title: Metabolic risk factors and mechanisms of disease in epithelial ovarian cancer: A review.
abstract: OBJECTIVE
  Epithelial ovarian cancer continues to be the deadliest gynecologic malignancy. Patients with both diabetes mellitus and obesity have poorer outcomes, yet research correlating metabolic abnormalities, such as metabolic syndrome, to ovarian cancer risk and outcomes is lacking. This article reviews the literature regarding metabolic derangements and their relationship to epithelial ovarian cancer, with a focus on potential mechanisms behind these associations.
  
  
  METHODS
  PubMed and Google Scholar were searched for articles in the English language regarding epithelial ovarian cancer, obesity, diabetes mellitus, and metabolic syndrome, with a focus on studies conducted since 1990.
  
  
  RESULTS
  Obesity, type II diabetes mellitus, and metabolic syndrome have been associated with poor outcomes in epithelial ovarian cancer. More studies investigating the relationship between metabolic syndrome and epithelial ovarian cancer are needed. A variety of pathologic factors may contribute to cancer risk in patients with metabolic derangements, including altered adipokine and cytokine expression, altered immune responses to tumor cells, and changes in pro-tumorigenic signaling pathways.
  
  
  CONCLUSIONS
  More research is needed to examine the effects of metabolic syndrome on epithelial ovarian cancer risk and mortality, as well as the underlying pathophysiologies in patients with obesity, diabetes mellitus, and metabolic syndrome that may be targeted for therapeutic intervention.
authors.affiliation: School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Eric R
authors.initials: ER
authors.lastname: Craig
authors.affiliation: Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Angelina I
authors.initials: AI
authors.lastname: Londoño
authors.affiliation: Department of Nutrition Sciences and Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Lyse A
authors.initials: LA
authors.lastname: Norian
authors.affiliation: Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: rarend@uabmc.edu.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Arend
mesh_terms: D054392:Adipokines / Q000378:metabolism; D000077216:Carcinoma, Ovarian Epithelial; D016207:Cytokines / Q000276:immunology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000276:immunology / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation / Q000276:immunology; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000276:immunology / Q000378:metabolism; D009375:Neoplasms, Glandular and Epithelial / Q000453:epidemiology* / Q000276:immunology / Q000378:metabolism; D009765:Obesity / Q000453:epidemiology* / Q000276:immunology / Q000378:metabolism; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000276:immunology / Q000378:metabolism; D012307:Risk Factors; D015398:Signal Transduction
chemical_list: D054392:Adipokines; D016207:Cytokines
keywords: Diabetes mellitus; Epithelial ovarian cancer; Immune suppression; Metabolic syndrome; Obesity