Risk of pancreatic cancer according to glycemic status in nonalcoholic fatty liver disease: a nationwide cohort study
Abstract We investigated the association between glycemic status and pancreatic cancer risk in individuals with nonalcoholic fatty liver disease (NAFLD). This study included 1,093,832 individuals with NAFLD who underwent the Korean national health screening in 2009. NAFLD was defined as fatty liver...
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Nature Portfolio
2025-07-01
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| Online Access: | https://doi.org/10.1038/s41598-025-05868-3 |
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| author | Han Na Jung Ji Hye Huh Eun Roh Bum Jun Kim Minwoo Lee Jwa-Kyung Kim Joo-Hee Kim Boram Han Kyung-Do Han Jun Goo Kang Seong Jin Lee Sung-Hee Ihm |
| author_facet | Han Na Jung Ji Hye Huh Eun Roh Bum Jun Kim Minwoo Lee Jwa-Kyung Kim Joo-Hee Kim Boram Han Kyung-Do Han Jun Goo Kang Seong Jin Lee Sung-Hee Ihm |
| author_sort | Han Na Jung |
| collection | DOAJ |
| description | Abstract We investigated the association between glycemic status and pancreatic cancer risk in individuals with nonalcoholic fatty liver disease (NAFLD). This study included 1,093,832 individuals with NAFLD who underwent the Korean national health screening in 2009. NAFLD was defined as fatty liver index ≥ 30 after excluding heavy alcohol use and viral hepatitis. Multivariable Cox proportional hazards regression assessed the risk of pancreatic cancer according to glycemic status (normoglycemia, impaired fasting glucose [IFG], and diabetes mellitus [DM]). During a median follow-up of 10.3 years, 4124 (0.38%) developed pancreatic cancer. Compared to normoglycemic controls, the risk of pancreatic cancer was significantly higher in those with IFG (adjusted hazard ratio [aHR] 1.16; 95% confidence interval [CI] 1.08–1.25) and DM (aHR 1.48; 95% CI 1.37–1.60). The increased risk of pancreatic cancer with advanced hyperglycemia was consistent across subgroups, including obesity, smoking, and alcohol use. People without regular exercise showed a stronger association between hyperglycemia and pancreatic cancer compared to regular exercisers. In conclusion, hyperglycemia was associated with a higher risk of incident pancreatic cancer among people with NAFLD, independent of obesity and health behaviors. This suggests that hyperglycemia, even in IFG status, is an important modifiable risk factor for pancreatic cancer in NAFLD. |
| format | Article |
| id | doaj-art-6a1d8a2ea7d74c0f9094a9a9af2f4369 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-6a1d8a2ea7d74c0f9094a9a9af2f43692025-08-20T03:45:23ZengNature PortfolioScientific Reports2045-23222025-07-0115111110.1038/s41598-025-05868-3Risk of pancreatic cancer according to glycemic status in nonalcoholic fatty liver disease: a nationwide cohort studyHan Na Jung0Ji Hye Huh1Eun Roh2Bum Jun Kim3Minwoo Lee4Jwa-Kyung Kim5Joo-Hee Kim6Boram Han7Kyung-Do Han8Jun Goo Kang9Seong Jin Lee10Sung-Hee Ihm11Department of Internal Medicine, Hallym University College of MedicineDepartment of Internal Medicine, Hallym University College of MedicineDepartment of Internal Medicine, Hallym University College of MedicineDepartment of Internal Medicine, Hallym University College of MedicineDepartment of Neurology, Hallym University College of MedicineDepartment of Internal Medicine, Hallym University College of MedicineDepartment of Internal Medicine, Hallym University College of MedicineDepartment of Internal Medicine, Hallym University College of MedicineDepartment of Statistics and Actuarial Science, College of Natural Sciences, Soongsil UniversityDepartment of Internal Medicine, Hallym University College of MedicineDepartment of Internal Medicine, Hallym University College of MedicineDepartment of Internal Medicine, Hallym University College of MedicineAbstract We investigated the association between glycemic status and pancreatic cancer risk in individuals with nonalcoholic fatty liver disease (NAFLD). This study included 1,093,832 individuals with NAFLD who underwent the Korean national health screening in 2009. NAFLD was defined as fatty liver index ≥ 30 after excluding heavy alcohol use and viral hepatitis. Multivariable Cox proportional hazards regression assessed the risk of pancreatic cancer according to glycemic status (normoglycemia, impaired fasting glucose [IFG], and diabetes mellitus [DM]). During a median follow-up of 10.3 years, 4124 (0.38%) developed pancreatic cancer. Compared to normoglycemic controls, the risk of pancreatic cancer was significantly higher in those with IFG (adjusted hazard ratio [aHR] 1.16; 95% confidence interval [CI] 1.08–1.25) and DM (aHR 1.48; 95% CI 1.37–1.60). The increased risk of pancreatic cancer with advanced hyperglycemia was consistent across subgroups, including obesity, smoking, and alcohol use. People without regular exercise showed a stronger association between hyperglycemia and pancreatic cancer compared to regular exercisers. In conclusion, hyperglycemia was associated with a higher risk of incident pancreatic cancer among people with NAFLD, independent of obesity and health behaviors. This suggests that hyperglycemia, even in IFG status, is an important modifiable risk factor for pancreatic cancer in NAFLD.https://doi.org/10.1038/s41598-025-05868-3Nonalcoholic fatty liver diseasePancreatic cancerDiabetes mellitusImpaired fasting glucoseNational health insurance service |
| spellingShingle | Han Na Jung Ji Hye Huh Eun Roh Bum Jun Kim Minwoo Lee Jwa-Kyung Kim Joo-Hee Kim Boram Han Kyung-Do Han Jun Goo Kang Seong Jin Lee Sung-Hee Ihm Risk of pancreatic cancer according to glycemic status in nonalcoholic fatty liver disease: a nationwide cohort study Scientific Reports Nonalcoholic fatty liver disease Pancreatic cancer Diabetes mellitus Impaired fasting glucose National health insurance service |
| title | Risk of pancreatic cancer according to glycemic status in nonalcoholic fatty liver disease: a nationwide cohort study |
| title_full | Risk of pancreatic cancer according to glycemic status in nonalcoholic fatty liver disease: a nationwide cohort study |
| title_fullStr | Risk of pancreatic cancer according to glycemic status in nonalcoholic fatty liver disease: a nationwide cohort study |
| title_full_unstemmed | Risk of pancreatic cancer according to glycemic status in nonalcoholic fatty liver disease: a nationwide cohort study |
| title_short | Risk of pancreatic cancer according to glycemic status in nonalcoholic fatty liver disease: a nationwide cohort study |
| title_sort | risk of pancreatic cancer according to glycemic status in nonalcoholic fatty liver disease a nationwide cohort study |
| topic | Nonalcoholic fatty liver disease Pancreatic cancer Diabetes mellitus Impaired fasting glucose National health insurance service |
| url | https://doi.org/10.1038/s41598-025-05868-3 |
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