21. yüzyılın en önemli sağlık problemi: Yaşam dönemlerine göre obezitenin incelenmesi

Year 2022, Volume: 4 Issue: 4, 183 - 190, 06.12.2022

Rabiye Akın , Füsun Terzioğlu

https://doi.org/10.46969/EZH.1010936

Abstract

Obezite, vücutta aşırı yağ birikimini içeren kompleks bir hastalıktır ve her yaştan kadın ve erkeği etkileyen önemli bir halk sağlığı sorunudur. Obeziteden genetik, çevresel, nörolojik, fizyolojik, biyokimyasal, kültürel ve ruhsal birçok faktörün sorumlu olduğu gösterilmiştir. Dünya Sağlık Örgütü (WHO) basitliği, maliyet etkinliği ve yüksek doğruluğu nedeniyle obezite sınıflandırması için Vücut Kitle İndeksi'nin (VKI) kullanılmasını önermektedir. Ancak VKI’nin dışında, bel çevresi ölçümü, kilo-boy, deri kıvrım kalınlığı ve çevre ölçümleri de kullanılmaktadır. Dünya Sağlık Örgütü'ne göre her yıl 2,8 milyon insan obezite nedeniyle ölmektedir. Obezite her yaş ve sosyal grubu etkilemekle birlikte, kadınlar birçok biyolojik faktörle ilişkili olarak erkeklerden daha kiloludurlar. Ancak, medikal problemi olan kadınlar bile erkeklerden daha uzun yaşar ancak daha yüksek sağlık bakım harcamalarına sahiptir. Bu derlemede obezitenin kadın sağlığı ve yaşamı üzerindeki etkileri tartışılacaktır.

Keywords

Obezite, Kadın Sağlığı, Hemşirelik, Obesity, Women, Nursing

Supporting Institution

YOK

Project Number

YOK

The Most Important Health Problem of the 21st Century: Investigation of Obesity in Women According to Their Life Periods

Abstract

Obesity is a complex disease involving an excessive amount of body fat and an important public health problem affecting all ages in both men and women. It has been shown that obesity is responsible for many genetic, environmental, neurological, physiological, biochemical, cultural and spiritual factors. World Health Organization (WHO) recommends Body Mass Index (BMI) for obesity classification due to its simplicity, cost-effectivity, and high accuracy. Apart from BMI, waist circumference measurement, weight-to-height, skinfold thickness, and circumference measurements are also used. According to the WHO, 2.8 million people die every year due to obesity. Although obesity affects all ages and social groups, women have been more overweight compared to men since and has been linked to many biological factors. However, even with the medical problems, obese women live longer than men, but not without higher healthcare costs. In this review, the effects of obesity on women's health and life will be discussed.

