Skip to main content
SpringerLink
Log in

Tumorrisiko antiarteriosklerotischer Maßnahmen

  • Conference paper
Arteriosklerose

  • 19 Accesses

Zusammenfassung

Eine krebserzeugende oder -fördernde Wirkung von lipidsenkenden Pharmaka konnte in keiner der bis jetzt bekannten großen klinischen Studien nachgewiesen werden.

Die epidemiologisch beschriebenen Zusammenhänge zwischen einem erniedrigten Plasmacholesterinspiegel und einer erhöhten Krebsinzidenz sind allenfalls schwach, zudem widersprüchlich und in großen prospektiven, klinisch orientierten Studien am Modellbeispiel des Kolonkarzinoms nicht nachvollziehbar. Zudem ist kein adäquates Modell zur Erklärung dieser Zusammenhänge sichtbar.

Die Zusammenhänge zwischen den Bestandteilen der menschlichen Nahrung und der Karzinogenese sind ausgesprochen komplex und bedürfen einer weiteren intensiven Abklärung. Die pathogenetische Bedeutung der sogenannten Transfettsäuren erscheint (noch) nicht hinreichend abgesichert.

Die vorgelegten Befunde erlauben nicht die Schlußfolgerung, daß eine wie immer zu erreichende Senkung des Plasmacholesterinspiegels in den für die Vermeidung bzw. Verzögerung der Atherogenese sinnvollen Bereich zwischen 180 und 200 mg/dl das Krebsrisiko dieser großen Gruppe von Patienten erhöht.

Die vorgelegten Befunde lassen an der Realisierung von Studien zur Krebsprävention mit diätetischen Maßnahmen, wie sie jetzt konzipiert bzw. bereits durchgeführt werden, Zweifel aufkommen.

Summary

A cancer-producing or -promoting effect of lipid-lowering drugs could not be detected in any of the large clinical trials reported so far. The epidemiologically described connections between a lowered plasma cholesterol level and an increased incidence of cancer are at best sparse, besides being contradictory and nonreproduciable in extensive clinically oriented studies using colon carcinoma as a model. In addition, there is no adequate theory for the explanation of these correlations. The connections between constituents of the human diet and carcinogenesis are extremely complex and must continue to be examined intensively. The present results do not permit the conclusion that a lowering of plasma cholesterol between 180 and 200 mg/dl, which is regarded as appropriate for preventing or decelerating atherogenesis, increases the cancer risk in this large group of patients, by whatever means this reduction is achieved.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 59.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 79.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Oliver MF, Heady JA, Morris JN, Cooper J (1978) A co-operative trial in the primary prevention of ischaemic heart disease using Clofibrate. Report from the Committee of Principal Investigators. Br Heart J 40:1069–1118.

    Article  Google Scholar 

  2. Oliver MF, Heady JA, Morris JN, Cooper J (1984) WHO cooperative trial on primary prevention of ischaemic heart disease with Clofibrate to lower serum cholesterol: final mortality follow-up. Report of the Committee of Principal Investigators. Lancet 11:600–604.

    Google Scholar 

  3. Peto R (1987) persönliche Mitteilung.

    Google Scholar 

  4. Lipid Research Clinics Program (1984) The Lipid Research Clinics Coronary Primary Prevention Trial results. I. Reduction in incidence of coronary heart disease. II. The relationship of reduction in incidence of coronary heart disease to cholesterol lowering. JAMA 251:365–374.

    Article  Google Scholar 

  5. Blankenhorn DH, Nessum SA, Johnson RL et al. (1987) Beneficial effects of combined colestipol-niacin therapy on coronary atherosclerosis and coronary venous bypass grafts. JAMA 257:3233–3240.

    Article  PubMed  CAS  Google Scholar 

  6. Multiple Risk Factor Intervention Trial Research Group (1982) Multiple Risk Factor Intervention Trial: risk factor changes and mortality results. JAMA 248:1465–1477.

    Article  Google Scholar 

  7. Frick MH, Elo O, Haapa K et al. (1987) Helsinki heart study: primary prevention trial with Gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors, and incidence of coronary heart disease. N Engl J Med 317:1237–1245.

    Article  PubMed  CAS  Google Scholar 

  8. Canner PL, Berge KG, Wenger NK et al. (1986) Fifteen year mortality in coronary drug project patients: long-term benefit with niacin. J Am Coll Cardiol 8:1245–1255.

    Article  PubMed  CAS  Google Scholar 

  9. Kark JD, Smith AH, Harnes CG (1980) The relationship of serum cholesterol to the incidence of cancer in Evans County, Georgia. J Chronic Dis 33:311–322.

    Article  PubMed  CAS  Google Scholar 

  10. Garcia-Palmieri MR, Sorlie PD, Costas R et al. (1981) An apparent inverse relationship between serum cholesterol and cancer mortality in Puerto Rico. Am J Epidemiol 114:29–40.

    PubMed  CAS  Google Scholar 

  11. Beaglehole R, Foulkes MA, Prior IAM et al. (1980) Cholesterol and mortality in New Zealand maoris. Br Med J 280:285–287.

    Article  PubMed  CAS  Google Scholar 

  12. Williams RR, Sorlie PD, Feinleib et al. (1981) Cancer incidence by levels of cholesterol. JAMA 245:247–252.

    Article  PubMed  CAS  Google Scholar 

  13. Kagan A, McGee D, Yano K et al. (1981) Serum cholesterol and mortality in a Japanese-American population: the Honolulu Heart Program. Am J Epidemiol 114:11–20.

    PubMed  CAS  Google Scholar 

  14. Morris DL, Borhani NO, Fitzsimons D et al. (1983) Serum cholesterol and cancer in the hypertension detection and follow-up program. Cancer 52:1754–1759.

