健康体重,科学抗癌:肥胖与癌症发病的关联及量效关系

邹辉; 许淑芳

doi:10.16689/j.cnki.cn11-9349/r.2026.04.006

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肿瘤代谢与营养电子杂志 ›› 2026, Vol. 13 ›› Issue (4) : 491-495. DOI: 10.16689/j.cnki.cn11-9349/r.2026.04.006

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健康体重,科学抗癌:肥胖与癌症发病的关联及量效关系

¹邹辉, ²许淑芳

作者信息 +

Healthy weight and cancer prevention:the mechanistic and dose-effect relationship between obesity and cancer

¹Zou Hui, ²Xu Shufang

Author information +

文章历史 +

摘要

肥胖与癌症发病风险增加相关,脂肪堆积和脂肪组织功能障碍引发炎症反应和激素分泌异常,肠道益生菌种减少以及与癌症发展相关的细菌群落过度增殖,抑制免疫介导的肿瘤细胞清除过程,并通过氧化应激和DNA损伤引发的基因组不稳定性来刺激癌症发展,还可能影响癌症患者的治疗效果和生存结局。通过合理膳食、增加身体活动、保持良好规律的生活方式,以及药物和手术治疗有助于达到健康体重。减重治疗可通过减轻肥胖的不良影响而降低癌症风险,但可能需要超过10%的体重减轻才能有效降低癌症风险。本文从肥胖与癌症发生发展机制的相关性,以及减重与科学抗癌的角度展开论述。

Abstract

Obesity is associated with an increased risk of cancer. Fat accumulation and dysfunction of adipose tissue trigger inflammatory responses and abnormal hormone secretion, leading to a reduction in gut probiotic species and an overgrowth of bacterial communities linked to cancer development. These changes inhibit immune-mediated tumor cell clearance and promote cancer progression through genomic instability induced by oxidative stress and DNA damage, potentially adversely affecting treatment outcomes and survival rates in cancer patients. Achieving a healthy body weight can be achieved through a balanced diet, increased physical activity, maintaining a regular lifestyle, as well as pharmacological and surgical interventions. Weight loss therapy reduces cancer risk by mitigating the adverse effects of obesity; however, a weight loss over 10% is typically required to achieve significant cancer risk reduction. This article discusses the correlation between obesity and cancer pathogenesis, as well as weight loss strategies from a scientific anticancer perspective.

导出引用

邹辉, 许淑芳. 健康体重,科学抗癌:肥胖与癌症发病的关联及量效关系[J]. 肿瘤代谢与营养电子杂志. 2026, 13(4): 491-495 https://doi.org/10.16689/j.cnki.cn11-9349/r.2026.04.006

Zou Hui, Xu Shufang. Healthy weight and cancer prevention:the mechanistic and dose-effect relationship between obesity and cancer[J]. Electronic Journal of Metabolism and Nutrition of Cancer. 2026, 13(4): 491-495 https://doi.org/10.16689/j.cnki.cn11-9349/r.2026.04.006