Keywords

Obesity, Women, Nursing

Project Number

YOK

References

• Waters E, de Silva-Sanigorski A, Hall BJ, Brown T, Campbell KJ, Gao Y, et al. Interventions for preventing obesity in children. Cochrane Database Syst Rev 2011: CD001871.
• Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 384: 766-81.
• Talmor A, Dunphy B. Female obesity and infertility. Best Pract Res Clin Obstet Gynaecol 2015; 29: 498-506.
• Prevention and management of the global epidemic of obesity. Report of the WHO Consultation on Obesity Geneva: WHO; 1997 [Available from: file:///C:/Users/tr/Documents/Downloads/WHO_NUT_NCD_98.1_(p1-158).pdf
• Ergin AB. Obezitenin kadın sağlığı ve toplumsal cinsiyet açısından değerlendirilmesi. KASHED 2014; 1: 41-54.
• Kanter R, Caballero B. Global gender disparities in obesity: a review. Adv Nutr 2012; 3: 491-8.
• Kozakowski J, Gietka-Czernel M, Leszczynska D, Majos A. Obesity in menopause - our negligence or an unfortunate inevitability? Prz Menopauzalny 2017; 16: 61-5.
• Stevens GA, Singh GM, Lu Y, Danaei G, Lin JK, Finucane MM, et al. National, regional, and global trends in adult overweight and obesity prevalences. Popul Health Metr 2012; 10: 22.
• Türkiye’de Obezite Oranı: Türkiye İstatistik Kurumu; 2016 [Available from: http://tuik.gov.tr/PreTablo.do?alt_id=1068
• Nazlıcan E, Demirhindi H, Akbaba M. Adana İli Solaklı ve Karataş Merkez Sağlık Ocağı Bölgesinde yaşayan 20-64 yaş arası kadınlarda obezite ve ilişkili risk faktörlerinin incelenmesi. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 2011; 1: 5-12.
• Rong K, Yu K, Han X, Szeto IM, Qin X, Wang J, et al. Pre-pregnancy BMI, gestational weight gain and postpartum weight retention: a meta-analysis of observational studies. Public Health Nutr 2015; 18: 2172-82.
• Pegington M, French DP, Harvie MN. Why young women gain weight: A narrative review of influencing factors and possible solutions. Obes Rev 2020; 21: e13002.
• Meldrum DR. Introduction: Obesity and reproduction. Fertil Steril 2017; 107: 831-2.
• Waters H, DeVol R. Weighing down America: the health and economic impact of obesity 2016 [Available from: http://www.milkeninstitute.org/publications/view/833.
• Yavuz R, Tontuş HÖ. Erişkin, adolesan ve çocukluk yaş grubunda obeziteye klinik yaklaşım. Journal of Experimental and Clinical Medicine 2013; 30: 1.
• WHO expert consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. The Lancet 2004: 157-63.
• Yücel BB, Toprak D. 6-16 Yaş Arası Obez Çocuklarda Antropometrik Ölçümlerin Ve Biyokimyasal Parametrelerin Değerlendirilmesi. Ankara Med J 2016; 16: 27-40.
• Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E, et al. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary]. CMAJ 2007; 176: S1-13.
• Ersoy R, Çakır B. Obezite. Turkish Medical Journal 2007; 1: 109-11.
• Güler Y, Gönener HD, Altay B, Gönener A. Adölesanlarda obezite ve hemsirelik bakımı. Fırat Saglık Hizmetleri Dergisi 2009; 4: 165.
• Aksoydan E, Cakir N. Adolesanların Beslenme Alışkanlıkları, Fiziksel Aktivite Duzeyleri ve Vücut Kitle İndekslerinin Değerlendirilmesi. Gülhane Tıp Dergi 2011: 264-70.
• Cordeiro LS, Lamstein S, Mahmud Z, Levinson FJ. Adolescent malnutrition in developing countries: a close look at the problem and at two national experience. Standing Committee on Nutrition (SCN News) 2005; 31: 6-13.
• Karacaören A. Adölesanlarda duygu değişiklikleri ile yeme eğilimi ilişkisinin değerlendirilmesi Ankara: Başkent Üniversitesi; 2019.
• World Health Organization. Nutrition in adolescence: issues and challenges for the health sector: Issues in adolescent health and development: World Health Organization; 2005.
• Erkekoğlu P, Giray B, Şahin G. Çocukluk ve adölesan dönemde kullanılan antiobezitik ilaçların toksikolojik açıdan değerlendirilmesi. Hacettepe Tıp Dergisi 2007; 38: 199-211.
• Chandra-Mouli V, Haider R, Moreira A. Adolescent nutrition. Lessons learnt and challenges ahead. Editorial. Standing Committee on Nutrition. SCN News 2006; 31: 40-2.