    Article  PubMed  CAS  Google Scholar 

  15. Westlund K, Nicolaysen R (1972) Ten-year mortality and morbidity related to serum cholesterol: a follow-up of 3,751 men aged 40–59. Scand J Lab Invest [Suppl 127] 30:3–24.

    Google Scholar 

  16. Dyer AR, Stamler J, Paul O et al. (1981) Serum cholesterol and risk of death from cancer and other causes in three Chicago epidemiological studies. J Chronic Dis 34:249–260.

    Article  PubMed  CAS  Google Scholar 

  17. Kozarevic D, McGee D, Vojvodic N et al. (1981) Serum cholesterol and mortality: the Yugoslavia Cardiovascular Disease Study. Am J Epidemiol 114:21–28.

    PubMed  CAS  Google Scholar 

  18. Yaari S, Goldbourt U, Even-Zohar S et al. (1981) Associations of serum high density lipoprotein and total cholesterol with total, cardiovascular, and cancer mortality in a seven-year prospective study of 10000 men. Lancet 1:1011–1015.

    Article  PubMed  CAS  Google Scholar 

  19. Rose G, Shipley MJ (1980) Plasma lipids and mortality: a source of error. Lancet 1:523–526.

    Article  PubMed  CAS  Google Scholar 

  20. Cambien F, Ducimetiere P, Richard J (1980) Total serum cholesterol and cancer mortality in a middle-aged male population. Am J Epidemiol 112:388–394.

    PubMed  CAS  Google Scholar 

  21. International Collaborative Group (1982) Circulating cholesterol level and risk of death from cancer in men aged 40 to 69 years. JAMA 248:2853–2859.

    Article  Google Scholar 

  22. Schatzkin A, Hoover RN, Taylor PR et al. (1987) Serum cholesterol and cancer in the NHANES I epidemiologic followup study. Lancet 11:298–301.

    Article  Google Scholar 

  23. Reddy BS, Mastromarino A, Gustafson C et al. (1976) Fecal bile acids and neutral steroids in patients with familial polyposis. Cancer 38:1694–1698.

    Article  PubMed  CAS  Google Scholar 

  24. Ponz de Leon M, Roncucci L, di Donato P et al. (1987) Fecal neutral steroids in normal conditions and in patients with polyps or cancer of the large bowel. Cancer Res 47:305–310.

    PubMed  CAS  Google Scholar 

  25. Neugut AI, Johnson CM, Fink DJ (1986) Serum cholesterol levels in adenomatous polyps and cancer of the colon. A case-control study. JAMA 255:365–367.

    Article  PubMed  CAS  Google Scholar 

  26. Törnberg SA, Holm LE, Carstensen JM, Eklund GA (1986) Risks of cancer of the colon and rectum in relation to serum cholesterol and beta-lipoprotein. N Engl J Med 315:1629–1633.

    Article  PubMed  Google Scholar 

  27. Mannes GA, Maier A, Thieme C, Wiebecke B, Paumgartner G (1986) Relation between the frequency of colorectal adenoma and the serum cholesterol level. N Engl J Med 315:1634–1638.

    Article  PubMed  CAS  Google Scholar 

  28. Hill MJ, Morson BC, Bussey HJR (1978) Aetiology of adenoma-carcinoma sequence of large bowel. Lancet 1:245–247.

    Article  PubMed  CAS  Google Scholar 

  29. Peto R (1986) Cancer around the world: evidence for avoidability. In: Hallgren B et al. (eds) Diet and prevention of coronary heart disease and cancer. Raven, New York, pp 1–15.

    Google Scholar 

  30. Carroll KK, Braden LM, Bell JA, Kalamegham R (1986) Fat and cancer. Cancer 58:1818–1825.

    Article  PubMed  CAS  Google Scholar 

  31. Wilhelmsen L (1986) Epidemiology of coronary heart disease. In: Hallgren B et al. (eds) Diet and prevention of coronary heart disease and cancer. Raven, New York, pp 17–23.

    Google Scholar 

  32. Steinberg D (1986) Lipoproteins and atherogenesis: current concepts. In: Hallgren B et al. (eds) Diet and prevention of coronary heart disease and cancer. Raven, New York, pp 95–111.

    Google Scholar 

  33. Study Group, European Atherosclerosis Sociecy (1987) Strategies for the prevention of coronary heart disease: a policy statement of the European Atherosclerosis Society. Eur Heart J 8:77–88.

    Google Scholar 

  34. Enig MG, Munn RJ, Keeney M (1978) Dietary fat and cancer trends — a critique. Fed Proc 37:2215–2220.

    PubMed  CAS  Google Scholar 

  35. Ames BN (1983) Dietary carcinogens and anticarcinogens. Oxygen radicals and degenerative disease. Science 221:1256–1264.

    Article  PubMed  CAS  Google Scholar 

  36. Kritchevsky D (1986) Diet, nutrition, and cancer. The role of fiber. Cancer 58:1830–1836.

    Article  PubMed  CAS  Google Scholar 

  37. Dewys WD, Malone WF, Butrum RR, Sestili MA (1986) Clinical trials in cancer prevention. Cancer 58:1954–1962.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. G. Middelhoff
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Medizinische Klinik, Zentralkrankenhaus links der Weser, Senator-Weßling-Straße 1, 2800, Bremen 61, Bundesrepublik Deutschland

    Gerald Klose

Rights and permissions

Reprints and permissions

Copyright information

© 1989 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Middelhoff, G. (1989). Tumorrisiko antiarteriosklerotischer Maßnahmen. In: Klose, G. (eds) Arteriosklerose. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-74518-8_32

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-74518-8_32

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-74519-5

  • Online ISBN: 978-3-642-74518-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation