Obesity and cancer risk: Emerging biological mechanisms and perspectives

A Novel Insight into the Role of Obesity-Related Adipokines in Ovarian Cancer-State-of-the-Art Review and Future Perspectives

Ovarian cancer (OC) is one of the most fatal gynecological neoplasms. Meta-analyses have shown that the relationship between body mass index (BMI) and ovarian cancer incidence was detected in some types of ovarian cancer. Chronic inflammation and excessive accumulation of free fatty acids are key adipose tissue-derived factors initiating cancer development. Cancer cells transform adipose-derived stem cells into cancer-associated adipocytes, which produce adipokines and interleukins. It was revealed that adipokines exert a pleiotropic role in ovarian cancer pathogenesis. Chemerin presents both pro-cancer and anti-cancer action in ovarian cancer development. Chemerin induces angiogenesis and increases programmed death ligand-1 (PD-L1) expression, leading to enhanced proliferation and migration of OC cells. Apelin impacts cancer cell migration and acts as a mitogenic factor. Moreover, apelin exerts influence on lipid uptake into cancer cells and accelerates fatty acid oxidation, which provides energy for cancer cells. Visfatin induces matrix metallopeptidase 2 (MMP2) expression involved in extracellular matrix degradation and suppresses claudin 3 and 4 expression. Visfatin also induces a shift to anaerobic glucose metabolism and influences poly-ADP ribose polymerase (PARP). Resistin induces MMP2 and vascular endothelial growth factor (VEGF) expression and contributes to cisplatin-resistance development. A substantial body of evidence indicates that antagonists of adipokines mitigate OC progression, and adipokines are gaining gradual recognition as a potential therapeutic aim in ovarian cancer targeted therapy.

Genetic evidence identifies a causal relationship between EBV infection and multiple myeloma risk

BACKGROUND

Previous observational studies have suggested a potential association between Epstein-Barr virus (EBV) infection and the development of multiple myeloma (MM), but this relationship is not clear. Therefore, we conducted a systematic Mendelian randomization (MR) analysis to investigate the causal relationship between EBV infection and the risk of MM, while exploring the possible mediating role of immune cells in this association.

METHODS

The study first conducted a two-sample MR analysis using the MM R11 dataset from the FinnGen Consortium to evaluate the causal relationship between five EBV infection-related antibodies (AEB-IgG, EA-D, EBNA-1, VCA-p18, and ZEBRA) and MM, with validation in the MM R10 dataset. A reverse MR analysis was then performed. For significant results, multivariable MR (MVMR) was used to adjust for the effects of confounding risk factors. Next, a two-step MR mediation analysis was applied to investigate the potential mediating role of 731 immune cell types between positive exposure and MM. Multiple sensitivity analyses were conducted to assess the robustness of the findings.

RESULTS

A two-sample MR study found that EBNA-1 antibodies (OR = 1.36, 95% CI: 1.06-1.73; P = 0.015) were associated with an increased risk of MM, with similar results observed in the FinnGen Consortium R10 replication study. Although the association did not remain statistically significant after false discovery rate (FDR) adjustment (P_fdr = 0.075), further adjustment for relevant confounders using multivariable MR (MVMR) demonstrated that EBNA-1 antibodies (OR = 1.33, 95% CI: 1.01-1.75; P = 0.041) were still significantly associated with an increased risk of MM. Reverse MR analysis indicated no causal effect of MM on EBV-related antibodies. A two-sample MR analysis involving 731 immune cell phenotypes identified 27 potential mediating cell types. Ultimately, two-step MR confirmed that HLA-DR on myeloid dendritic cells (HLA-DR⁺ mDC) serves as a mediating factor, with EBNA-1 antibodies downregulating HLA-DR⁺ mDC, thereby increasing MM risk. Multiple sensitivity analyses supported the robustness of these findings.

CONCLUSION

The findings of this study suggest that EBNA-1 antibodies may increase the risk of MM by downregulating HLA-DR⁺ mDC. This indicates that chronic EBV infection may contribute to an elevated risk of MM. We hope these results provide new insights for future research on the prevention and treatment of MM.

Phytochemical synergies in BK002: advanced molecular docking insights for targeted prostate cancer therapy

Achyranthes japonica (Miq.) Nakai (AJN) and Melandrium firmum (Siebold and Zucc.) Rohrb. (MFR) are medicinal plants recognized for their bioactive phytochemicals, including ecdysteroids, anthraquinones, and flavonoids. This study investigates the anticancer properties of key constituents of these plants, focusing on the BK002 formulation, a novel combination of AJN and MFR. Specifically, the research employs advanced molecular docking and in silico analyses to assess the interactions of bioactive compounds ecdysterone, inokosterone, and 20-hydroxyecdysone (20-HE) with key prostate cancer-related network proteins, including 5α-reductase, CYP17, DNMT1, Dicer, PD-1, and PD-L1. Molecular docking techniques were applied to evaluate the binding affinities contributions of the bioactive compounds in BK002 against prostate cancer-hub network targets. The primary focus was on enzymes like 5α-reductase and CYP17, which are central to androgen biosynthesis, as well as on cancer-related proteins such as DNA methyltransferase 1 (DNMT1), Dicer, programmed death-1 (PD-1), and programmed death ligand-1 (PD-L1). Based on data from prostate cancer patients, key target networks were identified, followed by in silico analysis of the primary bioactive components of BK002.In silico assessments were conducted to evaluate the safety profiles of these compounds, providing insights into their therapeutic potential. The docking studies revealed that ecdysterone, inokosterone, and 20-hydroxyecdysonec demonstrated strong binding affinities to the critical prostate cancer-related enzymes 5α-reductase and CYP17, contributing to a potential reduction in androgenic activity. These compounds also exhibited significant inhibitory interactions with DNMT1, Dicer, PD-1, and PD-L1, suggesting a capacity to interfere with key oncogenic and immune evasion pathways. Ecdysterone, inokosterone, and 20-hydroxyecdysone have demonstrated the ability to target key oncogenic pathways, and their favorable binding affinity profiles further underscore their potential as novel therapeutic agents for prostate cancer. These findings provide a strong rationale for further preclinical and clinical investigations, supporting the integration of BK002 into therapeutic regimens aimed at modulating tumor progression and immune responses.

Pancreatic endocrine and exocrine signaling and crosstalk in physiological and pathological status

The pancreas, an organ with dual functions, regulates blood glucose levels through the endocrine system by secreting hormones such as insulin and glucagon. It also aids digestion through the exocrine system by secreting digestive enzymes. Complex interactions and signaling mechanisms between the endocrine and exocrine functions of the pancreas play a crucial role in maintaining metabolic homeostasis and overall health. Compelling evidence indicates direct and indirect crosstalk between the endocrine and exocrine parts, influencing the development of diseases affecting both. From a developmental perspective, the exocrine and endocrine parts share the same origin-the "tip-trunk" domain. In certain circumstances, pancreatic exocrine cells may transdifferentiate into endocrine-like cells, such as insulin-secreting cells. Additionally, several pancreatic diseases, including pancreatic cancer, pancreatitis, and diabetes, exhibit potential relevance to both endocrine and exocrine functions. Endocrine cells may communicate with exocrine cells directly through cytokines or indirectly by regulating the immune microenvironment. This crosstalk affects the onset and progression of these diseases. This review summarizes the history and milestones of findings related to the exocrine and endocrine pancreas, their embryonic development, phenotypic transformations, signaling roles in health and disease, the endocrine-exocrine crosstalk from the perspective of diseases, and potential therapeutic targets. Elucidating the regulatory mechanisms of pancreatic endocrine and exocrine signaling and provide novel insights for the understanding and treatment of diseases.

Novel multiparametric bulk and single extracellular vesicle pipeline for adipose cell-specific biomarker discovery in paired human biospecimens

Obesity remains a growing and global public health burden across a broad spectrum of metabolic, systemic, and neurodegenerative diseases. Previously considered merely a fat storage depot, adipose tissue is now recognized as an active endocrine organ crucial for metabolic and systemic regulation of local and distant organs. A burgeoning line of investigation centers on adipose-derived extracellular vesicles (ADEVs) and their pivotal role in obesity-associated pathobiology. However, robust methodologies are lacking for specifically isolating and characterizing human ADEVs. To bridge this gap, we have developed a robust multiparametric framework incorporating bulk and single EV characterization, proteomics, and mRNA phenotyping. EVs from matched human visceral adipose tissue, mature adipocyte-conditioned media, and plasma collected from the same individual bariatric surgical patients were analyzed and subjected to bottom-up proteomics analysis. This framework integrates bulk EV proteomics for cell-specific marker identification and subsequent single EV interrogation with single-particle interferometric reflectance imaging (SP-IRIS) and total internal reflection fluorescence (TIRF) microscopy. Our proteomics analysis revealed 76 unique proteins from adipose tissue-derived EVs (ATEVs), 512 unique proteins from adipocyte EVs (aEVs), and 1003 shared proteins. Prominent pathways enriched in ATEVs included lipid metabolism, extracellular matrix organization, and immune modulation, while aEVs exhibited enhanced roles in chromatin remodeling, oxidative stress responses, and metabolic regulation. Notably, adipose tissue-specific proteins such as adiponectin and perilipin were highly enriched in ADEVs and confirmed in circulating plasma EVs. Colocalization of key EV and adipocyte markers, including CD63 and PPARG, were validated in circulating plasma EVs. In summary, our study paves the way toward a tissue and cell-specific, multiparametric framework for an 'adiposity EV signature' in obesity-driven diseases.

The emerging role of dysregulated propionate metabolism and methylmalonic acid in metabolic disease, aging, and cancer

Propionate metabolism dysregulation has emerged as a source of metabolic health alterations linked to aging, cardiovascular and renal diseases, obesity and diabetes, and cancer. This is supported by several large cohort population studies and recent work revealing its role in cancer progression. Mutations in several enzymes of this metabolic pathway are associated with devastating inborn errors of metabolism, resulting in severe methylmalonic and propionic acidemias. Beyond these rare diseases, however, the broader pathological significance of propionate metabolism and its metabolites has been largely overlooked. Here, we summarize earlier studies and new evidence that the alteration of this pathway and associated metabolites are involved in the development of various metabolic diseases and link aging to cancer progression and metastasis.

