Healthy and metabolically unhealthy forms of obesity are associated with an increased risk of obesity-related cancers

New research will be presented at the European Conference on Obesity next week in Dublin, Ireland (May 17-20) and published in Journal of the National Cancer Institute It shows that both healthy and metabolically unhealthy “forms” of obesity are associated with an increased risk of various types of obesity-related cancers, and that the relationship is stronger in metabolically unhealthy obesity. The study is by Dr Meng Sun, Lund University, Malmö, Sweden and colleagues.

Studies of how cancer relates to obesity with metabolic complications (commonly termed metabolically unhealthy obesity) or without such complications (healthy obesity) are scarce.
In this new research, the authors investigated BMI (body mass index, normal weight/overweight/obesity) jointly and in the interaction with metabolic health status in relation to obesity-related cancer risk (n = 23,630) among 797,193 European individuals.

A metabolic score comprising blood pressure, plasma glucose, and triglycerides (blood fats) was used to determine metabolically healthy and unhealthy status, and statistical modeling was used to estimate any relationship.

The participants were thus divided into six different categories – metabolically unhealthy obesity (6.8% of participants); Metabolic healthy obesity (3.4%), metabolically unhealthy overweight (15.4%), metabolically healthy overweight (19.8%), metabolically unhealthy normal weight (12.5%), metabolically healthy normal weight (42.0%).

Metabolically unhealthy obesity, compared to a metabolically healthy normal weight, was associated with an increased relative risk of any obesity-related cancer, colorectal, pancreatic, endometrial, liver, gallbladder, and renal cell carcinomas, with the highest risk estimates for endometrial, hepatocellular carcinoma, and renal cell carcinomas (increases The risk is 2.5 to 3.0 times).

In women, compared to metabolically healthy women of normal weight, metabolically incorrect women with obesity had a 21% increased risk of colon cancer, a 3-fold increased risk of endometrial cancer, and a 2.5-fold increased risk of kidney cancer. . The risk of endometrial cancer in metabolically healthy women with obesity increased by 2.4 times, and the risk of kidney cancer increased by 80% – but the relationship with colon cancer was no longer statistically significant.

In men, compared to otherwise healthy men of normal weight, metabolically unhealthy men with obesity had a 2.6-fold increased risk of kidney cancer, an 85% increased risk of colon cancer, and an 85% increased risk of pancreatic and rectal cancer. 32%. Metabolically healthy men with obesity had a 67% increased risk of kidney cancer, and a 42% increased risk of colon cancer, but the relationship with both pancreatic and rectal cancer was no longer statistically significant. In an unusual finding, both healthy and unhealthy men who were overweight (but not obese) had a 50% increased risk of developing multiple myeloma — yet neither healthy nor healthy men with obesity had an increased risk of this cancer.

Only among men, the authors say, does the data show that obesity combined with metabolic complications raises the risk of these obesity-related cancers more than would be expected from the sum of the individual risk factors. They say: “This has important public health implications, suggesting that a large number of cancer cases could be prevented by targeting the coexistence of metabolic problems and obesity, particularly obesity-related cancers among men.”

The authors concluded: “This study highlights that the type of metabolic obesity phenotype is important when assessing obesity-related cancer risk. Overall, poor metabolic health leads to an increased risk of obesity-related cancer, suggesting that both obesity and metabolic states are Beneficial targets for the prevention of obesity-related cancers”.