Diabetes/metabolism research and reviews · 2026
Cardiovascular-Kidney-Metabolic Syndrome Severity and Risk of Pancreatic Cancer in a Large Prospective Cohort.
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Choi Munseok, Heo Seok-Jae, Kwon Yu-Jin, Kang Chang Moo
Аннотация
AIMS: Pancreatic cancer remains one of the most lethal malignancies due to late diagnosis and limited opportunities for prevention. Cardiovascular-kidney-metabolic (CKM) syndrome reflects the cumulative burden of metabolic, renal, and cardiovascular dysfunction, but its association with pancreatic cancer risk has not been well established. We investigated this relationship in a large prospective cohort from the UK Biobank.
MATERIALS AND METHODS: Participants without pancreatic cancer at baseline (2006-2010) were followed through national cancer and mortality registries until 31 December 2022. CKM syndrome was categorised into five stages (0-4) according to American Heart Association criteria. Incident pancreatic cancer was identified using ICD-9 and ICD-10 codes. Fine-Gray subdistribution hazard models accounting for death were used to estimate subdistribution hazard ratios (SHRs) and 95% confidence intervals (CIs), with prespecified subgroup analyses performed.
RESULTS: Among 326,148 participants, 1234 incident pancreatic cancer cases were identified over a mean follow-up of 13.5 years (SD 2.0). Incidence rates increased progressively from 9.0 to 48.6 per 100,000 person-years across CKM stages. Compared with CKM stage 0, multivariable-adjusted SHRs for pancreatic cancer were 1.97 (95% CI 1.28-3.02) for stage 1, 2.02 (1.42-2.87) for stage 2, and 2.08 (1.42-3.04) for stages 3-4 (p for trend < 0.001). Associations were generally consistent across subgroup analyses according to age, sex, smoking status, and alcohol consumption, without statistically significant interaction effects.
CONCLUSIONS: Advanced CKM syndrome was independently associated with higher pancreatic cancer risk, supporting its potential role in risk stratification and early detection strategies.
MATERIALS AND METHODS: Participants without pancreatic cancer at baseline (2006-2010) were followed through national cancer and mortality registries until 31 December 2022. CKM syndrome was categorised into five stages (0-4) according to American Heart Association criteria. Incident pancreatic cancer was identified using ICD-9 and ICD-10 codes. Fine-Gray subdistribution hazard models accounting for death were used to estimate subdistribution hazard ratios (SHRs) and 95% confidence intervals (CIs), with prespecified subgroup analyses performed.
RESULTS: Among 326,148 participants, 1234 incident pancreatic cancer cases were identified over a mean follow-up of 13.5 years (SD 2.0). Incidence rates increased progressively from 9.0 to 48.6 per 100,000 person-years across CKM stages. Compared with CKM stage 0, multivariable-adjusted SHRs for pancreatic cancer were 1.97 (95% CI 1.28-3.02) for stage 1, 2.02 (1.42-2.87) for stage 2, and 2.08 (1.42-3.04) for stages 3-4 (p for trend < 0.001). Associations were generally consistent across subgroup analyses according to age, sex, smoking status, and alcohol consumption, without statistically significant interaction effects.
CONCLUSIONS: Advanced CKM syndrome was independently associated with higher pancreatic cancer risk, supporting its potential role in risk stratification and early detection strategies.