Non-clinical and first-in-human characterization of ECC5004/AZD5004, a novel once-daily, oral small-molecule GLP-1 receptor agonist

AIMS

GLP-1 receptor agonists (GLP-1 RAs) are proven therapies for type 2 diabetes mellitus (T2DM) and overweight or obesity. We performed non-clinical and first-in-human (FIH) evaluation of ECC5004/AZD5004, an oral small-molecule GLP-1 RA.

MATERIALS AND METHODS

ECC5004 was profiled in cell lines overexpressing human GLP-1R, in glucose-stimulated insulin secretion (GSIS) assays in a human β-cell line and non-human primates (NHPs). To evaluate safety, ECC5004 was orally administered to NHPs for 9 months and a phase I, double-blind, placebo-controlled FIH study was conducted. This study evaluated single doses of ECC5004 (1-300 mg) in healthy volunteers, and multiple daily doses (5, 10, 30 and 50 mg) in patients with T2DM for 28 days.

RESULTS

ECC5004 bound to the hGLP-1R (IC50 = 2.4 nM) augmented cAMP signalling without β-arrestin-2 recruitment or receptor internalization. ECC5004 potentiated GSIS in both EndoC-βH5 cells (EC50 = 5.9 nM) and in vivo in NHPs (EC50 = 0.022 nM). Dose-dependent body weight changes compared to control were seen in the 9-month NHP toxicity study. In the first-in-human study, ECC5004 was well tolerated with no serious adverse events. Dose-dependent reductions in glucose and body weight were observed with a dose-proportional exposure at doses ≥25 mg.

CONCLUSION

ECC5004 engaged the GLP-1R across the therapeutic dose range tested and had a safety and tolerability profile consistent with other GLP-1 RAs, along with a pharmacokinetic profile compatible with once-daily oral dosing. These data support continued development of ECC5004 as a potential therapy for T2DM and overweight or obesity.

CLINICAL TRIAL REGISTRATION

NCT05654831.

Diagnostic, prognostic, and therapeutic potentials of gut microbiome profiling in human schistosomiasis: A comprehensive systematic review

BACKGROUND

Several studies have highlighted alteration in the gut microbiome associated with the onset and progression of diseases. Recognizing the potential of gut microbiota as biomarkers, this systematic review seeks to synthesize current data on the intricate relationship between the host gut microbiome profiles and their usefulness for the development of diagnostic, prognostic and therapeutic approaches to control human schistosomiasis.

METHODS

A systematic literature review was carried out by searching for relevant studies published until date, that is May 2024, using Medline, Embase, Global Health, Web of Science, and Global Index Medicus databases. The keywords used to select articles were "Gut microbiome", "Gut Microbiota", "Schistosomiasis", "Bilharziasis ", and "Human". Extracted data were analysed qualitatively from the selected articles.

RESULTS

Of the 885 articles retrieved and screened, only 13 (1.47%) met the inclusion criteria and were included in this review. Of the included studies, 6 (46.2%) explored alterations of gut microbiome in schistosome-infected patients, 4 (30.7%) in patients with liver pathologies, and 3 (23.1%) in patients treated with praziquantel. Bacteria from the genera Bacteroides, Faecalibacterium, Blautia and Megasphaera were associated with S. japonicum and S. haematobium infection in school-aged children, whereas infection with S. mansoni rather associated with Klebsiella and Enterobacter. The gut microbiota signature in patient with schistosomiasis-induced liver pathology was reported only for S. japonicum, and the genus Prevotella appeared as a non-invasive biomarker of S. japonicum-associated liver fibrosis. For S. mansoni-infected school-aged children, it further appeared that the treatment outcome following praziquantel administration associated with the abundance in the gut microbiome of bacteria from the classes Fusobacteriales, Rickettsiales and Neisseriales.

CONCLUSION

The host gut microbiome appears to be a valuable, non-invasive, but still poorly utilized, source of host biomarkers potentially informative for better diagnosing, prognosing and treating schistosomiasis. Further studies are therefore needed to comprehensively define such gut microbial biomarkers of human schistosomiasis and catalyse the informed development of gut microbiome-based tools of schistosomiasis control.

Immunometabolic Changes Following Gastric Bypass and Sleeve Gastrectomy: A Comparative Study

BACKGROUND

Immunometabolism is the interaction between immune system and nutrient metabolism. Severe obesity is considered a state of meta-inflammation associated with obesity that influences the development of chronic-degenerative diseases.

OBJECTIVE

We aimed to establish the immunometabolic differences in bariatric patients and to determine whether cellular immunity is associated with metabolic changes.

METHODOLOGY

We conducted an observational study in patients who underwent laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB). We explored the differences in the immunometabolic profile before and after surgery in the study group, by surgical technique, and we evaluated the changes in immunological variables as a function of metabolic variables with correlation analysis.

RESULTS

The follow-up rate was 88.7%. After the intervention, there were changes in cellular immunity, with a decrease in effector T lymphocytes (CD8+CD28-) and an increase in B lymphocytes, memory helper T cells, and cytotoxic T lymphocytes. LSG resulted in a greater decrease in (CD4+CD62-) T lymphocytes compared with LRYGB. Patients who underwent surgery with LRYGB presented greater clinical and metabolic improvements, as well as improvement of obesity-associated medical problems. Women who underwent LRYGB showed a greater reduction in fat-free mass compared with women who underwent LSG.

CONCLUSION

Bariatric surgery, mainly LRYGB, leads to immunometabolic changes and improves associated medical problems.

ECM-mimicking hydrogel models of human adipose tissue identify deregulated lipid metabolism in the prostate cancer-adipocyte crosstalk under antiandrogen therapy

Antiandrogen therapies are effectively used to treat advanced prostate cancer, but eventually cancer adaptation drives unresolved metastatic castration-resistant prostate cancer (mCRPC). Adipose tissue influences metabolic reprogramming in cancer and was proposed as a contributor to therapy resistance. Using extracellular matrix (ECM)-mimicking hydrogel coculture models of human adipocytes and prostate cancer cells, we show that adipocytes from subcutaneous or bone marrow fat have dissimilar responses under the antiandrogen Enzalutamide. We demonstrate that androgen receptor (AR)-dependent cancer cells (LNCaP) are more influenced by human adipocytes than AR-independent cells (C4-2B), with altered lipid metabolism and adipokine secretion. This response changes under Enzalutamide, with increased AR expression and adipogenic and lipogenic genes in cancer cells and decreased lipid content and gene dysregulation associated with insulin resistance in adipocytes. This is in line with the metabolic syndrome that men with mCRPC under Enzalutamide experience. The all-human, all-3D, models presented here provide a significant advance to dissect the role of fat in therapy response for mCRPC.

Healthy Lifestyle in the First 1000 Days and Overweight and Obesity Throughout Childhood

OBJECTIVES

Investigate associations of different family healthy lifestyle scores (HLS) during the first 1000 days with childhood overweight and obesity (OWOB).

METHODS

Cohort-specific analyses were conducted on participants (n = 25 006) from 4 European birth cohorts (The study on the pre- and early postnatal determinants of child health and development [EDEN], Elfe, France; Generation R, the Netherlands; and Lifeways, Ireland). Three composite HLSs were calculated: a maternal pregnancy HLS based on prepregnancy body mass index (BMI) and diet quality, physical activity, smoking status, and alcohol consumption during pregnancy; a parental pregnancy HLS additionally considering paternal BMI and smoking status; and an infancy HLS based on breastfeeding duration, age of solid food introduction, and exposure to passive smoking. Associations with child BMI (primary outcome) and waist-to-height ratio (WHtR, available in 2 cohorts) in early (5-5.5 years), middle (7-8 years), and late childhood (9-12 years) were assessed using linear (BMI and WHtR z-scores) and robust Poisson (International Obesity Task Force [IOTF] categories) regression analyses adjusted for sociodemographic confounders.

RESULTS

Only a small proportion of families had favorable lifestyle factors during pregnancy and early infancy, with 3.4% to 10.0%, 1.9% to 3.7%, and 12.2% to 23.6% scoring maximum for maternal, parental, and infancy HLS, respectively. Associations between higher HLSs and a lower risk of OWOB when measured by BMI z-scores or IOTF categories were found for maternal HLS and early (3/4 cohorts with available data), middle (1/2), and late childhood (2/4); parental HLS and early (3/4), middle (2/2), and late childhood (4/4). Associations between infancy HLS and childhood OWOB were less consistent and did not remain significant after additional adjustment for parental HLS. Associations with WHtR were solely significant in EDEN at 5.5 years.

CONCLUSIONS

Greater maternal and parental adherence to healthy lifestyle behaviors during pregnancy was associated with a lower risk of offspring OWOB throughout childhood, illustrating the importance of promoting healthy lifestyle behaviors at the family level during pregnancy.

Impact of breakfast skipping on esophageal health: A mendelian randomization study

BACKGROUND & AIMS

Previous studies have indicated that, in addition to the types of food consumed, eating habits are also associated with the risk of esophageal diseases. Some studies have suggested a possible link between breakfast skipping and esophageal tumors as well as gastroesophageal reflux disease. However, it remains unclear whether breakfast skipping has a causal relationship with esophageal diseases. To address this issue, this study aimed to investigate the potential causal relationship between breakfast skipping and esophageal diseases using a two-sample mendelian randomization (MR) approach.

METHODS

We obtained data from genome-wide association studies (GWAS) involving 193,860 individuals from the UK Biobank on breakfast skipping. The summary statistics for the esophageal diseases were derived from the IEU open GWAS project. In this two-sample MR analysis, inverse variance weighted was used, supplemented with weighted median, simple mode and weighted mode methods.

