Impact of metabolically healthy obesity on the risk of incident gastric cancer: a population-based cohort study

Hashimoto, Yoshitaka; Hamaguchi, Masahide; Obora, Akihiro; Kojima, Takao; Fukui, Michiaki

doi:10.1186/s12902-019-0472-2

Cited by 22 publications

(17 citation statements)

References 43 publications

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“…Important to note is that the epidemic of obesity and the MetS are essential causes of morbidity and mortality, and metabolically abnormal obese people appear to exhibit a higher risk for incident GC than metabolically healthy obese ones [ 86 ]. In this respect, there is a potential impact of Hp -associated MetS on the sequence chronic active gastritis-GA—IM—dysplasia-gastric oncogenesis [ 48 ].…”

Section: Discussionmentioning

confidence: 99%

Helicobacter pylori-Related Metabolic Parameters and Premalignant Gastric Mucosa Histological Lesions in Swiss Bariatric Patients

et al. 2021

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Obesity, as a major risk factor of metabolic syndrome (MetS), represents a pandemic, especially in Western societies, and is considered a risk factor for malignancies. Helicobacter pylori (Hp), is a definite carcinogen with global distribution. We aimed to investigate, for the first time in Switzerland, the main gastric mucosa premalignant histological lesions of bariatric patients in correlation with MetS components and Hp Infection (Hp-I). By reviewing retrospectively 94304 patient cases, a total of 116 eligible patients having undergone bariatric surgery were identified. The mean patient age was 48.66 years. Hp(+) patients were 24% (28/116). Presence of gastric mucosa atrophy was documented in 8/28 Hp(+) patients (29%) and (2/88) Hp(−) ones (2%) (p = 0.006). Gastric mucosa intestinal metaplasia was observed in 14/28 (50%) Hp(+) patients versus 3/88 (3.4%) of Hp(-) group (p < 0.0001). Hp(+) patients exhibited statistically higher arterial hypertension (p = 0.033). The homeostatic model of assessment insulin resistance was also statistically significantly higher for the Hp(+) group (p < 0.001). In a multivariate analysis, including arterial hypertension, gastric mucosa atrophy, and intestinal metaplasia as variables, statistical significance remained only for intestinal metaplasia (p = 0.001). In conclusion, Hp-I is associated with premalignant gastric mucosa histologic lesions and MetS components, including arterial hypertension and IR. Further large-scale prospective studies are required to confirm these findings.

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Section: Discussionmentioning

confidence: 99%

Helicobacter pylori-Related Metabolic Parameters and Premalignant Gastric Mucosa Histological Lesions in Swiss Bariatric Patients

et al. 2021

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“…Previous studies shed a light on the incidence rates of gastric cancer in MHO patients. Compared to all other subtypes, the incidence and hazard ratios of gastric cancer were lower than all other groups [ 179 ]. Similarly, the risks of colorectal neoplasia in MHO individuals are lower when compared to their non-obese counterparts, whether healthy or unhealthy [ 180 ].…”

Section: Obesity and Cancer-related Physiological Statesmentioning

confidence: 99%

The ambiguous role of obesity in oncology by promoting cancer but boosting antitumor immunotherapy

Assumpção

Pasquarelli-do-Nascimento

Duarte

et al. 2022

J Biomed Sci

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Obesity is nowadays considered a pandemic which prevalence’s has been steadily increasingly in western countries. It is a dynamic, complex, and multifactorial disease which propitiates the development of several metabolic and cardiovascular diseases, as well as cancer. Excessive adipose tissue has been causally related to cancer progression and is a preventable risk factor for overall and cancer-specific survival, associated with poor prognosis in cancer patients. The onset of obesity features a state of chronic low-grade inflammation and secretion of a diversity of adipocyte-derived molecules (adipokines, cytokines, hormones), responsible for altering the metabolic, inflammatory, and immune landscape. The crosstalk between adipocytes and tumor cells fuels the tumor microenvironment with pro-inflammatory factors, promoting tissue injury, mutagenesis, invasion, and metastasis. Although classically established as a risk factor for cancer and treatment toxicity, recent evidence suggests mild obesity is related to better outcomes, with obese cancer patients showing better responses to treatment when compared to lean cancer patients. This phenomenon is termed obesity paradox and has been reported in different types and stages of cancer. The mechanisms underlying this paradoxical relationship between obesity and cancer are still not fully described but point to systemic alterations in metabolic fitness and modulation of the tumor microenvironment by obesity-associated molecules. Obesity impacts the response to cancer treatments, such as chemotherapy and immunotherapy, and has been reported as having a positive association with immune checkpoint therapy. In this review, we discuss obesity’s association to inflammation and cancer, also highlighting potential physiological and biological mechanisms underlying this association, hoping to clarify the existence and impact of obesity paradox in cancer development and treatment.

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“…Moreover, 245 articles were identified after searching, and 207 were excluded on the basis of titles and abstracts. The other 38 publications were further assessed for eligibility via fulltext review, and 11 articles were eventually selected for metaanalysis (21,22,(27)(28)(29)(30)(31)(32)(33)(34)(35). Notably, of the 27 excluded articles, seven studies compared the incidence of colorectal neoplasm (benign tumor included) between MHO and MUO with the overlapped database.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

The Association Between Metabolic Status and Risk of Cancer Among Patients With Obesity: Metabolically Healthy Obesity vs. Metabolically Unhealthy Obesity

Zheng

Peng

et al. 2022

Front. Nutr.

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BackgroundControversial evidence about the association between cancer risk and metabolic status among individuals with obesity has been reported, but pooled data remain absent. This study aims to present pooled data comparing cancer risk between patients with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO).MethodsThe current study systematically searched pieces of literature on January 4, 2021, of prospective cohorts that compare the incidence of cancer between MHO and MUO. The quality of included studies was assessed using Newcastle–Ottawa scale, and publication bias was evaluated using funnel plots.ResultsEleven high-quality studies were eventually selected. Quantitative analysis indicates that a lower cancer incidence exists for MHO phenotype than that for MUO (odds ratio [OR], 0.71; 95% confidential interval [CI], 0.61–0.84). Consistent outcomes are presented by subgroup analyses, which are grouped by cohort region (western population: [OR, 0.84; 95% CI, 0.75–0.93]; Asian population: [OR, 0.64; 95% CI, 0.54–0.77]); definition of metabolic unhealthiness (≥3 metabolic abnormalities: [OR, 0.62; 95% CI, 0.54–0.71]; ≥1 metabolic abnormality: [OR, 0.76; 95% CI, 0.62–0.94]); and definition of obesity (body mass index (BMI), ≥30 kg/m2: [OR, 0.84; 95% CI, 0.73–0.98]; BMI, ≥25 kg/m2: [OR, 0.53; 95% CI, 0.52–0.55]).ConclusionIn conclusion, this study suggests a reduced cancer risk for MHO compared to MUO regardless of population heterogeneity, or the definitions of obesity and metabolic status.

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Impact of metabolically healthy obesity on the risk of incident gastric cancer: a population-based cohort study

Cited by 22 publications

References 43 publications

Helicobacter pylori-Related Metabolic Parameters and Premalignant Gastric Mucosa Histological Lesions in Swiss Bariatric Patients

Helicobacter pylori-Related Metabolic Parameters and Premalignant Gastric Mucosa Histological Lesions in Swiss Bariatric Patients

The ambiguous role of obesity in oncology by promoting cancer but boosting antitumor immunotherapy

The Association Between Metabolic Status and Risk of Cancer Among Patients With Obesity: Metabolically Healthy Obesity vs. Metabolically Unhealthy Obesity

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