• Zhu H, Luo X, Cai T, Li Z, Liu W. Self-control and parental control mediate the relationship between negative emotions and emotional eating among adolescents. Appetite 2014; 82: 202-7.
• Kaltiala-Heino R, Kosunen E, Rimpela M. Pubertal timing, sexual behaviour and self-reported depression in middle adolescence. J Adolesc 2003; 26: 531-45.
• Elizondo-Montemayor L, Hernandez-Escobar C, Lara-Torre E, Nieblas B, Gomez-Carmona M. Gynecologic and Obstetric Consequences of Obesity in Adolescent Girls. J Pediatr Adolesc Gynecol 2017; 30: 156-68.
• Panaitescu AM, Rotaru D, Ban I, Peltecu G, Zagrean AM. The Prevalence of Underweight, Overweight and Obesity in a Romanian Population in the First Trimester of Pregnancy - Clinical Implications. Acta Endocrinol (Buchar) 2019; 15: 323-32.
• Yu CK, Teoh TG, Robinson S. Obesity in pregnancy. BJOG 2006; 113: 1117-25.
• Kominiarek MA, Chauhan SP. Obesity Before, During, and After Pregnancy: A Review and Comparison of Five National Guidelines. Am J Perinatol 2016; 33: 433-41.
• Catalano PM, Shankar K. Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. BMJ 2017; 356: j1.
• Akyol MA. Çocukluk Çağında Metabolik Sendrom: Maternal Obezite, Gestasyonel Diyabet, Doğum Ağırlığı İlişkisi. 1 ed. Tayfur M, Yabancı AN, editors. Ankara: Hatipoğlu Yayınevi; 2015.
• Lee CY, Koren G. Maternal obesity: effects on pregnancy and the role of pre-conception counselling. J Obstet Gynaecol 2010; 30: 101-6.
• Al Wattar BH, Pidgeon C, Learner H, Zamora J, Thangaratinam S. Online health information on obesity in pregnancy: a systematic review. Eur J Obstet Gynecol Reprod Biol 2016; 206: 147-52.
• Yanıkkerem E, Mutlu S. Maternal obezitenin sonuçları ve önleme stratejileri. TAF Preventive Medicine Bulletin 2012; 11: 353-64.
• Aune D, Saugstad OD, Henriksen T, Tonstad S. Maternal body mass index and the risk of fetal death, stillbirth, and infant death: a systematic review and meta-analysis. JAMA 2014; 311: 1536-46.
• Hajagos-Toth J, Ducza E, Samavati R, Vari SG, Gaspar R. Obesity in pregnancy: a novel concept on the roles of adipokines in uterine contractility. Croat Med J 2017; 58: 96-104.
• Knight-Agarwal CR, Williams LT, Davis D, Davey R, Cochrane T, Zhang H, et al. Association of BMI nad interpregnancy BMI change with birth outcomes in an Australian obstetric population: a retrospective cohort study. BMJ 2016; 6: 1-9.
• Simic M, Wahlin IA, Marsal K, Kallen K. Maternal obesity is a potential source of error in mid-trimester ultrasound estimation of gestational age. Ultrasound Obstet Gynecol 2010; 35: 48-53.
• Taşdemir D, Karaman E, Yıldız A, Han A, Karaman Y, Talay H. Obezitenin term gebelerde maternal ve fetal sonuçlara etkisi: Bir olgu kontrol çalışması. İstanbul Kanuni Sultan Süleyman Tıp Dergisi (IKSST) 2015; 7: 73-8.
• Kürklü N, Kamarlı H. Maternal Obezitenin Emzirmeye Etkisi. Journal of Anatolia Nursing and Health Sciences 2016; 19: 53-6.
• Lacoursiere DY, Baksh L, Bloebaum L, Varner MW. Maternal body mass index and self-reported postpartum depressive symptoms. Matern Child Health J 2006; 10: 385-90.
• The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Obesity in Pregnancy, Management of (C-Obs49) (March 2013, revised September 2013) [Available from: https://www.ranzcog.edu.au/college-statements-guidelines.html.
• Stothard KJ, Tennant PW, Bell R, Rankin J. Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis. JAMA 2009; 301: 636-50.
• An X, Zhao Y, Zhang Y, Yang Q, Wang Y, Cheng W, et al. Risk assessment of morbidly obese parturient in cesarean section delivery: A prospective, cohort, single-center study. Medicine (Baltimore) 2017; 96: e8265.
• Chen CN, Chen HS, Hsu HC. Maternal Prepregnancy Body Mass Index, Gestational Weight Gain, and Risk of Adverse Perinatal Outcomes in Taiwan: A Population-Based Birth Cohort Study. Int J Environ Res Public Health 2020; 17.