RESULTS

The results revealed significant causal relationships between breakfast skipping and esophageal cancer (odds ratio (OR): 5.992, 95 % confidence interval (CI): 1.606-22.350, p = 0.008), Barrett's esophagus (OR: 4.041, 95 % CI: 1.837-8.889, p < 0.001), gastroesophageal reflux disease (OR: 2.463, 95 % CI: 1.995-3.041, p < 0.001), and esophageal varices (OR: 4.454, 95 % CI: 1.785-11.112, p = 0.001). All of the supplementary methods supported the findings.

CONCLUSION

Our research provides evidence for the association between breakfast skipping and esophageal diseases. Breakfast skipping could be a potential risk factor for esophageal cancer, Barrett's esophagus, gastroesophageal reflux disease and esophageal varices. For high-risk groups prone to these esophageal diseases, emphasizing the importance of regular breakfast and maintaining consistent dietary habits is crucial for esophageal health.

Transfer Learning Prediction of Early Exposures and Genetic Risk Score on Adult Obesity in Two Minority Cohorts

Due to ethnic heterogeneity in genetic architecture, genetic risk score (GRS) constructed within the European population generally possesses poor portability in underrepresented non-European populations, but substantial genetic similarity exists across diverse ancestral groups. We here explore the prediction performance of early exposures and GRS on body mass index (BMI) through leveraging genetic similarity knowledge acquired from Europeans into non-Europeans. We present a linear mixed prediction model for BMI in three distinct UK Biobank cohorts under the transfer learning framework, where we consider Asians (n = 7487) and Africans (n = 7533) as target samples and Europeans (n = 280,575) as informative auxiliary samples. Besides environmental and behavior exposures, we incorporate multiple BMI-related variants, by which the GRS is constructed via transfer machine learning techniques informed by genetic similarity shared across target and auxiliary samples. The use of GRS gained more predictive odds for BMI than the model with traditional risk factors alone in the Asian and African cohorts, leading to an approximately 3.6% and 0.7% accuracy improvement in each target population. After borrowing genetic similarity from Europeans via transfer learning, the R2 increased to 0.270 for Asians and 0.302 for Africans, enhanced by 21.1% and 7.5%, respectively, compared to the early exposure-only models. We also provided evidence for the well-known conclusion that GRS constructed in the European population behaved poorly in non-Europeans. Prediction accuracy is greatly elevated in racial minority or underrepresented populations via the transfer learning method by leveraging shared genetic similarity from informative auxiliary populations.

Efficacy and safety of the subcutaneous implantable cardioverter-defibrillator in patients with and without obesity: A meta-analysis

BACKGROUND

The subcutaneous implantable cardioverter-defibrillator (S-ICD) has emerged as an alternative to transvenous systems for prevention of sudden cardiac death. However, concerns have been raised regarding its efficacy and safety in obese individuals.

OBJECTIVE

The purpose of this study was to perform a meta-analysis to evaluate the efficacy and safety of the S-ICD in patients with obesity by assessing the relationship between body mass index (BMI) and clinical outcomes.

METHODS

A comprehensive search of multiple databases was conducted for English-language peer-reviewed studies reporting clinical outcomes in S-ICD recipients with (BMI ≥30 kg/m2) and without obesity (BMI <30 kg/m2). Data on preimplantation screening failure, defibrillation testing, complications, appropriate and inappropriate shocks, and survival were analyzed using standard, random-effects, meta-analytical techniques.

RESULTS

Twenty-nine studies involving 20,486 patients were included. There was no statistically significant difference in mean BMI values of patients with failed or successful preimplantation screening (mean difference -0.60 kg/m2; 95% confidence interval [CI] -2.06 to 0.86). Obesity was associated with higher rates of failed defibrillation testing at ≤65 J (odds ratio [OR] 2.16; 95% CI 1.39-3.35), and malpositioning/suboptimal positioning occurred more frequently in obese compared to nonobese patients (OR 3.37; 95% CI 1.76-6.44). Increased BMI as a continuous variable (per increase in 1 kg/m2 BMI) was associated with elevated defibrillation thresholds (OR 1.05; 95% CI 1.03-1.08); higher risk of complications (hazard ratio [HR] 1.04; 95% CI 1.02-1.05); a trend toward an increased number of appropriate shocks (HR 1.02; 95% CI 1.00-1.04); and no significant increase in the risk of inappropriate shocks (HR 1.01; 95% CI 0.99-1.03).

CONCLUSION

This meta-analysis underscores the importance of considering obesity in S-ICD implantation decisions. Although S-ICD remains effective in obese patients, attention to potential technical challenges and higher complication rates is warranted.

Association between a body shape index and colorectal cancer in US population: a cross-sectional study based on NHANES

Background

Colorectal cancer (CRC) is linked to obesity, particularly visceral fat. A more accurate measure of visceral fat accumulation is offered by a body shape index (ABSI). Currently, the direct application of the ABSI to populations with varying ethnic backgrounds might be restricted. Moreover, there is less evidence about the correlation between ABSI and CRC among individuals from different ethnical backgrounds.

Methods

A total of 40,998 individuals who took part in the National Health and Nutrition Examination Survey (NHANES) spanning from 2003 to 2023 were subjected to analysis. Logistic regression was utilized to examine the associations between the ABSI and the risk of CRC. In addition, restricted cubic spline curves (RCS) were utilized, and subgroup analyses along with interaction tests were also carried out. The receiver operating characteristic curve (ROC) was employed to predict the risk of CRC relying on various anthropometric indicators.

Results

After adjusting for covariates, ABSI demonstrated a positive association with the incidence of CRC (OR = 1.03 [95% CI: 1.01-1.05], p = 0.018). Individuals in the upper quartile of ABSI exhibited a greater prevalence of CRC than those in the lower quartile (OR = 1.88 [95% CI: 1.19-2.96], p = 0.006). RCS analysis indicated a nonlinear correlation between ABSI and CRC (P for nonlinear = 0.030). Subgroup analysis indicated a notable interaction between age and BMI subgroups (interaction p < 0.05), and ROC curves indicated that the ABSI was effective in predicting CRC risk (AUC = 0.658), demonstrating good sensitivity, particularly in individuals under 60 years of age.

Conclusion

A positive correlation exists between ABSI levels and the increased incidence of CRC among U.S. adults. This is especially true for people under 60 years of age (40-60 years), with a BMI below 25 kg/m2, and those with a BMI of 30 kg/m2 or beyond. ABSI can be used as a simple anthropometric predictor of CRC.

Effect of weight loss following Roux-en-Y gastric bypass on cancer risk: A Mendelian randomization study

Cancer incidence and development are strongly correlated with obesity, however there is insufficient data to support a causal relationship between intentional weight loss and the prevention or promotion of cancer. We investigated the causal relationship between weight loss following Roux-en-Y gastric bypass (RYGB) and the incidence of 18 cancers using Mendelian randomization (MR). A genome-wide association studies (GWAS) data related to weight loss following RYGB from the GWAS catalog database were used as exposure, and GWAS data related to 18 cancers from the Medical Research Council integrative epidemiology unit open GWAS project were used as outcomes. In order to investigate the causal relationship between exposure and results, we used a two-sample MR approach. The primary analysis technique was inverse variance weighting, with weighted median, and MR-Egger regression utilized as supplemental techniques to confirm the findings. Heterogeneity and horizontal pleiotropy were investigated using a variety of sensitivity studies, including the Cochran Q test, MR-Egger regression pleiotropy test, MR pleiotropy residual sum and outlier, and leave-one-out analysis. We included a total of 4 single-nucleotide polymorphisms as instrumental variables through rigorous quality control screening. Under the limitations of Bonferroni correction threshold (P < 2.78 × 10-3), our results suggest that the weight loss following RYGB has a significant causal relationship with a reduced risk of breast (odds ratio [OR]: 0.784; 95% confidence interval [CI]: 0.762-0.808; P = 2.167e-58) and lung cancer (OR: 0.992; 95% CI: 0.987-0.997; P = .0023), and a potential causal relationship with a decreased risk of hematological cancer (OR: 0.9998462; 95% CI: 0.9997088-0.9999836; P = .028) and an increased risk of cervical cancer (OR: 1.000123; 95% CI: 1.0000313-1.000215; P = .009). Sensitivity analysis confirms the robustness of our analysis results. Genetically predicted weight loss following RYGB has significant causal effects in reducing the risk of breast and lung cancer. It also has potential benefits in lowering the risk of hemotological cancers and increasing the risk of cervical cancer. Considering the limitations of our study, the reliability of its results and the underlying mechanisms require further investigation.

Association of oxidative balance score with all-cause and cardiovascular mortality in overweight and obese

Background

The oxidative balance score (OBS) combines diverse dietary components with lifestyle factors to comprehensively evaluate oxidative stress. The investigation focuses on the link between the OBS and mortality outcomes, including cardiovascular and all-cause deaths, in overweight and obese individuals.

Methods

The analysis utilized data from the National Health and Nutrition Examination Survey (NHANES), covering the period from 1999 to 2018. Mortality information, categorized into all-cause and cardiovascular deaths, was gathered from the National Death Index (NDI). Kaplan-Meier survival analysis, along with multivariate Cox regression and restricted cubic spline (RCS) modeling, were utilized to explore the link between OBS and mortality risks. Subgroup analysis and sensitivity analysis were used to assess the robustness of the results and possible effect modifiers. Mediation analysis identifies pathways through which the independent variable affects the dependent variable.

Results

In this study, 26,219 participants with overweight or obesity were enrolled, with an average age of 49.8 ± 17.4 years. During a median follow-up duration of 115 months, 2,239 participants (8.5%) died, including 837 (3.2%) from cardiovascular disease. According to Kaplan-Meier analysis, mortality was highest among participants in the lowest OBS quartile (Q1) and lowest among those in the highest quartile (Q4). Participants in the fourth OBS quartile experienced a 21.7% decrease in the risk of mortality from all causes and a 29.5% decrease in cardiovascular mortality risk, according to fully adjusted results, compared to those in the first quartile. These results were validated through subgroup analyses. The analysis of RCS revealed a notable inverse association between OBS and mortality outcomes. Mediation analysis indicates that white blood cell count (WBC) and gamma-glutamyl transferase (GGT) serve as significant mediators in the association between OBS and mortality risk.

