Risk of gastrointestinal cancer in patients with metabolic syndrome. Literature review

Abstract

Metabolic syndrome is known to be a combination of metabolic abnormalities, such as abdominal obesity, abnormal glucose metabolism, elevated level of triglycerides, decreased level of high-density lipoprotein cholesterol, and hypertension. The presence of these abnormalities contributes to insulin resistance and increases the risk of diabetes mellitus development. The increase in the prevalence of metabolic syndrome worldwide is a concern not only in terms of increasing overall and cardiovascular mortality, but also in the fact that it is a potential risk factor for specific types of gastrointestinal cancer. Recent investigations, in particular a large-scale prospective study of the British Biobank cohort, which included 502.656 adults, showed that metabolic syndrome, independently of diabetes prevalence, directly correlated with an overall risk of gastrointestinal cancer as a whole and its individual components in both men and women. Metabolic syndrome closely correlated with an increased risk of colorectal cancer, hepatocellular carcinoma, pancreatic cancer in women and esophageal adenocarcinoma in men. Possible mechanisms that are likely to affect gastrointestinal neoplasia include chronic inflammation associated with obesity, hyperglycemia and hyperinsulinemia associated with metabolic syndrome, production by visceral adipose tissue of large numbers of adipokines that inhibit apoptosis and stimulate mitogenesis by promoting proliferation. It is generally concluded that metabolic syndrome and its individual components present the independent factors that increase the risk of gastrointestinal cancer, and various strategies (both surgical and therapeutic), impacting the metabolic syndrome and its individual components, are of great importance in the prevention of various gastrointestinal cancers.