Effect of Metabolic Health and Obesity Phenotype on the Risk of Pancreatic Cancer: A Nationwide Population-Based Cohort Study
Effect of Metabolic Health and Obesity Phenotype on the Risk of Pancreatic Cancer: A Nationwide Population-Based Cohort Study
复制标题
DOI：
10.1158/1055-9965.epi-20-1262
复制
发表时间：
2021-03-01
影响因子：
3.8
通讯作者：
Choi, Kyung Mook
中科院分区：
文献类型：
--
作者：
Chung, Hye Soo;Lee, Ji Sung;Choi, Kyung Mook
背景：最近，一些研究报道了代谢健康与肥胖表型和几种癌症之间的关系的不同结果。我们使用全国人口队列数据库研究了代谢健康和肥胖表型对胰腺癌的影响。方法：使用韩国国民健康保险服务健康筛查队列，我们招募了347,434名韩国成年人，他们在2009年至2010年期间接受了健康检查，并随访至2015年。根据代谢健康状况和体重指数（BMI）将该人群分为四组：代谢健康正常体重（MHNW）、代谢不健康正常体重（MUNW）、代谢健康肥胖（MHO）和代谢不健康肥胖（MUO）。结果：在中位随访6.1（5.5-6.5）年期间，886人被诊断为胰腺癌。在调整各种混杂因素后，MUNW和MUO表型（与MHNW表型相比）发生胰腺癌的调整hr为1.52[95%可信区间（CI） 1.27-1.81]和1.34 （95% CI, 1.12-1.61）。然而，与MHNW表型相比，MHO表型并未显示胰腺癌的风险升高。此外，胰腺癌的HR随着代谢不健康成分数量的增加而逐渐增加，即使在调整BMI后也是如此（p趋势< 0.001）。结论：无论BMI如何，代谢不健康表型显著增加胰腺癌的风险，而代谢健康表型的肥胖个体则没有。影响：这些研究结果表明，代谢不健康的表型可能是独立于肥胖的胰腺癌发生的潜在危险因素。
Background: Recently, a few studies have reported different results regarding the relationship between metabolic health and obesity phenotype and several cancers. We examined the effects of metabolic health and obesity phenotype on pancreatic cancer using a nationwide population-based cohort database.Methods: Using the Korean National Health Insurance Service-Health Screening Cohort, we enrolled 347,434 Korean adults who underwent a health examination between 2009 and 2010 and were followed until 2015. This population was divided into four groups based on metabolically healthy status and body mass index (BMI): metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO).Results: Over a median follow-up of 6.1 (5.5-6.5) years, 886 individuals were diagnosed with pancreatic cancer. The adjusted HRs for incident pancreatic cancer were 1.52 [95% confidence interval (CI) 1.27-1.81] and 1.34 (95% CI, 1.12-1.61) for the MUNW and MUO phenotypes (compared with the MHNW phenotype) after adjusting for various confounding factors. However, compared with the MHNW phenotype, the MHO phenotype did not show an elevated risk of pancreatic cancer. Moreover, the HR for pancreatic cancer gradually increased with an increase in number of metabolically unhealthy components, even after adjusting for BMI (P-trend < 0.001).Conclusions: Regardless of BMI, metabolically unhealthy phenotype demonstrated significantly increased risk of pancreatic cancer, whereas obese individuals with metabolically healthy phenotype did not.Impact: These findings suggest that metabolically unhealthy phenotype might represent a potential risk factor for pancreatic cancer occurrence independent of obesity.