Conclusion

Elevated levels of OBS were strongly linked to reduced potential for both cardiovascular and all-cause mortality among individuals who are overweight or obese.

Distribution and Related Influencing Factors of AMH Level in Family-Planning Women of Childbearing Age: A Cross-Sectional Study from Beijing, China

Purpose

This study aimed to analyze the distribution and factors influencing anti-Müllerian hormone (AMH) levels among family-planning women of childbearing age in Beijing, China.

Patients and Methods

We collected the data of 3,236 family-planning women of childbearing age who underwent pre-pregnancy examinations at Xicheng District Maternal and Child Health Hospital in Beijing between October 2021 and July 2024. Collected data included age, education level, ethnicity, height, weight, and systolic and diastolic blood pressure. We calculated the body mass index (BMI) of each participant. The collected blood test results included AMH, fasting blood glucose (FBG), thyroid-stimulating hormone (TSH), creatinine (Cr), and alanine aminotransferase, and hemoglobin levels and platelet count. A structured questionnaire was used to document the subjects' dietary and lifestyle habits, environmental factors, and emotional and mental stress statuses. The patients were divided into age groups (≥36 years versus ≤35 years) and factors compared between them. Two different factors influencing AMH level were analyzed using a logistics model.

Results

The AMH level decreased with age, with a median AMH of <2.0 ng/mL for subjects aged ≥36 years. Significant intergroup differences were noted in ethnicity, education level, FBG, creatinine level, BMI, diastolic blood pressure, hemoglobin level, smoking rate, and life-related stress level. A logistic regression analysis suggested that age was a negative factor affecting AMH level in both groups (P=0.000 and 0.002, respectively). Hemoglobin and educational levels were also important influential factors of AMH in patients aged ≤ 35 years but not in those aged ≥ 36 years.

Conclusion

AMH levels gradually decreased with age. Although nutritional status and educational level significantly impacted AMH levels among women ≤ 35 years of age, their effects decreased thereafter. Thus, 35 years of age is considered an important reproductive boundary for women of childbearing age.

Ovarian sex cord-stromal cell tumors and the risk of sex hormone-sensitive cancers

BACKGROUND

Sex cord-stromal cell tumors are rare ovarian tumors. Some sex cord-stromal cell tumors secrete hormones that originate from the ovarian sex or stromal cells. Previous studies have indicated an increased risk for breast and endometrial cancers. However, these studies focused only on the sex cord-stromal cell tumor-subtype of adult granulosa cell tumors, and the estimates stemmed from selected cohorts and lacked a well-described cohort, making it difficult to adjust for possible confounders.

OBJECTIVE

We examined the incidence of other primary hormone-sensitive cancers and compared their risk with that in a matched cohort of women without sex cord-stromal cell tumors.

STUDY DESIGN

This nested cohort study evaluated women diagnosed with sex cord-stromal cell tumors. We established a cohort of women diagnosed with sex cord-stromal cell tumors using Systematized Medical Nomenclature for Medicine codes from the Danish Pathology Register. Sex cord-stromal cell tumors diagnoses were considered valid if the primary diagnosis was established at a tertiary referral center or confirmed by at least 2 pathologists. A 1:10 matched control group matched by birth year was selected from national registries. Variables for the follow-up of cases and controls were drawn from national registries and included assessment of the rates of breast, ovarian, and endometrial cancer, hormone use, Charlson Comorbidity Index, and sociodemographics. Hazard ratios for cancer rates were calculated using multivariate Cox proportional hazards models with sex cord-stromal cell tumor exposure estimated in early and delayed models to capture cancer rates over time. The standardized incidence ratios for very rare sex cord-stromal cell tumors were determined using a log-linear Poisson model.

RESULTS

Among the 1516 tumors with Systematized Medical Nomenclature for Medicine codes for sex cord-stromal cell tumors, 1387 met the inclusion criteria after pathologic chart review. The majority had benign tumors, primarily thecoma or fibrothecomas (66%), and 26% had adult granulosa cell tumors. Increased rates of breast cancer were found among patients with thecomas (hazard ratio, 1.2; 95% confidence interval, 1.0-1.4). In the analysis of all sex cord-stromal cell tumors combined, an increased rate of synchronous endometrial cancer was found (hazard ratio, 3.3; 95% confidence interval, 2.7-4.1). In the subgroup analysis, malignant and benign sex cord-stromal cell tumors showed significantly higher hazard ratios for synchronous endometrial cancer, notably adult granulosa cell tumors (hazard ratio, 10.7; 95% confidence interval, 5.7-20.1). In the model that assessed the rates of endometrial cancer 2 months after surgical removal of the sex cord-stromal cell tumor, no increased rates were found. Sertoli cell tumors were associated with an increased incidence of breast cancer (standardized incidence ratio, 18.9; 95% confidence interval, 2.7-134). Both Sertoli and Leydig cell tumors were associated with a higher incidence of synchronous endometrial cancer with standardized incidence ratios of 41.4 (95% confidence interval, 10.4-166) and 44.9 (95% confidence interval, 18.7-108), respectively.

CONCLUSION

Women with sex cord-stromal cell tumors have an increased rate of synchronous endometrial cancer, and women with benign sex cord-stromal cell tumors have an increased rate of synchronous ovarian cancer. A marginally increased rate of breast cancer has been observed in women with thecomas. There was no increase in the rate of breast cancer among women with adult granulosa cell tumors. It is recommended that women diagnosed with hormone-secreting sex cord-stromal cell tumors and additional risk factors for endometrial cancer (abnormal uterine bleeding and/or abnormal endometrial thickness) should undergo an endometrial biopsy to assess for the presence of cancer.

Association between individual occupational noise exposure and overweight/obesity among automotive manufacturing workers in South China

BACKGROUND

Occupational noise has been associated with numerous adverse health outcomes. However, limited evidence exists regarding its association with obesity. We aim to investigate the effect of occupational noise exposure on the risk of overweight/obesity among workers, providing scientific evidence for the prevention and management of overweight/obesity in the occupational population.

METHODS

This study included 3427 participants from two factories in Guangzhou, China. Individual occupational noise exposure levels were assessed using cumulative noise exposure (CNE). Body mass index (BMI) data were obtained from physical examinations. Linear and logistic regression models, restricted cubic spline, as well as subgroup analyses, were used to explore the association.

RESULTS

In continuous models, each 1 dB-year increase in CNE was significantly associated with a 0.03 (95% confidence interval (CI): 0.00, 0.05) kg/m² increase in BMI. In categorical models, higher CNE levels were significantly associated with BMI (β = 0.54, 95% CI: 0.16, 0.92) and overweight/obesity (odd ratio (OR) = 1.57, 95%CI: 1.21, 2.04). Restricted cubic splines (RCS) analysis demonstrated a linear dose-response relationship between CNE and overweight/obesity (Pfor overall=0.013, Pfor non-linear=0.175). Additionally, shift and night work were identified as critical moderating factors, with a stronger association observed among workers engaged in shift and night work.

CONCLUSION

Occupational noise exposure is positively associated with overweight/obesity, particularly among those engaged in shift and night work. Thus, enhancing noise source management and promoting awareness among workers for prevention are imperative.

Dietary-lifestyle patterns and colorectal cancer risk: Global Cancer Update Programme systematic literature review

BACKGROUND

Although healthy dietary and lifestyle factors have been individually linked to lower colorectal cancer (CRC) risks, recommendations for whole diet-lifestyle patterns remained unestablished because of limited studies and inconsistent pattern definitions.

OBJECTIVES

This updated review synthesized literature on dietary-lifestyle patterns and CRC risk/mortality.

METHODS

PubMed and Embase were searched through March 31, 2023 for randomized controlled trials and prospective cohort studies examining adulthood dietary patterns combined with modifiable lifestyle factors such as adiposity, smoking, alcohol consumption, physical activity, and/or others. Patterns were categorized by derivation methods: a priori, a posteriori, and a hybrid combining both; and were then descriptively reviewed for the primary outcomes: CRC risk or mortality. The Global Cancer Update Programme Expert Committee and Expert Panel independently graded the evidence on the likelihood of causality using predefined grading criteria.

RESULTS

Thirty-three observational studies were reviewed. "Strong-probable" evidence was concluded for higher levels of alignment with the a priori-derived World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) recommendations score and lower CRC risk; and "limited-suggestive" evidence for the American Cancer Society guidelines and Healthy Lifestyle Index with lower CRC risk (mainly because of concerns about risk of bias for confounding). A posteriori-derived patterns lack firm evidence (only 1 study). "Strong-probable" evidence was concluded for higher levels of alignment with the Empirical Lifestyle Index for Hyperinsulinemia hybrid pattern and higher CRC risk. By cancer subsite, only the WCRF/AICR recommendations score showed "strong-probable" evidence with lower colon cancer risk. All exposure-mortality pairs were graded "limited-no conclusion." The evidence for other pattern-outcome associations was graded as "limited-no conclusion."

CONCLUSIONS

Adopting a healthy pattern of diet, maintaining a healthy weight, staying physically active, and embracing health-conscious habits, such as avoiding tobacco and moderating alcohol, are collectively associated with a lower CRC risk. Healthy lifestyle habits are key to primary CRC prevention. This study was registered at PROSPERO as CRD42022324327 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022324327).

Environmental factors inducing gastric cancer: insights into risk and prevention strategies

Gastric cancer, a prevalent malignant tumor worldwide, poses a significant challenge to global health. Despite ongoing advancements in treatment methods, its high incidence and mortality rates remain concerning. Although progress in treating gastric cancer is encouraging, a more critical focus is on enhancing prevention efforts. Understanding the risk factors associated with gastric cancer is crucial for its prevention. This article summarizes the environmental factors related to the development of gastric cancer and their prevention, including: Living or working environment factors (air pollution, water quality, soil pollution, radiation, altitude, climate), dietary habits (meat, high-fat diet, high-salt diet), lifestyle habits (smoking, Drinking, sleep, coffee), and viral and bacterial exposures (Epstein-Barr virus, Human cytomegalovirus, Helicobacter pylori). Additionally, the article discusses current research directions and aims to provide a reference for researchers, paving the way for future preventive and therapeutic strategies.