• Sullivan EA, Dickinson JE, Vaughan GA, Peek MJ, Ellwood D, Homer CS, et al. Maternal super-obesity and perinatal outcomes in Australia: a national population-based cohort study. BMC Pregnancy Childbirth 2015; 15: 322.
• Vinturache AE, McDonald S, Slater D, Tough S. Perinatal outcomes of maternal overweight and obesity in term infants: a population-based cohort study in Canada. Sci Rep 2015; 5: 9334.
• Boney CM, Verma A, Tucker R, Vohr BR. Metabolic syndrome in childhood: association with birth weight, maternal obesity, and gestational diabetes mellitus. Pediatrics 2005; 115: e290-6.
• Yılmaz FÇ, Yardımcı H. eden Kütle İndeksinin İnfertilite Üzerine Etkisi. Hacettepe University Faculty of Health Sciences Journal 2015; 1: s1.
• Amanak K, Karaöz B, Sevil Ü. Modern Yaşamın İnfertilite Üzerine Etkisi. TAF Preventive Medicine Bulletin 2014; 13.
• Bhattacharya S, Porter M, Amalraj E, Templeton A, Hamilton M, Lee AJ, et al. The epidemiology of infertility in the North East of Scotland. Hum Reprod 2009; 24: 3096-107.
• Bosdou JK, Kolibianakis EM, Tarlatzis BC, Fatemi HM. Sociocultural influences on fertility in the Middle East: the role of parental consanguinity, obesity and vitamin D deficiency. Fertil Steril 2016; 106: 259-60.
• Agarwal A, Aponte-Mellado A, Premkumar BJ, Shaman A, Gupta S. The effects of oxidative stress on female reproduction: a review. Reprod Biol Endocrinol 2012; 10: 49.
• Cinar O, Dilbaz S, Terzioglu F, Karahalil B, Yucel C, Turk R, et al. Does cigarette smoking really have detrimental effects on outcomes of IVF? Eur J Obstet Gynecol Reprod Biol 2014; 174: 106-10.
• Weiss RV, Clapauch R. Female infertility of endocrine origin. Arq Bras Endocrinol Metabol 2014; 58: 144-52.
• van der Steeg JW, Steures P, Eijkemans MJ, Habbema JD, Hompes PG, Michgelsen HW, et al. Predictive value of pregnancy history in subfertile couples: results from a nationwide cohort study in the Netherlands. Fertil Steril 2008; 90: 521-7.
• Metwally M, Li TC, Ledger WL. The impact of obesity on female reproductive function. Obes Rev 2007; 8: 515-23.
• Brannian JD, Hansen KA. Leptin and ovarian folliculogenesis: implications for ovulation induction and ART outcomes. Semin Reprod Med 2002; 20: 103-12.
• Moschos S, Chan JL, Mantzoros CS. Leptin and reproduction: a review. Fertil Steril 2002; 77: 433-44.
• Spicer LJ. Leptin: a possible metabolic signal affecting reproduction. Domest Anim Endocrinol 2001; 21: 251-70.
• Pantasri T, Norman RJ. The effects of being overweight and obese on female reproduction: a review. Gynecol Endocrinol 2014; 30: 90-4.
• Levens ED, Skarulis MC. Assessing the role of endometrial alteration among obese patients undergoing assisted reproduction. Fertil Steril 2008; 89: 1606-8.
• Schwartz MW, Seeley RJ. Seminars in medicine of the Beth Israel Deaconess Medical Center. Neuroendocrine responses to starvation and weight loss. N Engl J Med 1997; 336: 1802-11.
• Luke B, Brown MB, Stern JE, Missmer SA, Fujimoto VY, Leach R, et al. Female obesity adversely affects assisted reproductive technology (ART) pregnancy and live birth rates. Hum Reprod 2011; 26: 245-52.
• Rittenberg V, Seshadri S, Sunkara SK, Sobaleva S, Oteng-Ntim E, El-Toukhy T. Effect of body mass index on IVF treatment outcome: an updated systematic review and meta-analysis. Reprod Biomed Online 2011; 23: 421-39.
• Karaca N, Batmaz G, Aydın S. Effect of obesity on fertility. Bezmialem Science 2015; 3: 78-82.
• Robker RL, Akison LK, Bennett BD, Thrupp PN, Chura LR, Russell DL, et al. Obese women exhibit differences in ovarian metabolites, hormones, and gene expression compared with moderate-weight women. J Clin Endocrinol Metab 2009; 94: 1533-40.
• Gosman GG, Katcher HI, Legro RS. Obesity and the role of gut and adipose hormones in female reproduction. Hum Reprod Update 2006; 12: 585-601.
• Jungheim ES, Moley KH. Current knowledge of obesity's effects in the pre- and periconceptional periods and avenues for future research. Am J Obstet Gynecol 2010; 203: 525-30.
