Metabolic syndrome is linked to the incidence of pancreatic cancer

Yohei Miyashita; Tatsuro Hitsumoto; Hiroki Fukuda; Jiyoong Kim; Shin Ito; Naoki Kimoto; Koko Asakura; Yutaka Yata; Masami Yabumoto; Takashi Washio; Masafumi Kitakaze

doi:10.1016/j.eclinm.2023.102353

Metabolic syndrome is linked to the incidence of pancreatic cancer

EClinicalMedicine. 2023 Dec 12:67:102353. doi: 10.1016/j.eclinm.2023.102353. eCollection 2024 Jan.

Authors

Yohei Miyashita¹, Tatsuro Hitsumoto², Hiroki Fukuda², Jiyoong Kim³, Shin Ito², Naoki Kimoto⁴, Koko Asakura⁵, Yutaka Yata⁶, Masami Yabumoto⁶, Takashi Washio⁷, Masafumi Kitakaze^{4

6

8}

Affiliations

¹ Department of Legal Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan.
² Department of Clinical Research and Development, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, Japan.
³ Kim Cardiovascular Clinic, 3-6-8 Katsuyama, Tennoji-ku, Osaka, Japan.
⁴ Non Profit Organization Think of Medicine in Science, 3-7-11 Minami-Sumiyoshi, Sumiyoshi-ku, Osaka, Japan.
⁵ Department of Data Science, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, Japan.
⁶ Hanwa Memorial Hospital, 3-5-8 Minamisumiyoshi, Sumiyoshi-ku, Osaka, Japan.
⁷ The Institute of Scientific and Industrial Research, Osaka University, 1-1 Yamadaoka, Suita, Osaka, Japan.
⁸ The Osaka Medical Research Foundation for Intractable Diseases, 2-6-29 Abikohigashi, Sumiyoshi-ku, Osaka, Japan.

Abstract

Background: Although previous studies have showed that metabolic syndrome is one of the contributors of pancreatic cancer, there is no clear consensus that early stages of metabolic syndrome are linked to increased incidence of pancreatic cancer. Therefore, we confirmed the linkage between metabolic syndrome and pancreatic cancer, and shown that even early stage of metabolic syndrome is linked to pancreatic cancer in the retrospective observational study.

Methods: We recruited approximately 4.6 million Japanese in 2005 and followed up these subjects for more than 10 years. At the time of the enrollment, after obtaining clinical data with prescribed drugs and examining the presence or absence of metabolic syndrome (MetS), we followed up on these subjects with and without MetS to examine the incidence of pancreatic cancer. The modified criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATPIII) were used to define MetS.

Findings: During the 40.7-month average follow-up period for 2,707,296 subjects with complete data for identifying MetS and important risk factors without pancreatic cancer before the enrollment, 87,857 suffered from pancreatic cancer. Pancreatic cancers occurred in 16,154 of 331,229 subjects (4.9%) in the MetS group and 71,703 of 2,376,067 patients (3.0%) in the non-MetS group (hazard ratio (HR), 1.37; 95% confidence interval [CI], 1.34-1.39; p < 0.0001 after the adjustment with age, smoking and sex). As the number of the constituent factors of MetS increased from one to five, the incidence of pancreatic cancer correspondingly increased (HR: 1.11, 1.23, 1.42, 1.66 and 2.03 using Cox proportional hazard models, p < 0.0001 each). When we defined MetS using the Japanese criteria, the results are in accord with the results using NCEP/ATPIII. Especially pre-metabolic syndrome (pre-MetS) in the Japanese criteria was tightly linked to the incidence of pancreatic cancers.

Interpretation: MetS is confirmed to be linked to pancreatic cancer. Although we cannot conclude causality. We also demonstrated the link between pre-MetS and pancreatic cancer.

Funding: The sponsors of the study were Japanese Heart Foundation and Japan Cardiovascular Research Foundation. This is also partially supported by Grants-in-Aid from the Ministry of Education, Culture, Sports, Science and Technology of Japan; and Grants-in-Aid from the Japan Agency for Medical Research and Development.

Keywords: Big data; Early stage of metabolic syndrome; Metabolic syndrome; Pancreatic cancer; Prevention of metabolic syndrome.