肥胖重塑肿瘤代谢的营养治疗策略及前景

李浩; 胡启辉; 黄真豪; 王继兴; 陶锐

doi:10.16689/j.cnki.cn11-9349/r.2026.01.020

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肿瘤代谢与营养电子杂志 ›› 2026, Vol. 13 ›› Issue (1) : 148-154. DOI: 10.16689/j.cnki.cn11-9349/r.2026.01.020

综述

肥胖重塑肿瘤代谢的营养治疗策略及前景

¹李浩, ¹胡启辉, ¹黄真豪, ¹王继兴, ²陶锐

作者信息 +

Nutritional therapy strategies and prospects for obesity-remodeled tumor metabolism

¹Li Hao, ¹Hu Qihui, ¹Huang Zhenhao, ¹Wang Jixing, ²Tao Rui

Author information +

文章历史 +

摘要

肿瘤的代谢适应是其在复杂微环境中维持生存、促进增殖并产生耐药性的核心生物学特征,主要表现为对葡萄糖、谷氨酰胺及脂质等关键营养物质的代谢通路进行重新编程,通过调整物质的利用方式,以应对微环境中营养成分波动、缺氧等不利条件。在全球肥胖流行的背景下,肥胖已成为推动肿瘤发病率上升的重要危险因素,其通过多种途径重塑肿瘤代谢适应表型,包括诱发胰岛素抵抗导致高胰岛素血症,进而促进肿瘤细胞生长信号激活;引发慢性低度炎症,通过炎症因子调控代谢相关基因表达;导致异位脂肪沉积,为肿瘤提供额外脂质原料;以及扰乱肠道菌群平衡,间接影响机体代谢稳态等。而营养干预,例如限时饮食、代谢手术、生酮饮食等,可以通过调节物质的能量供应、饮食昼夜节律及相关代谢通路生物活性,逆转肿瘤的代谢适应。本综述系统阐述了肿瘤代谢适应及肥胖与肿瘤代谢交叉作用的分子机制,总结了营养治疗对肿瘤代谢适应的干预效果,并展望未来基于代谢靶点的精准营养治疗。

Abstract

Metabolic adaptation is a core biological feature of tumors that enables them to survive in complex microenvironments, promote proliferation, and develop drug resistance. This adaptation is primarily characterized by the reprogramming of metabolic pathways for key nutrients such as glucose, glutamine, and lipids. By altering the utilization of these substances, tumors respond to adverse conditions in the microenvironment, including fluctuations in nutrient availability and hypoxia. Against the backdrop of the global obesity epidemic, obesity has emerged as a significant risk factor driving the rising incidence of tumors. It remodels the metabolic adaptation phenotype of tumors through multiple pathways, including inducing insulin resistance and hyperinsulinemia, which in turn activate tumor cell growth signaling; triggering chronic low-grade inflammation that regulates the expression of metabolism-related genes via inflammatory factors; causing ectopic fat deposition that provides additional lipid resources for tumors; and disrupting gut microbiota balance, indirectly affecting systemic metabolic homeostasis.Nutritional interventions, such as time-restricted eating, metabolic surgery, and ketogenic diets, can reverse the metabolic adaptation of tumors by modulating energy supply, dietary circadian rhythms, and the bioactivity of related metabolic pathways. This review systematically elaborates on the molecular mechanisms underlying tumor metabolic adaptation and the intersection between obesity and tumor metabolism. It summarizes the effects of nutritional therapies on tumor metabolic adaptation and looks ahead to future metabolism-targeted precision nutritional treatments.

导出引用

李浩, 胡启辉, 黄真豪, 王继兴, 陶锐. 肥胖重塑肿瘤代谢的营养治疗策略及前景[J]. 肿瘤代谢与营养电子杂志. 2026, 13(1): 148-154 https://doi.org/10.16689/j.cnki.cn11-9349/r.2026.01.020

Li Hao, Hu Qihui, Huang Zhenhao, Wang Jixing, Tao Rui. Nutritional therapy strategies and prospects for obesity-remodeled tumor metabolism[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2026, 13(1): 148-154 https://doi.org/10.16689/j.cnki.cn11-9349/r.2026.01.020

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