Die Auswirkungen einer Lebensstilveränderung auf Biomarker der Adipositas und ihre mögliche Bedeutung für das Mammakarzinom

Zusammenfassung

Fragestellung Einer Reihe von epidemiologischen Erhebungen zufolge besteht ein erhöhtes Risikopotenzial übergewichtiger Frauen nach der Menopause an Brustkrebs zu erkranken. Eine einheitliche Erklärung für den Zusammenhang zwischen Adipositas und Tumorerkrankungen existiert bislang nicht. Neuere Forschungsansätze konzentrieren sich auf die Untersuchung verschiedener Biomarker der Adipositas, deren Veränderungen auch Auswirkungen auf die Tumorpathogenese haben können. Dazu zählen Östrogene und Androgene, das „sex hormone-binding globulin”, Insulin und eine Insulinresistenz sowie aus Fettzellen freigesetzte Mediatoren mit endokriner Aktivität. Die mögliche Rolle dieser Biomarker bei der Entstehung und der Progression eines Mammakarzinoms sowie ihre Beeinflussbarkeit durch Lebensstilveränderungen sollen im folgenden Übersichtsartikel dargestellt werden. Methoden Review der Literatur zu Änderungen der genannten Biomarker durch Lebensstilveränderungen. Der Fokus der zitierten Untersuchungen liegt dabei auf dem Gebiet der Primärprävention, da nur in einzelnen Fällen Studien mit Mammakarzinompatientinnen durchgeführt wurden. Ergebnisse Ernährungsverhalten oder körperliche Aktivität werden als unterstützende Maßnahme im Hinblick auf eine Verbesserung der Lebensqualität wahrgenommen, können darüber hinaus jedoch auch als ein Mechanismus verstanden werden, der die Rezidiv- oder Überlebensrate mitbestimmt. Es gibt Hinweise auf günstige Veränderungen der Serumspiegel von Insulin, „Insulin-like growth factor” und anderen Biomarkern durch Lebensstilveränderungen. Schlussfolgerung Diese Parameter bieten sich als wertvolle Werkzeuge für zukünftige Studien an, die sich mit den Auswirkungen einer positiven Lebensstilveränderung auf pathogenetische Mechanismen bei Brustkrebspatientinnen beschäftigen.

Abstract

Purpose Epidemiological data provide evidence that there is an increased risk for obese women to develop post-menopausal breast cancer. Hazardous lifestyle patterns may increase cancer risk by several mechanisms. These include a changed pattern of biomarkers of obesity, e. g. estrogens and androgens, hyperinsulinemia and insulin resistance, and endocrine functions of adipose tissue. It is the aim of this review to summarize the actual knowledge of the potential role of selected biological markers of obesity in breast cancer development and progression as well as their affection by lifestyle modifications. Methods Review of the literature on the changes of these biomarkers by lifestyle modifications. Results To the extent that lifestyle factors have been a focus of cancer prognosis studies, they have often been aimed at the question of whether they impact quality of life. Moreover, interventional programs may influence cancer survival or recurrence. Evidence points towards a beneficial modulation of biological obesity markers like insulin or insulin-like growth factor via lifestyle changes. Conclusion Thus, these parameters may provide a valuable tool for future studies dealing with the effects of positive lifestyle modifications on breast cancer risk and survival.

Schlüsselwörter

Adipositas - Biomarker - Lebensstilmodifikation - Mammakarzinom - Übergewicht

Key words

adipositas - biomarker - breast cancer - lifestyle intervention - overweight

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