癌症和代谢紊乱已成为全球主要的健康挑战，近几十年来已达到流行水平。代谢紊乱通常被视为独立的问题，但通过越来越多的证据表明，代谢紊乱会增加癌症风险和发病率。这种联系背后的复杂性仍在被揭开，其中包括肿瘤微环境（TME）内代谢物、癌细胞和免疫细胞之间复杂的相互作用。在这里，我们概述了在三种高度普遍的代谢性疾病（即肥胖）的背景下代谢和免疫细胞功能障碍之间的相互作用。两种相关的肝脏疾病，代谢功能障碍相关的脂肪性肝病（MASLD）和代谢功能障碍相关的脂肪性肝炎（MASH）；和2型糖尿病。我们主要关注巨噬细胞和 T 细胞，它们在代谢紊乱相关癌症中决定炎症反应和免疫监视的关键作用已被广泛报道。此外，考虑到近年来服用改变代谢紊乱药物和饮食的患者数量不断增加，我们讨论了这些疗法如何调节全身和局部免疫表型，从而影响癌症恶性肿瘤。总的来说，揭示代谢紊乱相关免疫环境的决定因素及其在加剧癌症恶性肿瘤中的作用将为治疗这些高度流行的疾病提供一个必要的框架。© 2024。Springer Nature Limited。

Cancer and metabolic disorders have emerged as major global health challenges, reaching epidemic levels in recent decades. Often viewed as separate issues, metabolic disorders are shown by mounting evidence to heighten cancer risk and incidence. The intricacies underlying this connection are still being unraveled and encompass a complex interplay between metabolites, cancer cells and immune cells within the tumour microenvironment (TME). Here, we outline the interplay between metabolic and immune cell dysfunction in the context of three highly prevalent metabolic disorders, namely obesity; two associated liver diseases, metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH); and type 2 diabetes. We focus primarily on macrophages and T cells, the critical roles of which in dictating inflammatory response and immune surveillance in metabolic disorder-associated cancers are widely reported. Moreover, considering the ever-increasing number of patients prescribed with metabolism disorder-altering drugs and diets in recent years, we discuss how these therapies modulate systemic and local immune phenotypes, consequently impacting cancer malignancy. Collectively, unraveling the determinants of metabolic disorder-associated immune landscape and their role in fuelling cancer malignancy will provide a framework essential to therapeutically address these highly prevalent diseases.© 2024. Springer Nature Limited.