Jung Han Na, Huh Ji Hye, Roh Eun, Kim Bum Jun, Lee Minwoo, Kim Jwa-Kyung, Kim Joo-Hee, Han Boram, Han Kyung-Do, Kang Jun Goo, Lee Seong Jin, Ihm Sung-Hee
Department of Internal Medicine, Hallym University College of Medicine, 1, Hallymdaehak-Gil, Chuncheon-si, 24252, Gangwon-do, Republic of Korea.
Department of Neurology, Hallym University College of Medicine, 1, Hallymdaehak-Gil, Chuncheon-si, 24252, Gangwon-do, Republic of Korea.
Sci Rep. 2025 Jul 2;15(1):23308. doi: 10.1038/s41598-025-05868-3.
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.
我们调查了非酒精性脂肪性肝病（NAFLD）患者血糖状态与胰腺癌风险之间的关联。本研究纳入了2009年接受韩国国民健康筛查的1,093,832例NAFLD患者。NAFLD被定义为在排除大量饮酒和病毒性肝炎后脂肪肝指数≥30。多变量Cox比例风险回归根据血糖状态（正常血糖、空腹血糖受损[IFG]和糖尿病[DM]）评估胰腺癌风险。在中位随访期10.3年期间，4124例（0.38%）发生了胰腺癌。与正常血糖对照组相比，IFG患者（调整后风险比[aHR] 1.16；95%置信区间[CI] 1.08 - 1.25）和DM患者（aHR 1.48；95% CI 1.37 - 1.60）的胰腺癌风险显著更高。高血糖进展期胰腺癌风险增加在各亚组中一致，包括肥胖、吸烟和饮酒亚组。与经常锻炼者相比，不经常锻炼的人高血糖与胰腺癌之间的关联更强。总之，高血糖与NAFLD患者发生胰腺癌的较高风险相关，独立于肥胖和健康行为。这表明，即使处于IFG状态，高血糖也是NAFLD患者胰腺癌的一个重要可改变风险因素。
