Visceral Obesity and Its Shared Role in Cancer and Cardiovascular Disease: A Scoping Review of the Pathophysiology and Pharmacological Treatments

Abstract

The association between obesity, cancer and cardiovascular disease (CVD) has been demonstrated in animal and epidemiological studies. However, the specific role of visceral obesity on cancer and CVD remains unclear. Visceral adipose tissue (VAT) is a complex and metabolically active tissue, that can produce different adipokines and hormones, responsible for endocrine-metabolic comorbidities. This review explores the potential mechanisms related to VAT that may also be involved in cancer and CVD. In addition, we discuss the shared pharmacological treatments which may reduce the risk of both diseases. This review highlights that chronic inflammation, molecular aspects, metabolic syndrome, secretion of hormones and adiponectin associated to VAT may have synergistic effects and should be further studied in relation to cancer and CVD. Reductions in abdominal and visceral adiposity improve insulin sensitivity, lipid profile and cytokines, which consequently reduce the risk of CVD and some cancers. Several medications have shown to reduce visceral and/or subcutaneous fat. Further research is needed to investigate the pathophysiological mechanisms by which visceral obesity may cause both cancer and CVD. The role of visceral fat in cancer and CVD is an important area to advance. Public health policies to increase public awareness about VAT’s role and ways to manage or prevent it are needed.

Visceral Adiposity in Relation to Body Adiposity and Nutritional Status in Elderly Patients with Stable Coronary Artery Disease

“…More importantly, a growing body of evidence suggests that many adipokines may directly mediate atherogenesis by affecting the function of endothelial cells, arterial smooth muscle cells, and macrophages within arterial walls [ 2 , 3 ]. The accumulation of visceral abdominal tissue (VAT) seems to be a hallmark feature of abdominal obesity and substantially contributes to metabolic abnormalities [ 4 ]. In that respect, visceral adiposity may explain more of the variance in the CVD risk factors than would general obesity [ 5 ].…”

The Effectiveness of Extra Virgin Olive Oil and the Traditional Brazilian Diet in Reducing the Inflammatory Profile of Individuals with Severe Obesity: A Randomized Clinical Trial

“…In fact, the association between obesity and cardiovascular disease (CVD) has been established in animal and epidemiological studies [7]. The excess of adipose tissue in individuals with severe obesity has been associated with the release of inflammatory blood markers such as C-reactive protein (CRP), white blood cell count (WBC), fibrinogen (FB), leukocyte count and neutrophil-to-lymphocyte ratio (NLR) which constitute low-grade chronic inflammation, representing a potential link between obesity and metabolic disorders or systemic vascular complications [8][9][10][11][12][13][14][15][16]. Individuals with obesity and an increased concentration of serum insulin showed a higher total leukocyte count [16].…”

The Role of Sarcopenic Obesity in Cancer and Cardiovascular Disease: A Synthesis of the Evidence on Pathophysiological Aspects and Clinical Implications

“…As previously discussed, amino acids derived from proteolysis and sarcopenic condition may serve as an additional supply to tumor nutrition. Thus, sarcopenic obesity is associated with endometrial, breast, uterine, ovarian and prostate cancers [18]. The mechanism of action of sex hormones in these diseases involves the participation of the aromatase enzyme, whose expression is increased with the increase of adipose tissue.…”

“…The sarcopenic obese phenotype has been increasingly identified among cancer patients [105][106][107], which is probably due to the increasing prevalence of obesity all over the world combined with intense muscular catabolism caused by the treatment and/or by the staging of the disease itself [108]. It is worth mentioning that obesity has reached epidemic proportions worldwide and that this, in turn, increases the risk of several types of cancer [1,18].…”

“…However, there is no evidence currently showing the role of sarcopenic obesity in the occurrence of CVD and cancer and its potential pathophysiological mechanisms involved. CVD and cancer share many pathophysiological aspects, risk factors, prevention and treatment [18]. The present study is relevant considering the global context of an everincreasing older adult population, the epidemic and associated burden of CVD and cancer and the increased rates of obesity and sarcopenia, especially among older adults.…”