参考文献

[1] Wang Y, Zhao L, Gao L, et al. Health policy and public health implications of obesity in China[J]. Lancet Diabetes Endocrinol, 2021,(7):446-461.
[2] Chen K, Shen Z, Gu W, et al. Meinian investigator group. Prevalence of obesity and associated complications in China: a cross-sectional, real-world study in 15.8 million adults[J]. Diabetes Obes Metab, 2023,25(11):3390-3399.
[3] Zheng R S, Chen R, Han B F, et al. Cancer incidence and mortality in China, 2022[J]. Zhonghua Zhong Liu Za Zhi,2024,46(3):221-231.
[4] Liu C, Yuan Y C, Guo M N, et al. Rising incidence of obesity-related cancers among younger adults in China: a population-based analysis (2007-2021)[J]. Med,2024,5(11):1402-1412.e2.
[5] Jensen B W, Bjerregaard L G, Nngquist L, et al. Change in weight status from childhood to early adulthood and late adulthood risk of colon cancer in men: a population-based cohort study[J]. Int J Obes (Lond),2018,42(10):1797-1803.
[6] Mahamat-saleh Y, Aune D, Freisling H, et al. Association of metabolic obesity phenotypes with risk of overall and site-specific cancers: a systematic review and meta-analysis of cohort studies[J]. Br J Cancer, 2024,131(9):1480-1495.
[7] Kwon Y R, Kim Y, Kim Y. Exercise-induced modulation of IGF-1 in healthy, obese, and cancer populations: a systematic review and meta-analysis[J]. Ann Med,2025,57(1):2586331.
[8] Knuppel A, Fensom G K, Watts E L, et al. Circulating insulin-like growth factor-I concentrations and risk of 30 cancers: prospective analyses in UK Biobank[J]. Cancer Res, 2020,80(18):4014-4021.
[9] Straub L G, Scherer P E. Metabolic messengers: adiponectin[J]. Nat Metab, 2019,1(3):334-339.
[10] Moukarzel L A, Ferrando L, Stylianou A, et al. Impact of obesity and white adipose tissue inflammation on the omental microenvironment in endometrial cancer[J].Cancer,2022,128(18):3297-3309.
[11] Peng J, Hu Q, Chen X, et al. Diet-induced obesity accelerates oral carcinogenesis by recruitment and functional enhancement of myeloid-derived suppressor cells[J]. Cell Death Dis,2021,12(10):946.
[12] Tang W, Zhou J, Yang W, et al. Aberrant cholesterol metabolic signaling impairs antitumor immunosurveillance through natural killer T cell dysfunction in obese liver[J]. Cell Mol Immunol, 2022, 19(7):834-847.
[13] Gelsomino L, Barone I, Caruso A, et al. Proteomic profiling of extracellular vesicles released by leptin-treated breast cancer cells: a potential role in cancer metabolism[J]. Int J Mol Sci,2022,23(21):12941.
[14] Bhardwaj P, Iyengar N M, Zahid H, et al. Obesity promotes breast epithelium DNA damage in women carrying a germline mutation in BRCA1 or BRCA2[J]. Sci Transl Med,2023,15(684):eade1857.
[15] Fernandez E, Wargo J A, Helmink B A. The microbiome and cancer: a translational science review[J].JAMA, 2025,333(24):2188-2196.
[16] Kang X, Ng S K, Liu C, et al. Altered gut microbiota of obesity subjects promotes colorectal carcinogenesis in mice[J]. EBioMedicine,2023,93: 104670.
[17] Zhu X, Xu P, Zhu R, et al. Multi-kingdom microbial signatures in excess body weight colorectal cancer based on global metagenomic analysis[J]. Commun Biol,2024,7(1):24.
[18] Sánchez-alcoholado L, Ordóez R, Otero A, et al. Gut microbiota-mediated inflammation and gut permeability in patients with obesity and colorectal cancer[J]. Int J Mol Sci,2020,21(18):6782.
[19] Li J, Chen Z, Wang Q, et al. Microbial and metabolic profiles unveil mutualistic microbe-microbe interaction in obesity-related colorectal cancer[J]. Cell Rep Med,2024,5(3):101429.
[20] Shen S, Brown K A, Green A K,et al. Obesity and cancer: a translational science review[J]. JAMA, 2026,335(15):1341-1350.
[21] Campbell K L, Landells C E, Fan J, et al. A systematic review of the effect of lifestyle interventions on adipose tissue gene expression: implications for carcinogenesis[J]. Obesity (Silver Spring), 2017,25(suppl 2):S40-S51.
[22] Yeh H C, Bantle J P, Cassidy-begay M, et al. Look AHEAD Research Group. Intensive weight loss intervention and cancer risk in adults with type 2 diabetes: analysis of the Look AHEAD randomized clinical trial[J]. Obesity (Silver Spring), 2020,28(9): 1678-1686.
[23] Aminian A, Wilson R, Al-kurd A, et al. Association of bariatric surgery with cancer risk and mortality in adults with obesity[J].JAMA,2022,327 (24):2423-2433.
[24] Ligibel J A, Ballman K V, Mccall L, et al. Impact of a weight loss intervention on 1-year weight change in women with stage II/III breast cancer: secondary analysis of the Breast Cancer Weight Loss (BWEL) trial[J].JAMA Oncol,2025,11(10):1194-1203.
[25] Benedetti R, Benincasa G, Glass K, et al. Effects of novel SGLT2 inhibitors on cancer incidence in hyperglycemic patients: a meta-analysis of randomized clinical trials[J]. Pharmacol Res,2022,175: 106039.
[26] Liu F, Yang Q, Zhang H, et al. The effects of glucagon-like peptide-1 receptor agonists on adipose tissues in patients with type 2 diabetes: a meta-analysis of randomised controlled trials[J]. PLoS One, 2022,17(7):e0270899.
[27] Wang L, Xu R, Kaelber D C, et al. Glucagon-like peptide 1 receptor agonists and 13 obesity-associated cancers in patients with type 2 diabetes[J]. JAMA Netw Open,2024,7(7):e2421305.
[28] Wilding J P H, Batterham R L, Calanna S, et al. STEP 1 Study Group. Once-weekly semaglutide in adults with overweight or obesity[J]. N Engl J Med, 2021,384(11):989-1002.
[29] Jastreboff A M, Aronne L J, Ahmad N N, et al. SURMOUNT-1 Investigators. Tirzepatide once weekly for the treatment of obesity[J]. N Engl J Med, 2022,387(3):205-216.
[30] Dai H, Li Y, Lee Y A, et al. GLP-1 receptor agonists and cancer risk in adults with obesity[J]. JAMA Oncol,2025,11(10):1186-1193.
[31] Xande J G, Del G A. GLP-1 receptor agonists in breast cancer: a new frontier in obesity and prognosis management[J]. Int J Mol Sci, 2025,26(16):7744.
[32] Sukumar J S, Raghavendra A S, Pasyar S, et al. Weight loss patterns and clinical outcomes of GLP1 receptor agonists in breast cancer survivors[J]. Cancer Res Commun, 2026 6(3):447-455.