Kolorektal kanser, dünyada ve ülkemizde en yaygın görülen üçüncü; kansere bağlı mortalite açısından ise dördüncü sırada yer alan önemli bir sağlık sorunudur. Oluşumunda genetik yatkınlığın payı olmakla birlikte; vakaların çoğunluğu sporadik olarak meydana gelmektedir. Özellikle obezite açısından düşünüldüğünde, yağ dokusunda artışla birlikte adipoz dokudan salınan adipokinlerin oranında değişim ile inflamasyon ve oksidatif stresin uyarılması kolorektal kanser gelişiminde uyarıcı olabilmektedir. Ayrıca nükleer faktör kappa-B (NF-κB) transkripsiyon faktörü ile uyarılmış inflamasyon, oksidatif stres ve lipit peroksidasyonunda artış veya inflamasyon ve oksidatif stres kaynaklı adiponektin/leptin oranında oluşan değişim kısır bir döngü halinde çeşitli mekanizmalar yoluyla kolorektal kanser gelişimini destekleyebilmektedir. Beslenme ile ilişkili risk faktörleri açısından ele alındığında ise diyet yağı, posası, antioksidan besin ögeleri, kırmızı et ve işlenmiş et ürünleri gibi birçok faktör kolorektal kanser gelişiminde rol alabilmektedir. Bu derlemede kolorektal kanser oluşumunda rol oynayan farklı mekanizmalar ve beslenme ile ilişkili risk faktörleri değerlendirilecektir.
Anahtar Kelimeler: Kolorektal kanser; adipokinler; inflamasyon; oksidatif stres; beslenme
Colorectal cancer, the third most common cancer in the world and in our country and the fourth in terms of cancer-related mortality, is a major health problem. Although there is genetic predisposition in the formation of colorectal cancer, the majority of cases are sporadic. Particularly when considered in terms of obesity, inflammation and oxidative stress induced by the change of adipokines released from the adipocytes with an increase in fat tissue may stimulate the development of colorectal cancer. In addition, increased nuclear factor kappa-B (NF-κB) transcription factor-induced inflammation, oxidative stress and lipid peroxidation or the change in adiponectin/leptin ratio due to inflammation and oxidative stress can support the development of colorectal cancer through various mechanisms in a vicious cycle. When considered in terms of nutritional risk factors, many factors such as dietary fat, dietary fiber, antioxidant nutrients, red meat and processed meat products can play a role in the development of colorectal cancer. In this review, different mechanisms that play a role in the formation of colorectal cancer and nutritional risk factors will be evaluated.
Keywords: Colorectal cancer; adipokines; inflammation; oxidative stress; nutrition
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