Obesity is one of the major risk factors for developing endometrial cancer, it was revealed that 40% of cases can be attributed to obesity (Int J Cancer 2001; 19: 421-30). In a study of the Norwegian population it has been shown that obese women have six times greater risk of developing this cancer compared with lean women (Br J Cancer 2008; 98: 1582-5).
The authors examined the association between plasma levels of triglycerides, total cholesterol, LDL cholesterol, non HDL cholesterol and HDL cholesterol and the risk of developing endometrial cancer in 31,473 women. During the period of follow up of 9 years, 100 cases were identified. This study showed a positive correlation between plasma levels of triglycerides and the risk of endometrial cancer, but it has not been shown an association with the plasma levels of total cholesterol, LDL cholesterol and HDL. Triglycerides can have a direct effect, but other mechanisms may be involved. Some nuclear receptors can modulate both lipid metabolism and the cellular carcinogenesis (Science 2001, 294: 1866-70). The PPAR (peroxisome proliferator activated receptor) can modulate lipid homeostasis and adipogenesis (Genes Dev 1994, 8: 1224-34) as well as cancer cell growth (Immunol Cell Biol 2000, 78: 436-41). Activation of PPARα by fibrates leads to lower level of triglycerides and thus to a control of dyslipidemia (NEJM 1987, 317: 1237-45; NEJM 1999; 341: 410-8). Endometrial cancer in the PPARα seems to be up-regulated and has been shown in vitro that fenofibrate has antiproliferative effect on endometrial cancer cells (Clin Cancer Res 2006, 12: 4200-8). Further prospective studies are needed to better understand the association between plasma levels of lipids and this tumor.