed meal.

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来源期刊
Endocrine-related cancer
Endocrine-related cancer 医学-内分泌学与代谢
CiteScore
7.80
自引率
2.60%
发文量
138
审稿时长
6-12 weeks
期刊介绍: Endocrine-Related Cancer is an official flagship journal of the Society for Endocrinology and is endorsed by the European Society of Endocrinology, the United Kingdom and Ireland Neuroendocrine Society, and the Japanese Hormones and Cancer Society. Endocrine-Related Cancer provides a unique international forum for the publication of high quality original articles describing novel, cutting edge basic laboratory, translational and clinical investigations of human health and disease focusing on endocrine neoplasias and hormone-dependent cancers; and for the publication of authoritative review articles in these topics. Endocrine neoplasias include adrenal cortex, breast, multiple endocrine neoplasia, neuroendocrine tumours, ovary, prostate, paraganglioma, parathyroid, pheochromocytoma pituitary, testes, thyroid and hormone-dependent cancers. Neoplasias affecting metabolism and energy production such as bladder, bone, kidney, lung, and head and neck, are also considered.
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