Update on Hypothalamic Inflammation and Gliosis: Expanding Evidence of Relevance Beyond Obesity

PURPOSE OF REVIEW

To evaluate the role of hypothalamic inflammation and gliosis in human obesity pathogenesis and other disease processes influenced by obesity.

RECENT FINDINGS

Recent studies using established and novel magnetic resonance imaging (MRI) techniques to assess alterations in hypothalamic microarchitecture in humans support the presence of hypothalamic inflammation and gliosis in adults and children with obesity. Studies also identify prenatal exposure to maternal obesity or diabetes as a risk factor for hypothalamic inflammation and gliosis and increased obesity risk in offspring. Hypothalamic inflammation and gliosis have been further implicated in reproductive dysfunction (specifically polycystic ovarian syndrome and male hypogonadism), cardiovascular disease namely hypertension, and alterations in the gut microbiome, and may also accelerate neurocognitive aging. The most recent translational studies support the link between hypothalamic inflammation and gliosis and obesity pathogenesis in humans and expand our understanding of its influence on broader aspects of human health.

The research progress and prospects of circadian rhythm in obesity: a bibliometric analysis

Background

Numerous studies have shown a link between circadian rhythms disruptions and a higher risk of obesity. This article aims to conduct an extensive bibliometric analysis to deepen our understanding of the relationship between circadian rhythms and obesity.

Methods

The literature related to the circadian rhythm of obesity, published from the inception of the Web of Science Core Collection (WoSCC) until June 30, 2024, was extracted from the WoSCC databases (SCIE, SSCI, ESCI). Using CiteSpace, Vosviewer, WPS, and other software, this paper examines the publication trends, including the number of papers, countries/regions, institutions, authors, journals, references, and keywords.

Results

A total of 2,870 articles were included in this analysis, revealing a consistent year by year increase in research on the circadian rhythm of obesity. These publications originate from 460 institutions in 88 countries. Among the authors analysis, Garaulet, Marta was the most prolific, and Turek FW was the most co-cited. Proceedings of the National Academy of Sciences of the United States of America emerged as the journal with the highest number of publications, and American Journal of Physiology had the highest centrality. The most frequently used keywords were "obesity," "circadian rhythm," "circadian clock," "metabolic syndrome," "metabolism." Additionally, research areas involving intermittent fasting, restricted feeding, and gut microbiota were rapidly developing and represented the forefront of research on circadian rhythms and obesity.

Conclusion

Our study demonstrates that research on circadian rhythms in obesity has been rapidly expanding, with increasingly in-depth exploration of the topic. It is recommended to strengthen cooperation between countries and institutions to jointly promote research in this field. The gene expression of obesity is an early hotspot in the study of circadian rhythm and obesity, and emerging research areas such as intermittent fasting, restricted feeding, endothelial nitric oxide synthase and gut microbiota will become significant hotspots and trends in the field of circadian rhythm and obesity. These findings provide researchers critical directions for future studies and may have significant implications for clinical practice and public health policy.

Overcoming underestimation of the share of colorectal cancer cases attributable to excess weight: a population-based study

OBJECTIVE

Previous research may have underestimated the relationship between overweight/obesity and colorectal cancer (CRC) risk by overlooking important potential sources of bias.

METHODS

We used data from a large, population-based case-control study encompassing 7098 CRC cases and 5757 age- and sex-matched controls with comprehensive information on risk factors, including self-reported body weight. Multivariate logistic regression was used to assess the associations of BMI with CRC risk before and after considering prediagnostic weight loss, history of lower gastrointestinal endoscopy, and potentially increased CRC risk beneath the overweight threshold (BMI 25 kg/m2). Subsequently, population attributable fractions were calculated.

RESULTS

In the standard analysis evaluating the BMI-CRC association, in which none of the three aforementioned factors was considered, the fraction of CRC cases attributable to overweight and obesity was estimated to be 11.5%. This finding is consistent with estimates from previous studies, which mostly did not consider any of the three factors. However, when all three factors were considered in the analysis, a higher BMI was estimated to account for 23.4% of all CRC cases.

CONCLUSIONS

Careful consideration of important sources of bias suggests that a substantially larger share of the CRC burden may be attributable to excess weight than previously thought.

Stearic acid metabolism in human health and disease

Named after the Greek term for "hard fat", stearic acid has gradually entered people's field of vision. As an important component of various physiological cellular functions, stearic acid plays a regulatory role in diverse aspects of energy metabolism and signal transduction. Its applications range from serving as a bodily energy source to participating in endogenous biosynthesis. Similar to palmitate, stearic acid serves as a primary substrate for the stearoyl coenzyme A desaturase, which catalyzes the conversion of stearate to oleate and is involved in the synthesis of triglyceride and other complex lipids. Additionally, stearic acid functions as a vital signaling molecule in pathological processes such as cardiovascular diseases, diabetes development, liver injury and even nervous system disorders. Therefore, we conduct a comprehensive review of stearic acid, summarizing its role in various diseases and attempting to provide a systematic overview of its homeostasis, physiological functions, and pathological process. From a medical standpoint, we also explore potential applications and discuss stearic acid as a potential therapeutic target for the treatment of human diseases.

DsbA-L: A Promising Therapeutic Target for Metabolic Diseases

The increasing incidence of metabolic diseases, including obesity and diabetes, is a serious social public problem. Therefore, there is an urgent need to find effective prevention and treatment measures for these diseases. DsbA-L is a protein that is widely expressed in many tissues and is closely related to metabolism. Emerging evidence shows that DsbA-L plays an important role in antioxidative stress, promoting the synthesis and secretion of adiponectin and maintaining mitochondrial homeostasis, and the abnormalities of these functions are also closely related to the occurrence and development of metabolic diseases. Here, we reviewed the tissue expression patterns and regulatory factors of DsbA-L, summarized its biological functions and the current research progress of DsbA-L in metabolic diseases, and found that DsbA-L may be a promising target for metabolic diseases.

Long-term outcomes and risk modifiers of metabolic dysfunction-associated steatotic liver disease between lean and non-lean populations

One-third of adults across the globe exhibit metabolic dysfunction-associated steatotic liver disease (MASLD)-formerly known as nonalcoholic fatty liver disease (NAFLD). To date, MASLD is the fastest-growing etiology of chronic liver disease and hepatocellular carcinoma (HCC). Besides the population with obesity, MASLD can also be found in lean populations, accounting for 13% of the global population, especially Asians. Notably, individuals with lean MASLD face equal or higher overall mortality rates compared to their non-lean counterparts. Risk modifiers encompass advanced age, hepatic fibrosis, and type 2 diabetes mellitus (T2DM). Moreover, the population with lean MASLD is associated with an increased risk of HCC, while their non-lean counterparts are more prone to cardiovascular outcomes and T2DM. Existing evidence indicates a similar risk of liver-related events and extrahepatic cancer between the two groups. However, MASLD-related genetic variants, such as PNPLA3 and TM6SF2, did not significantly affect mortality between the two populations. Still, underreporting alcohol consumption and regional representation limits the study's comprehensiveness. Longitudinal studies and mechanistic explorations are needed to understand differences in lean versus non-lean MASLD populations. This review highlights the need for awareness and tailored interventions in managing MASLD, considering lean individuals' unique risks.

Endoscopic Band Ligation for Weight Loss: A Clinical Trial

BACKGROUND AND STUDY AIM

We previously reported the utility of endoscopic band ligation (EBL) in weight loss in a female patient with obesity. This study aimed to evaluate the safety of weight loss using EBL in a larger cohort.

PATIENTS AND METHODS

This prospective cohort study included 13 female patients aged ≥ 18 years with a body mass index of ≥ 30 kg/m2 who were unwilling to undergo bariatric surgery. Patients with obesity-related comorbidities such as diabetes, hypertension, dyslipidemia, and cardiovascular disease were included. Patients with a history of bariatric surgery and those with clinical manifestations of gastroparesis, portal hypertension, liver cirrhosis, and coagulopathies were excluded. Primary study outcomes were technical feasibility and safety, and secondary study outcomes were the percentage of total weight loss, excess weight loss, and the change in gastroparesis clinical symptom index at 1 month after surgery.

RESULTS

No serious complications occurred during the endoscopy or immediately after that. All patients experienced epigastric pain, nausea, and vomiting for the first 3 days, with one patient developing mild hematemesis on the second day that stopped spontaneously and revealed no abnormalities on endoscopy. At 1 month after EBL, the mean percent excess weight loss and total weight loss were 22.3% ± 9.9% and 7.8% ± 2.5%, respectively.

CONCLUSIONS

EBL is an effective and safe intervention for obesity management. Further studies with larger cohorts are warranted to comprehensively evaluate of the long-term efficacy and safety of EBL for obesity management.

Relationship between Cancer Incidence and Health Behaviors from Ecological Study in Korea

The aim of this ecological study was to examine the correlation between cancer incidence and health behaviors such as smoking, alcohol consumption, and obesity, and investigated whether there were differences in this correlation between metropolitan areas and other regions. Data on health behaviors exposure/prevalence and cancer incidence rates for 227 administrative districts (cities and counties) were obtained. The average exposure proportion measured annually from 2008 to 2011 in the Korea Community Health Survey data and the age-standardized cancer incidence data from 2014 to 2018, obtained through the cancer registry data, were downloaded from the Statistics Korea website. To examine the relationship between smoking, alcohol consumption, obesity exposure rate (prevalence), and cancer incidence, a correlation analysis was conducted, and Pearson's correlation coefficient was calculated. The correlation coefficient between male smoking and male cancer incidence rate across 227 districts was 0.259. This significance was more pronounced in large metropolitan areas, where the correlation coefficient was 0.631 in the 73 districts belonging to these areas. In large metropolitan areas, the correlation coefficient between alcohol consumption rate and cancer incidence rate was 0.390. In the correlation analysis between obesity prevalence and cancer incidence rate, no correlation was found in large metropolitan areas, while in areas outside of large cities, the correlation coefficient was -0.295, indicating a significant negative correlation. This ecological study demonstrated that the relationship between cancer incidence and health behaviors differed between large metropolitan areas and areas outside of large cities.