• Kadıoğlu M, Beji KN. Polikistik Over Sendromu ve Hemşirelik Yaklaşımı. FN Hem Derg 2013; 21: 187-97.
• Yildiz BO, Azziz R, Androgen E, Society P. Ovarian and adipose tissue dysfunction in polycystic ovary syndrome: report of the 4th special scientific meeting of the Androgen Excess and PCOS Society. Fertil Steril 2010; 94: 690-3.
• Georgopoulos NA, Saltamavros AD, Vervita V, Karkoulias K, Adonakis G, Decavalas G, et al. Basal metabolic rate is decreased in women with polycystic ovary syndrome and biochemical hyperandrogenemia and is associated with insulin resistance. Fertil Steril 2009; 92: 250-5.
• Yildirim B, Sabir N, Kaleli B. Relation of intra-abdominal fat distribution to metabolic disorders in nonobese patients with polycystic ovary syndrome. Fertil Steril 2003; 79: 1358-64.
• Gimble JM. Adipose tissue-derived therapeutics. Expert Opin Biol Ther 2003; 3: 705-13.
• McKinney A. A lifestyle perspective on infertility and pregnancy outcome. Am J Lifestyle Med 2015; 9: 368-77.
• Nestler JE. Obesity, insulin, sex steroids and ovulation. Int J Obes Relat Metab Disord 2000; 24 Suppl 2: S71-3.
• Nho JH. Lifestyle Intervention for Obese Women. J Lifestyle Med 2017; 7: 51-4.
• Norman RJ, Dewailly D, Legro RS, Hickey TE. Polycystic ovary syndrome. Lancet 2007; 370: 685-97.
• Teitelman M, Grotegut CA, Williams NN, Lewis JD. The impact of bariatric surgery on menstrual patterns. Obes Surg 2006; 16: 1457-63.
• Furer A, Afek A, Sommer A, Keinan-Boker L, Derazne E, Levi Z, et al. Adolescent obesity and midlife cancer risk: a population-based cohort study of 2.3 million adolescents in Israel. Lancet Diabetes Endocrinol 2020; 8: 216-25.
• Arnold M, Pandeya N, Byrnes G, Renehan PAG, Stevens GA, Ezzati PM, et al. Global burden of cancer attributable to high body-mass index in 2012: a population-based study. Lancet Oncol 2015; 16: 36-46.
• World Cancer Research Fund. 2nd ed. Washington, DC, USA: American Institute for Cancer Research; 2007.
• Gu W, Chen C, Zhao KN. Obesity-associated endometrial and cervical cancers. Front Biosci 2013; 5: 109-18.
• Nagle CM, Dixon SC, Jensen A, Kjaer SK, Modugno F, deFazio A, et al. Obesity and survival among women with ovarian cancer: results from the Ovarian Cancer Association Consortium. Br J Cancer 2015; 113: 817-26.
• Arem H, Irwin ML. Obesity and endometrial cancer survival: a systematic review. Int J Obes (Lond) 2013; 37: 634-9.
• Nindrea RD, Aryandono T, Lazuardi L, Dwiprahasto I. Association of Overweight and Obesity with Breast Cancer During Premenopausal Period in Asia: A Meta-Analysis. Int J Prev Med 2019; 10: 192.
• Gelsomino L, Naimo GD, Catalano S, Mauro L, Ando S. The Emerging Role of Adiponectin in Female Malignancies. Int J Mol Sci 2019; 20.
• Park J, Morley TS, Kim M, Clegg DJ, Scherer PE. Obesity and cancer--mechanisms underlying tumour progression and recurrence. Nat Rev Endocrinol 2014; 10: 455-65.
• Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 2003; 348: 1625-38.
• Secord AA, Hasselblad V, Von Gruenigen VE, Gehrig PA, Modesitt SC, Bae-Jump V, et al. Body mass index and mortality in endometrial cancer: A systematic review and meta-analysis. Gynecol Oncol 2016; 140: 184-90.
• Shaw E, Farris M, McNeil J, Friedenreich C. Obesity and Endometrial Cancer. Recent Results Cancer Res 2016; 208: 107-36.
• McDonald ME, Bender DP. Endometrial Cancer: Obesity, Genetics, and Targeted Agents. Obstet Gynecol Clin North Am 2019; 46: 89-105.
• Iskander K, Farhour R, Ficek M, Ray A. Obesity-related complications: few biochemical phenomena with reference to tumorigenesis. Malays J Pathol 2013; 35: 1-15.
• Divella R, De Luca R, Abbate I, Naglieri E, Daniele A. Obesity and cancer: the role of adipose tissue and adipo-cytokines-induced chronic inflammation. J Cancer 2016; 7: 2346-59.
• Conroy MJ, Dunne MR, Donohoe CL, Reynolds JV. Obesity-associated cancer: an immunological perspective. Proc Nutr Soc 2016; 75: 125-38.
