Endocrine Abstracts

Background: Lately, a few studies have showed different results regarding the relationship between metabolically healthy obesity and various cancers. We investigated the impact of metabolically healthy obesity on pancreatic cancer using a nationwide population-based cohort database.

Methods: Using the Korean National Health Insurance Service–Health Screening Cohort, we enrolled 347,434 Korean adults who underwent a health examination between 2009 and 2010 and were followed until 2015. This population was divided into four groups based on metabolically healthy status and body mass index: metabolically healthy normal weight, metabolically unhealthy normal weight, metabolically healthy obese, and metabolically unhealthy obese.

Results: During a median follow-up of 6.1 years, pancreatic cancer occurred in 886 individuals. The adjusted HRs for incident pancreatic cancer were 1.52 [95% confidence interval (CI) 1.27–1.81] and 1.34 (95% CI, 1.12–1.61) for the metabolically unhealthy normal weight and metabolically unhealthy obese phenotypes compared with the metabolically healthy normal weight phenotype after adjusting for several confounding factors. However, the metabolically healthy obese phenotype did not show an elevated risk of pancreatic cancer compared with the metabolically healthy normal weight phenotype. Moreover, the HR for pancreatic cancer gradually increased with an increase in number of metabolically unhealthy components, even after adjusting for body mass index (P trend <0.001).

Conclusions: Regardless of body mass index, metabolically unhealthy phenotype demonstrated significantly increased risk of pancreatic cancer, whereas obese individuals with metabolically healthy phenotype did not.