Is Insulin Resistance a High-Risk Factor for Postmenopausal Endometrial Cancer: Insights from the Triglyceride Glucose (TyG) Index and the Metabolic Score for Insulin Resistance (METS-IR)

Purpose

To evaluate the insulin resistance in patients with menopause who were newly diagnosed with endometrial cancer and its association with disease development.

Methods

The study included 356 patients with menopause who underwent hysteroscopy at Beijing Obstetrics and Gynecology Hospital between September 2013 and July 2018. Data on age, height, weight, menarche and menopausal age, pregnancies, births, and family history of tumors, hypertension, and diabetes were collected. Blood tests provided fasting blood glucose, triglycerides, total cholesterol, high-density lipoprotein, and low-density lipoprotein levels. Pathological testing determined whether patients had endometrial cancer or precancerous lesions. Differences in influencing factors between patients with endometrial cancer or precancerous lesions and those with normal or benign conditions were analyzed using univariate analysis. Quartile grouping of the Metabolic Score for Insulin Resistance (METS-IR) and Triglyceride-Glucose (TyG) index were applied to examine the impact of different insulin resistance on the development of endometrial cancer or precancerous lesions.

Results

Univariate analysis revealed that the proportion of patients with hypertension and diabetes was significantly higher among those with endometrial cancer and precancerous lesions. METS-IR and TyG levels were significantly increased in patients with endometrial cancer and precancerous lesions. The quartile grouping results of METS-IR and TyG suggested that age, BMI, FBG, TG, hypertension, and diabetes prevalence rates increased with an increase in METS-IR or TyG, whereas lipid indicators were negatively correlated and unstable Logistic regression suggested that none of the above influencing factors and METS-IR or TyG were related to the pathological results of the patients.

Conclusion

Patients with endometrial or precancerous lesions showed evidence of insulin resistance compared to others, though this was not directly associated with disease presence. This study provides relevant information for preventing of endometrial cancer in the future. Larger studies are needed to evaluate the role of METS-IR and TyG in endometrial cancer prevention.

FTO in health and disease

Fat mass and obesity-associated (FTO) protein, a key enzyme integral to the dynamic regulation of epitranscriptomic modifications in RNAs, significantly influences crucial RNA lifecycle processes, including splicing, export, decay, and translation. The role of FTO in altering the epitranscriptome manifests across a spectrum of physiological and pathological conditions. This review aims to consolidate current understanding regarding the implications of FTO in health and disease, with a special emphasis on its involvement in obesity and non-communicable diseases associated with obesity, such as diabetes, cardiovascular disease, and cancer. It also summarizes the established molecules with FTO-inhibiting activity. Given the extensive impact of FTO on both physiology and pathophysiology, this overview provides illustrative insights into its roles, rather than an exhaustive account. A proper understanding of FTO function in human diseases could lead to new treatment approaches, potentially unlocking novel avenues for addressing both metabolic disorders and malignancies. The evolving insights into FTO's regulatory mechanisms hold great promise for future advancements in disease treatment and prevention.

Temporal and spatial trends in gastric cancer burden in the USA from 1990 to 2021: findings from the global burden of disease study 2021

Background

Gastric cancer (GC) is a significant public health concern in the USA, and its burden is on the rise.

Methods

This study utilized the latest data from the Global Burden of Disease (GBD) study. We provided descriptive statistics on the incidence, prevalence, mortality, disability-adjusted life years (DALYs), and age-standardized rates (ASRs) of GC across the USA and states. By calculating percentage changes and average annual percentage changes (AAPC), along with conducting age-period-cohort analysis, we assessed the trends in the burden of GC. Decomposition analysis was then performed, followed by the application of an autoregressive integrated moving average (ARIMA) model to forecast changes in ASRs through 2036.

Results

From 1990 to 2021, the number of incidence and prevalence of GC in the USA increased, but age-standardized incidence rates (ASIR) trended downward (AAPC = -0.73, 95% confidence interval [CI]: -0.77 to -0.68) and age-standardized prevalence rates (ASPR) (AAPC = -0.99, 95% CI: -1.08 to -0.9) showed a decreasing trend. In addition, the number of deaths, DALYs, age-standardized mortality rates (ASMR) and age-standardized DALYs rates (ASDR) in GC showed a decreasing trend. The burden of GC was significantly higher in males compared to females. In addition, we found that the highest incidence and prevalence in females was in the age group of 75-79 years, whereas the highest incidence and prevalence in males was in the age group of 70-74 years.

Conclusion

GC is a major public health issue in the USA. Although ASIR, ASPR, ASMR, and ASDR for GC are decreasing, the number of incidence and prevalence of GC in the USA remains high, and the disease burden of GC in the USA remains high. Strengthening preventive interventions, particularly for men and patients over the age of 60, will be crucial in the future.

Obesity, Physical Activity, and Cancer Incidence in Two Geographically Distinct Populations; The Gulf Cooperation Council Countries and the United Kingdom-A Systematic Review and Meta-Analysis

BACKGROUND

The relationship between obesity, physical activity, and cancer has not been well studied across different countries. The age-standardized rate of cancer in the UK is double-triple that in the Gulf Cooperation Council Countries (GCCCs). Here, we study the association between obesity, physical activity, and cancer incidence with the aim to elucidate cancer epidemiology and risk factors in two geographically, ethnically, and climatically different parts of the world.

METHODS

Our systematic search (from 2016 to 2023) in PubMed, EMBASE, Scopus, and APA PsycINFO databases resulted in 64 studies totaling 13,609,578 participants. The Cochrane risk of bias tool, GRADE, R programming language, and the meta package were used.

RESULTS

Significant associations between obesity and cancer were found in both regions, with a stronger association in the UK (p ≤ 0.0001) than the GCCCs (p = 0.0042). While physical inactivity alone did not show a statistically significant association with cancer incidence, the pooled hazard ratio analysis revealed that the presence of both obesity and physical inactivity was associated with a significantly higher cancer incidence. The most common types of cancer were breast cancer in the UK and colorectal cancer across the GCCCs.

CONCLUSION

Although both regions share similarities, advanced healthcare systems, genetic characteristics, dietary habits, and cultural practices may influence cancer incidence and types.

Navigating the obesity paradox in bladder cancer prognosis-insights from the Taiwan National Health Insurance System Database

Purpose

This study investigates the complex relationship between body mass index (BMI) and bladder cancer outcomes, utilizing Taiwan's national database. Bladder cancer remains a significant health concern, especially in Taiwan, prompting a comprehensive retrospective analysis to explore the impact of obesity on survival outcomes.

Materials and methods

A meticulous exclusion process, based on Taiwan National Health Insurance System Database, refined the initial dataset of 15,086 bladder cancer patients to 10,352. Categorizing patients into BMI groups (underweight, normal weight, and obesity), the study examined baseline characteristics, comorbidities, and survival outcomes. The analysis involved Cox regression and subgroup assessments stratified by clinical stage.

Results

Among our patients, 71.5% are male, 78.5% are over 60 years of age, and 18.8% are between 45 and 60 years old. Despite a higher prevalence of comorbidities, obesity patients exhibited a more favorable prognosis, supporting the obesity paradox. The overall and specific mortality ratio of obesity patients were 0.76 fold and 0.82-fold compared with normal-weight patients (overall: 95% confidence interval [CI], 0.71-0.82, p < 0.0001; specific: 95% CI, 0.75-0.90, p < 0.0001). Conversely, underweight patients displayed an increased risk of both overall and cancer-specific mortality compared to normal-weight patients (p < 0.0001).

Conclusion

This study highlights the potential protective role of higher BMI in bladder cancer survival, revealing a more favorable prognosis among obesity patients, highlighting the need for cautious interpretation and suggesting avenues for future research. These insights could guide BMI-targeted intervention strategies, allowing clinicians to consider BMI as a factor in personalized treatment planning for bladder cancer patients.

Immunological roles for resistin and related adipokines in obesity-associated tumors

Rationale Obesity is an independent risk factor for the occurrence and development of tumors. Obesity is influenced by signaling of adipokines, which are secreted factors from adipocytes and resident immune cells within adipose tissues that mediate lipid metabolism. More recently, adipokines have been implicated in chronic inflammation as well as in tumor formation and growth. Among them, resistin has received increasing attention in research related to the growth and expansion of solid tumors and hematological cancers through various signaling pathways. Objective and findings We reviewed the physiological, biochemical, and immune functions of adipose tissue, with a focus on the structure and expression of resistin and adipokines within multiple adipose cell types, their signaling pathways and putative effects on tumor cells, as well as their in vivo regulation. Current evidence indicates that adipokines such as resistin act as pro-inflammatory factors to stimulate immune cells which, in turn, promotes tumor angiogenesis, connective tissue proliferation, and matrix fibrosis. Concurrently, in states of metabolic dysfunction and lipotoxicity in obese individuals, the numbers and functions of immune cells are compromised, leading to an immunosuppressive environment that fosters tumor cell survival and weak cancer immune monitoring. Conclusion Adipokines such as resistin are important to the development of obesity-related tumors. Clarifying the roles for obesity-related factors in immune regulation and tumor progression may lead to the discovery of novel anti-tumor strategies for targeting obesity factors such as resistin to limit tumor growth and manage obesity, or both.

