Fig. 3.

Metabolic syndrome-related cancer risk. The reduced adiponectin availability abolish its anti-inflammatory and anti-proliferative actions due to the inhibition of NF-κB. The increased leptin availability together with T-cell accumulation and macrophage recruitment in adipose tissue contribute to the upregulation of TNF-α and IL-6. These cytokines have a pro-inflammatory action, promote angiogenesis and are associated with insulin resistance. Adipose tissue inflammation is responsible for increased aromatase activity and estrogens production that favor cell proliferation. Insulin resistance favors a hyper-production of insulin and IGF-1, which inhibit apoptosis, support cell proliferation and VEGF release, as well as HIF-1α activation. In turn, HIF-1α assures cell surviving and promotes angiogenesis.