ABSTRACT
Rates of obesity and diabetes have increased significantly over the past decades and the prevalence is expected to continue to rise further in the coming years. Many observations suggest that obesity and diabetes are associated with an increased risk of developing several types of cancers, including liver, pancreatic, endometrial, colorectal, and post-menopausal breast cancer. The path towards developing obesity and diabetes is affected by multiple factors, including adipokines, inflammatory cytokines, growth hormones, insulin resistance, and hyperlipidemia. The metabolic abnormalities associated with changes in the levels of these factors in obesity and diabetes have the potential to significantly contribute to the development and progression of cancer through the regulation of distinct signaling pathways. Here, we highlight the cellular and molecular pathways that constitute the links between obesity, diabetes, cancer risk and mortality. This includes a description of the existing evidence supporting the obesity-driven morphological and functional alternations of cancer cells and adipocytes through complex interactions within the tumor microenvironment.
ABSTRACT
PURPOSE: We compared the diagnostic performance of aortic calcification volume with that of coronary artery calcification volume at CT in diagnosing obstructive coronary artery disease (OCAD). MATERIALS AND METHODS: A total of 308 patients (M: F=141:167) underwent coronary CT angiography using a 64-slice MDCT. We measured the calcification volume (mm3) of coronary artery (CAC), thoracic aorta (TAC), abdominal aorta (AAC), and whole aorta (AC) at unenhanced CT. OCAD was defined as the significant stenosis (>=50%) in any coronary artery at CT angiography. The diagnostic performance for OCAD was evaluated by calculating the area under the receiver operating characteristic (ROC) curve. RESULTS: Among the 308 patients studied, 45 patients were diagnosed with OCAD. The mean volumes of TAC, AAC, AC, and CAC were 518.8 mm3, 551.5 mm3, 1069.9 mm3, 57.6 mm3, respectively. The areas under the ROC curve of TAC, AAC, AC, and CAC for OCAD were 0.766 (0.694<95% confidence interval <0.838), 0.837 (0.784<95% confidence interval <0.892), 0.814 (0.755<95% confidence interval <0.873), 0.871 (0.812<95% confidence interval<0.930), respectively. CONCLUSION: The volume of aortic calcification as well as coronary artery calcification is associated with obstructive coronary artery disease.