Risk factors for second primary cancer in a prospective cohort of endometrial cancer survivors: an Alberta Endometrial Cancer Cohort Study

We examined associations between modifiable and nonmodifiable cancer-related risk factors measured at endometrial cancer diagnosis and during early survivorship (~3 years postdiagnosis) with second primary cancer (SPC) risk among 533 endometrial cancer survivors in the Alberta Endometrial Cancer Cohort using Fine and Gray subdistribution hazard models. During a median follow-up of 16.7 years (IQR, 12.2-17.9), 89 (17%) participants developed an SPC; breast (29%), colorectal (13%), and lung (12%) cancers were the most common. Dietary glycemic load before endometrial cancer diagnosis (≥90.4 vs < 90.4 g/day: subhazard ratio [sHR] = 1.71; 95% CI, 1.09-2.69), as well as older age (≥60 vs < 60 years: sHR = 2.48; 95% CI, 1.34-4.62) and alcohol intake (≥2 drinks/week vs none: sHR = 3.81; 95% CI, 1.55-9.31) during early survivorship, were associated with increased SPC risk. Additionally, reductions in alcohol consumption from prediagnosis to early survivorship significantly reduced SPC risk (sHR = 0.34; 95% CI, 0.14-0.82). With 1 in 6 survivors developing an SPC, further investigation of SPC risk factors and targeted surveillance options for high-risk survivors could improve long-term health outcomes in this population. Reductions in dietary glycemic load and alcohol intake from prediagnosis to early survivorship showed promising risk reductions for SPCs and could be important modifiable risk factors to target among endometrial cancer survivors. This article is part of a Special Collection on Gynecological Cancer.

Retinal vascular events and relationship to CANCER development

BACKGROUND

Central retinal vein occlusion (CRVO) is a frequent and clinically relevant vascular pathology. The main risk factors are the same as systemic cardiovascular risk factors, but recently other significant risk factors have been studied. The aim of this study is to analyse the risk factors for retinal venous thrombosis and their relationship with the development of cancer.

METHODS

710 patients with retinal vascular pathology were included, of whom 527 had suffered retinal venous thrombosis. Patients were followed up in internal medicine outpatient clinics between September 24, 1999, and April 30, 2022. The incidence of cancer during that time was collected.

RESULTS

Of 527 patients evaluated, 448 (86.7 %) presented cardiovascular risk factors, and 89 (17.2 %) developed some neoplasm, being the most frequent: prostate (19.1 %), colon (16.9 %), skin (12.4 %), breast (9.0 %). Retinal venous thrombosis was related to the development of neoplasms during follow-up time (Log Rank = 5.28, p = 0.022; Breslow = 4.84, p = 0.028). Other significant factors were age above the median, smoking, HbA1c levels, and homocysteine levels higher than the median, and cholesterol and LDL-Cholesterol lower than the median. Age above the median (p < 0.001), smoking (p = 0.003) and levels of cholesterol below the median (p = 0.026) were independently related to the development of neoplasms.

CONCLUSIONS

Retinal venous thrombosis is associated with the development of cancer. Other factors related to its development have been identified. If this is confirmed, the implications for the diagnosis, control, and treatment of these patients should be evaluated.

Cancer incidence following bariatric surgery in renal transplant recipients: a retrospective multi-center analysis

BACKGROUND

Obesity, a known independent risk factor for developing malignancy. Additionally, renal transplant recipients (RTR) confer a 2- to 4-fold increased risk of overall malignancies with an excess absolute risk of .7% per year. While transplant recipients are at risk for obesity and malignancy, the effect of bariatric surgery (BS) in the posttransplantation setting is not well known.

OBJECTIVES

Our study primarily evaluated the impact of BS on cancer incidence in RTR with severe obesity in the posttransplantation setting. Weight loss outcomes were analyzed secondarily.

SETTING

University Hospital.

METHODS

A retrospective study using TriNetX database was developed to analyze cancer outcomes in RTR with posttransplantation BS versus RTR without BS from 2000 to 2023. After the exclusion process and propensity matching, both cohorts consisted of 153 patients.

RESULTS

RTR-BS had a significantly lower incidence of overall cancer and transplant-related cancers (P < .05). No significant difference was identified in cutaneous, gastrointestinal, and reproductive cancers. Percent Excess Weight Loss (%EWL) was significantly lower in RTR-only cohort (11.4%) versus RTR-BS cohort (57.8%) at 5 years. Sleeve gastrectomy (SG) patients (73.19%) had significantly higher %EWL than Roux en-Y gastric bypass (RYGB) patients (49.33%) at 3 years. No difference in cancer incidence was noted between SG and RYGB patients.

CONCLUSION

Postrenal transplantation BS had a diminishing effect on overall and transplant-related cancer incidence in RTR with severe obesity. Significant weight loss was also demonstrated with post-renal transplantation BS.

Human adipose-derived stem cells promote migration of papillary thyroid cancer cell via leptin pathway

INTRODUCTION

Obesity is associated with the incidence and poor prognosis of thyroid cancer, but the mechanism is not fully understood. The aim of this study was to investigate the effects of human adipose-derived stem cells (ADSCs) on the invasion and migration of thyroid cancer cells.

METHODS

ADSCs-conditioned medium (ADSC-CM) was collected to culture thyroid cancer cell lines TPC-1 cells and BCPAP cells. The effects of ADSCs on thyroid cancer cell proliferation were determined by CCK8 and EdU assays, and the effects on migration were determined by Transwell and wound closure assays. Leptin neutralizing antibodies (NAB) were added to ADSC-CM to block leptin. In animal experiments, TPC-1 cells and BCPAP cells were injected into the tail vein of nude mice, and the leptin receptor antagonist peptide allo-aca was injected subcutaneously to block the leptin pathway. The number and size of metastatic lung tumours were observed after 8 weeks.

RESULTS

ADSC-CM significantly promoted the invasion and migration of thyroid cancer cells and upregulated their matrix metalloproteinase 2 (MMP-2) levels, while NAB with the addition of leptin reduced the invasion and migration of thyroid cancer cells and downregulated MMP-2 levels. Allo-aca treatment reduced the number of metastatic lung nodules formed by thyroid cancer cells in nude mice and reduced the diameter of metastatic lesions.

CONCLUSION

ADSCs upregulate MMP-2 levels of thyroid cancer cells through exocrine leptin, thereby promoting cancer cell migration, which may be one of the key mechanisms by which obesity increases the invasiveness of thyroid cancer.

Subcutaneous adipose tissue: Implications in dermatological diseases and beyond

Subcutaneous adipose tissue (SAT) is the deepest component of the three-layered cutaneous integument. While mesenteric adipose tissue-based immune processes have gained recognition in the context of the metabolic syndrome, SAT has been traditionally considered primarily for energy storage, with less attention to its immune functions. SAT harbors a reservoir of immune and stromal cells that significantly impact metabolic and immunologic processes not only in the skin, but even on a systemic level. These processes include wound healing, cutaneous and systemic infections, immunometabolic, and autoimmune diseases, inflammatory skin diseases, as well as neoplastic conditions. A better understanding of SAT immune functions in different processes, could open avenues for novel therapeutic interventions. Targeting SAT may not only address SAT-specific diseases but also offer potential treatments for cutaneous or even systemic conditions. This review aims to provide a comprehensive overview on SAT's structure and functions, highlight recent advancements in understanding its role in both homeostatic and pathological conditions within and beyond the skin, and discuss the main questions for future research in the field.

Obesity prevention across the lifespan: assessing the efficacy of intervention studies and discussing future challenges

INTRODUCTION

Obesity is intricately linked with metabolic conditions that disrupt hormones and metabolism, often resulting in weight-related challenges. Given the heightened mortality rates associated with cardiovascular and metabolic disorders linked to obesity, there is a pressing call to mobilize medical professionals, researchers, and policymakers towards advocating for healthy lifestyles and preventing obesity. Traditionally, obesity prevention and treatment have been viewed as separate endeavors, with prevention primarily falling under public health initiatives and treatment within the purview of clinicians. However, this division has led to significant healthcare costs without a substantial reduction in obesity rates.

EVIDENCE ACQUISITION

Our search encompassed published articles focused on prevention, excluding any mention of "treatment". Data was gathered from diverse sources including academic databases, government health agency websites like the CDC, research organizations, clinical trials registries, and public health campaigns.

EVIDENCE SYNTHESIS

Due to the diverse range of interventions (encompassing dietary modifications, physical activity promotion, policy initiatives, education, and community-based programs, either independently or in combination), and the variability in study design and population demographics, we conducted a narrative review to systematically present and critically analyze evidence on preventing overweight and obesity across different age groups.

CONCLUSIONS

Effectively addressing obesity prevention necessitates a comprehensive, multidisciplinary approach that establishes an environment where healthier choices are accessible and viable for all. This requires collaborative efforts between individuals, communities, healthcare providers, policymakers, and industries to institute enduring change. Furthermore, there remains a critical need for national and international guidelines tailored to age-related risk factors, paving the way for innovative precision medicine approaches centered on salutogenesis rather than pathogenesis.

Association of metabolic score for visceral fat with all-cause mortality, cardiovascular mortality, and cancer mortality: A prospective cohort study

AIM

Our study aimed to evaluate the association between the metabolic score for visceral fat (METS-VF) and mortality.

METHODS

We conducted a cohort study comprising 11,120 participants. We employed weighted multivariable Cox regression analysis to assess the relationship between METS-VF and mortality. Restricted cubic spline analyses were used to investigate potential non-linear associations. Receiver operating characteristic curves were used to evaluate the predictive value of METS-VF and other obesity-related indicators for mortality. Subgroup analysis and sensitivity analysis were performed to confirm the robustness of the results. Mendelian randomization analysis was utilized to assess potential causality.