• Uchikova E, Uchikov P, Parahuleva P. [Obesity and Endometrial Carcinogenesis]. Akush Ginekol (Sofiia) 2015; 54: 34-7.
• Daley-Brown D, Oprea-Ilies GM, Lee R, Pattillo R, Gonzalez-Perez RR. Molecular cues on obesity signals, tumor markers and endometrial cancer. Horm Mol Biol Clin Investig 2015; 21: 89-106.
• Aquila I, Ricci P, Oliverio A, Gratteri S. Role of the body mass index in the genesis of ascites in ovarian cancer: a forensic case and review of the literature. BMJ Case Rep 2018; 11.
• Olsen CM, Green AC, Whiteman DC, Sadeghi S, Kolahdooz F, Webb PM. Obesity and the risk of epithelial ovarian cancer: a systematic review and meta-analysis. Eur J Cancer 2007; 43: 690-709.
• Charkhchi P, Schabath MB, Carlos RC. Breast, Cervical, and Colorectal Cancer Screening Adherence: Effect of Low Body Mass Index in Women. J Womens Health (Larchmt) 2020.
• Donkers H, Smits A, Eleuteri A, Bekkers R, Massuger L, Galaal K. Body mass index and sexual function in women with gynaecological cancer. Psychooncology 2019; 28: 48-53.
• Benedetto C, Salvagno F, Canuto EM, Gennarelli G. Obesity and female malignancies. Best Pract Res Clin Obstet Gynaecol 2015; 29: 528-40.
• Huang YF, Shen MR, Hsu KF, Cheng YM, Chou CY. Clinical implications of insulin-like growth factor 1 system in early-stage cervical cancer. Br J Cancer 2008; 99: 1096-102.
• Poorolajal J, Jenabi E. The association between BMI and cervical cancer risk: a meta-analysis. Eur J Cancer Prev 2016; 25: 232-8.
• Frumovitz M, Jhingran A, Soliman PT, Klopp AH, Schmeler KM, Eifel PJ. Morbid obesity as an independent risk factor for disease-specific mortality in women with cervical cancer. Obstet Gynecol 2014; 124: 1098-104.
• Jung SY, Kim YA, Jo M, Park SM, Won YJ, Ghang H, et al. Prediagnosis obesity and secondary primary cancer risk in female cancer survivors: A national cohort study. Cancer Med 2019; 8: 824-38.
• Bhaskaran K, Douglas I, Forbes H, dos-Santos-Silva I, Leon DA, Smeeth L. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5.24 million UK adults. Lancet 2014; 384: 755-65.
• Olsen CM, Nagle CM, Whiteman DC, Ness R, Pearce CL, Pike MC, et al. Obesity and risk of ovarian cancer subtypes: evidence from the Ovarian Cancer Association Consortium. Endocr Relat Cancer 2013; 20: 251-62.
• Picon-Ruiz M, Morata-Tarifa C, Valle-Goffin JJ, Friedman ER, Slingerland JM. Obesity and adverse breast cancer risk and outcome: Mechanistic insights and strategies for intervention. CA Cancer J Clin 2017; 67: 378-97.
• Alsolami FJ, Azzeh FS, Ghafouri KJ, Ghaith MM, Almaimani RA, Almasmoum HA, et al. Determinants of breast cancer in Saudi women from Makkah region: a case-control study (breast cancer risk factors among Saudi women). BMC Public Health 2019; 19: 1554.
• Engin A. Obesity-associated Breast Cancer: Analysis of risk factors. Adv Exp Med Biol 2017; 960: 571-606.
• Picon-Ruiz M, Pan C, Drews-Elger K, Jang K, Besser AH, Zhao D, et al. Interactions between Adipocytes and Breast Cancer Cells Stimulate Cytokine Production and Drive Src/Sox2/miR-302b-Mediated Malignant Progression. Cancer Res 2016; 76: 491-504.
• Gilbert CA, Slingerland JM. Cytokines, obesity, and cancer: new insights on mechanisms linking obesity to cancer risk and progression. Annu Rev Med 2013; 64: 45-57.
• McArdle MA, Finucane OM, Connaughton RM, McMorrow AM, Roche HM. Mechanisms of obesity-induced inflammation and insulin resistance: insights into the emerging role of nutritional strategies. Front Endocrinol (Lausanne) 2013; 4: 52.
• Trayhurn P. Hypoxia and adipose tissue function and dysfunction in obesity. Physiol Rev 2013; 93: 1-21.
• Ollberding NJ, Kim Y, Shvetsov YB, Wilkens LR, Franke AA, Cooney RV, et al. Prediagnostic leptin, adiponectin, C-reactive protein, and the risk of postmenopausal breast cancer. Cancer Prev Res (Phila) 2013; 6: 188-95.
• Niu J, Jiang L, Guo W, Shao L, Liu Y, Wang L. The Association between Leptin Level and Breast Cancer: A Meta-Analysis. PLoS One 2013; 8: e67349.