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.

癌症和代谢紊乱已成为全球主要的健康挑战，近几十年来达到了流行病的水平。代谢紊乱通常被视为单独的问题，越来越多的证据表明会增加癌症的风险和发病率。这种联系背后的复杂性仍在解开，包括肿瘤微环境 （TME） 中代谢物、癌细胞和免疫细胞之间的复杂相互作用。在这里，我们概述了在三种非常普遍的代谢紊乱（即肥胖;两种相关的肝脏疾病，代谢功能障碍相关脂肪性肝病 （MASLD） 和代谢功能障碍相关脂肪性肝炎 （MASH）;和 2 型糖尿病。我们主要关注巨噬细胞和 T 细胞，它们在决定代谢紊乱相关癌症的炎症反应和免疫监视中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的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景观的决定因素及其在助长癌症恶性肿瘤中的作用，将为从治疗上解决这些高度普遍的疾病提供一个必要的框架。