RESULTS

Over a median follow-up duration of 83 months, a total of 1014 all-cause deaths, 301 cardiovascular deaths, and 262 cancer deaths occurred. For every 0.2-unit increase in METS-VF, the hazard ratios(HRs) of all-cause mortality, cardiovascular mortality, and cancer mortality were 1.13 [95% confidence interval (CI): 1.06, 1.20], 1.18 (95% CI: 1.06, 1.31), and 1.13 (95% CI: 1.03, 1.25), respectively. In addition, restricted cubic spline analyses revealed no significant non-linear associations between METS-VF and all-cause mortality, cardiovascular mortality, and cancer mortality. In multivariate Cox regression models, hazard ratios of all-cause mortality, cardiovascular mortality and cancer mortality were higher in the highest METS-VF group compared to the reference group. Subgroup and sensitivity analyses confirmed that our results were robust. Receiver operating characteristic curves indicated that METS-VF predicted mortality better than other obesity-related indicators. Mendelian randomization analysis confirmed significant causal relationships.

CONCLUSIONS

METS-VF was positively associated with all-cause mortality, cardiovascular mortality, and cancer mortality. These findings suggest that METS-VF could serve as a straightforward, reliable, and cost-effective marker for identifying individuals at high risk of mortality.

Regulatory roles of NAMPT and NAD+ metabolism in uterine leiomyoma progression: Implications for ECM accumulation, stemness, and microenvironment

Uterine leiomyoma (UL), commonly referred to as benign tumors, is characterized by excessive cell proliferation, extracellular matrix (ECM) accumulation, and the presence of stem cell-like properties. Nicotinamide adenine dinucleotide (NAD+) metabolism, regulated in part by nicotinamide phosphoribosyltransferase (NAMPT), plays a crucial role in these pathological processes and has emerged as a potential therapeutic target. Additionally, redox signaling pathways are integral to the pathogenesis of UL, influencing the dynamics of NAD+ metabolism. This study sought to elucidate the regulatory functions of NAMPT and NAD+ metabolism, in conjunction with redox signaling, in the progression of UL, and to explore potential therapeutic strategies targeting these pathways. Evaluation of NAMPT expression in human UL tissues revealed a positive correlation between elevated NAMPT levels and increased ECM deposition, as well as the expression of stemness markers. The use of FK866 and nicotinamide (NAM), to inhibit NAMPT significantly suppressed UL cell viability and attenuated stem cell-like characteristics. Redox signaling pathways, including those associated with DNA damage, lysosomal function homeostasis, and redox-sensitive phagophore formation, were implicated in the regulation of ECM dynamics, particularly through ECM-targeted inhibition. This study highlights the pivotal roles of NAMPT, NAD+ metabolism, and redox signaling in the pathophysiology of UL. Targeting NAMPT, particularly through the use of inhibitors FK866 and NAM, represents a promising therapeutic approach for mitigating UL progression by modulating redox and ECM dynamics. These findings offer novel insights into UL pathogenesis and establish NAMPT as a compelling target for future clinical investigation.

The multifactorial effect of obesity on the effectiveness and outcomes of cancer therapies

Epidemiology studies have demonstrated a clear association between obesity and the development of several distinct malignancies, with excessive visceral adiposity being an increasingly prevalent feature in patients with cancer presenting for therapeutic intervention. Clinical trials and meta-analyses have helped to inform effective and safe dosing of traditional systemically administered anticancer agents in adult patients with cancer and obesity, but there remains much debate not only regarding the effect of obesity on the more novel targeted molecular and immune-based therapies, but also about how obesity is best defined and measured clinically. Low muscle mass is associated with poor outcomes in cancer, and body composition studies using biochemical and imaging modalities are helping to fully delineate the importance of both obesity and sarcopenia in clinical outcomes; such studies might also go some way to explaining how obesity can paradoxically be associated with favourable clinical outcomes in certain cancers. As the cancer survivorship period increases and the duration of anticancer treatment lengthens, this Review highlights the challenges facing appropriate treatment selection and emphasizes how a multidisciplinary approach is warranted to manage weight and skeletal muscle loss during and after cancer treatment.

The effect of GLP-1R agonists on the medical triad of obesity, diabetes, and cancer

Glucagon-like peptide-1 receptor (GLP-1R) agonists have garnered significant attention for their therapeutic potential in addressing the interconnected health challenges of diabetes, obesity, and cancer. The role of GLP-1R in type 2 diabetes mellitus (T2DM) is highlighted, emphasizing its pivotal contribution to glucose homeostasis, promoting β-cell proliferation, and facilitating insulin release. GLP-1R agonists have effectively managed obesity by reducing hunger, moderating food intake, and regulating body weight. Beyond diabetes and obesity, GLP-1R agonists exhibit a multifaceted impact on cancer progression across various malignancies. The mechanisms underlying these effects involve the modulation of signaling pathways associated with cell growth, survival, and metabolism. However, the current literature reveals a lack of in vivo studies on specific GLP-1R agonists such as semaglutide, necessitating further research to elucidate its precise mechanisms and effects, particularly in cancer. While other GLP-1R agonists have shown promising outcomes in mitigating cancer progression, the association between some GLP-1R agonists and an increased risk of cancer remains a topic requiring more profound investigation. This calls for more extensive research to unravel the intricate relationships between the GLP-1R agonist and different cancers, providing valuable insights for clinicians and researchers alike.

Prognostic impact and reasons for variability by tumor location in gastric cancer

BACKGROUND

Gastric cancer (GC) is a highly prevalent gastrointestinal tract tumor. Several trials have demonstrated that the location of GC can affect patient prognosis. However, the factors determining tumor location remain unclear.

AIM

To investigate the tumor location of patients, we went on to study the influencing factors that lead to changes in the location of GC.

METHODS

A retrospective evaluation was carried out on 3287 patients who underwent gastrectomy for GC in Zhejiang Cancer Hospital. The patients were followed up post-diagnosis and post-gastrectomy. The clinicopathological variables and overall survival of the patients were recorded. By analyzing the location of GC, the tumor location was divided into four categories: "Upper", "middle", "lower", and "total". Statistical software was utilized to analyze the relationship of each variable with the location of GC.

RESULTS

A total of 3287 patients were included in this study. The clinicopathological indices of gender, age, serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen (CA19-9) and CA72-4 levels, were significantly associated with tumor location in patients with GC. In addition, there was a strong correlation between GC location and the prognosis of postoperative patients. Specifically, patients with "lower" and "middle" GC demonstrated a better prognosis than those with tumors in other categories.

CONCLUSION

The five clinicopathological indices of gender, age, CEA, CA19-9 and CA72-4 levels exhibit varying degrees of influence on the tumor location. The tumor location correlates with patient prognosis following surgery.

snRNA-seq of human ovaries reveals heat shock proteins are associated with obesity related cancer risk

BACKGROUND

Obesity significantly impacts female reproductive health and increases the risk of gynecological tumors. However, the specific transcriptional changes that occur in the ovarian microenvironment during obesity-induced stress and the relationship between obesity and ovarian cancer remain unclear.

METHODS

Our study investigated the single-cell landscape of the ovarian cortex in individuals with varying BMI levels by snRNA-seq, revealing weight-stage related cellular composition deviations and expression profile irregularities.

RESULTS

Using single-cell high-dimensional Weighted Gene Co-expression Network Analysis (hdWGCNA), we identified distinct obesity-related gene modules within various subpopulations of stroma cells and blood vascular endothelial cells. Notably, we observed a negative correlation between BMI and heat shock protein (HSP) family genes. Specifically, we found that HSPD1 might function as a potential regulator of ovarian carcinogenesis and progression under conditions of obesity, as supported by our co-analysis with data from three bulk RNA-seq ovarian cancer databases. Our findings suggested that lower expression of HSPD1 indicated a poorer prognosis for ovarian cancer.

CONCLUSIONS

Our study identified a cluster of genes in ovarian cells that are suppressed by obesity, including those belonging to HSP family genes. These findings provide valuable insights for investigating the link between obesity and ovarian diseases.

Acupuncture as an Adjunct to Lifestyle Interventions for Weight Loss in Simple Obesity: A Systematic Review and Meta-Analysis

Objective

This study aims to evaluate the efficacy of acupuncture as an adjunct to lifestyle interventions on weight loss in simple obesity.

Methods

Potentially eligible studies that assessed anthropometric outcomes as well as glucose and lipid metabolism following acupuncture combined with lifestyle interventions in simple obesity patients were searched from eight databases from inception to October 2023. All analyses were performed using the Review Manager software v5.4 and Stata software v17.0.

Results

Herein, 25 randomized controlled trials (RCTs) involving 2018 patients were included. Generally, acupuncture combined with lifestyle interventions outperformed lifestyle interventions alone in terms of body weight (MD = -4.73, 95% CI [-6.32, -3.13], p < 0.00001), body mass index (BMI) (MD = -2.11, 95% CI [-2.75, -1.48], p < 0.00001), waist circumference (WC) (MD = -4.96, 95% CI [-6.89, -3.03], p < 0.00001), body fat percentage (BF %) (MD = -2.61, 95% CI [-4,51, -0.71], p = 0.007), fasting plasma glucose (FPG) (SMD = -0.66, 95% CI [-1.02, -0.31], p = 0.0002), fasting serum insulin (FINS) (SMD = -1.12, 95% CI [-1.44, -0.81], p < 0.00001), homeostasis model assessment-insulin resistance (HOMA-IR) (MD = -1.22, 95% CI [-1.50, -0.94], p < 0.00001), total cholesterol (TC) (SMD = -1.14, 95% CI [-1.83, -0.45], p = 0.001), triglyceride (TG) (SMD = -1.31, 95% CI [-2.07, -0.56], p = 0.0006), and low-density lipoprotein cholesterol (LDL-C) (SMD = -1.81, 95% CI [-3.11, -0.51], p = 0.006). Subgroup analysis based on three subgroup variables (types of acupuncture and lifestyle interventions as well as treatment durations) could partially explain the heterogeneity of the results.

Conclusion

Acupuncture demonstrated an enhancing effect on the benefits of lifestyle interventions for weight loss in patients with simple obesity, including reducing body weight and improving glucose and lipid metabolism. This finding suggests its potential value as a complementary therapy alongside lifestyle interventions in a clinical setting. However, further validation with rigorously designed and high-quality RCTs is still needed in the future.