癌症、高血壓、肥胖與血管新生：流行病學及藥物學觀點

Cancer, Hypertension, Obesity and Angiogenesis: Epidemiological and Pharmacological Aspects

郭傑(Chieh Kuo) ； 唐正乾(Chang-Chen Tang) ； 許世元(Shih-Yuan Hsu)

《內科學誌》 16卷6期 (2005/12) Pp. 260-268

https://doi.org/10.6314/JIMT.2005.16(6).02

摘要

癌症、高血壓的盛行率隨著年齡老化而增加，死亡率也一直是全世界或台灣地區的前茅；最近的流行病學研究顯示，癌症、高血壓與肥胖三者間有著密切的關聯，三者的共同生物活性機轉包括，血管新生、瘦素、胰島素及類胰島素生長因子等。癌細胞會藉由分泌血管生長因子如，VEGF, bFGF, TNF-α及介白素等，誘導附近組織血管內皮細胞增殖，形成新的微血管是為血管新生；因此，血管新生為癌細胞生長及轉移所必須。流行病學研究發現，長期使用某些降血壓藥物或血糖控制藥物可能為癌症危險因子；特定降血壓藥物或胰島素分泌促進劑的血管新生作用活性，可能與細胞癌化活性有關。雖然降血壓藥物與血糖控制藥物的致癌性仍需有更多的支持證據；但無論如何，多瞭解這類藥物的細胞藥理學與癌化生理之間作用的關聯性，對於肥胖、高血壓的治療藥物與癌症的預防，是有正面的意義。畢竟，良好的血糖與血壓控制，是保障病患獲得最大利益的所在。

關鍵字

癌症 ； 高血壓 ； 肥胖 ； 高胰島素血症 ； 血管新生 ； 降血壓藥

並列摘要

Cancer and hypertension are two leading diseases in Taiwan for years. Often they coexist with some common predisposing factors in patients e.g., obesity and ageing. The common biologic mechanisms involved among cancer, hypertension and obesity are angiogenesis, leptin, insulin, insulin-like growth factor and steroid hormones. An abnormal angiogenesis is a common pathological feature, which may be induced by proangiogenic factors e.g., bFGF, VEGF, TNF-α and few interleukins. A number of epidemiological studies have found that the use of antihypertensives, antidiabetics may associate with risk of cancer, and they also have showed some proangiogenic activity on certain antihypertensives and insulin secretagogues. However, a better understanding of common cell biology and the relationship among hyperinsulinemia, hypertension and malignancy may be helpful in elucidating more preventive and therapeutic avenues to manage obesity, hypertension and cancer.

並列關鍵字

Cancer ； Hypertension ； Obesity ； Hyperinsulinemia ； Angiogenesis ； Antihypertensives