肥胖是一种过度肥胖的病症，通常定义为 BMI≥30，它会对新陈代谢和免疫力产生深远的影响，将该病症与多种疾病联系起来，包括癌症和负面结果。肥胖和癌症与多种癌症类型的发病率增加、进展和预后较差有关，部分原因是产生促炎症状态。令人惊讶的是，最近在临床前模型和临床结果中也证明肥胖与免疫检查点抑制（ICI）反应的改善有关。这些观察结果为所谓的“肥胖悖论”奠定了基础。鉴于肥胖对细胞和组织产生的多效性影响，这些增强的免疫治疗反应背后的机制仍不清楚。其他重要变量，如年龄和性别，正在接受进一步影响肥胖效应的研究。性别相关因素对肥胖生物学、代谢以及不同免疫细胞类型的差异效应产生显着影响。年龄可能是另一个影响性别相关变化、免疫状态和肥胖的混杂因素。本综述旨在重新审视当前描述肥胖介导的免疫和代谢变化的文献、肥胖在癌症免疫治疗中的作用，并强调性别差异如何影响肥胖和免疫治疗结果的问题。© 作者）2024 年。

Obesity, a condition of excess adiposity usually defined by a BMI > 30, can have profound effects on both metabolism and immunity, connecting the condition with a broad range of diseases, including cancer and negative outcomes. Obesity and cancer have been associated with increased incidence, progression, and poorer outcomes of multiple cancer types in part due to the pro-inflammatory state that arises. Surprisingly, obesity has also recently been demonstrated in both preclinical models and clinical outcomes to be associated with improved response to immune checkpoint inhibition (ICI). These observations have laid the foundation for what has been termed the "obesity paradox". The mechanisms underlying these augmented immunotherapy responses are still unclear given the pleiotropic effects obesity exerts on cells and tissues. Other important variables such as age and sex are being examined as further affecting the obesity effect. Sex-linked factors exert significant influences on obesity biology, metabolism as well as differential effects of different immune cell-types. Age can be another confounding factor contributing to the effects on both sex-linked changes, immune status, and obesity. This review aims to revisit the current body of literature describing the immune and metabolic changes mediated by obesity, the role of obesity on cancer immunotherapy, and to highlight questions on how sex-linked differences may influence obesity and immunotherapy outcome.© The Author(s) 2024.