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Impact of cumulative hyperglycemic burden on the pancreatic cancer risk: A nationwide cohort study

  • Author Footnotes
    1 Contributed equally to this work as first authors.
    Dong-Hoe Koo
    Footnotes
    1 Contributed equally to this work as first authors.
    Affiliations
    Division of Hematology/Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
    Search for articles by this author
  • Author Footnotes
    1 Contributed equally to this work as first authors.
    Kyungdo Han
    Footnotes
    1 Contributed equally to this work as first authors.
    Affiliations
    Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
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  • Cheol-Young Park
    Correspondence
    Corresponding author at: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, South Korea.
    Affiliations
    Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
    Search for articles by this author
  • Author Footnotes
    1 Contributed equally to this work as first authors.
Published:December 09, 2022DOI:https://doi.org/10.1016/j.diabres.2022.110208

      Highlights

      • New hyperglycemic burden system using four annual health check-ups was developed.
      • Pancreas cancer incidence increased according to sustained hyperglycemic exposure.

      Abstract

      Aims

      We aimed to investigate how much cumulative hyperglycemia exposure increases pancreatic cancer risk.

      Methods

      This study used the National Health Insurance Service Database of Claims and included 3,138,099 individuals who underwent four consecutive annual health screenings between 2009 and 2013. We defined hyperglycemic burden in two ways. First, the hyperglycemic burden was given a score from 0 to 4, with one point assigned for each time blood glucose was ≥100 mg/dL or the use of an antidiabetic drug. Furthermore, we performed semiquantitative scoring of a pre-diabetic (100–125; 1 point) and diabetic level (≥126; 2 points) and categorized into one of nine groups (hyperglycemic score 0–8).

      Results

      During the median 6.2 years of follow-up, groups with a hyperglycemic burden of 1, 2, 3, and 4 had a 15%, 30%, 26%, and 67% increased pancreatic cancer risk compared with normal subjects. In semiquantitative analyses, individuals with a pre-diabetic glucose level on at least one occasion had a 14% increased the risk. Furthermore, individuals with a burden score of 8 had an 89% higher risk than subjects with a normal range.

      Conclusions

      The pancreatic cancer incidence increased significantly according to the hyperglycemic burden, defined as sustained hyperglycemic exposure, including pre-diabetic levels.

      Keywords

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