Pancreas
Gastroenterology. 2022;162(2):509–20.e7
Changes in metabolic syndrome status are associated with altered risk of pancreatic cancer: A nationwide cohort study
Background and aims: Metabolic syndrome (MetS) is reversible; however, the effect of changes in MetS status on pancreatic cancer (PC) risk is unknown. The aim of the present study was to investigate the effects of changes and persistence in MetS status on PC risk.
Methods: This nationwide cohort study included 8,203,492 adults without cancer who underwent 2 consecutive biennial health screenings provided by the Korean National Health Insurance System between 2009 and 2012 and were followed up until 2017. MetS was defined as the presence of 3 of its 5 components, which were evaluated at 2 consecutive biennial health screenings. Participants were categorized into the MetS-free, MetS-recovered, MetS-developed, or MetS-persistent group. Multivariable Cox proportional hazards regression models were used.
Results: During the 40,464,586 person-years of follow-up (median, 5.1 years), 8010 individuals developed PC. Compared with the MetS-free group, the MetS-persistent group had the highest risk of PC (hazard ratio [HR] = 1.30, 95% confidence interval [CI]: 1.23–1.37), followed by the MetS-developed group (HR = 1.17, 95% CI: 1.09–1.25) and the MetS-recovered group (HR = 1.12, 95% CI: 1.04–1.21) after adjusting for potential confounders (ptrend < 0.001). The MetS-recovered group was associated with a lower risk of PC than that in the MetS-persistent group (p < 0.001). The association between changes in MetS status and PC risk did not differ according to sex or obesity (all pinteractions > 0.05).
Conclusions: In this study, recovering from metabolic syndrome (MetS) was associated with a reduced risk of pancreatic cancer (PC) compared with persistent MetS, suggesting that PC risk can be altered by changes in MetS.