Prospective associations of body composition and body shape with the risk of developing pancreatic cancer in the UK Biobank cohort
Author(s)
Christakoudi, Sofia
Tsilidis, konstantinos
Gunter, Marc
Riboli, Elio
Type
Journal Article
Abstract
Background
Obesity and diabetes are positively associated with pancreatic cancer risk. It is unclear, however, whether fat or fat-free mass play a role in these relationships, whether abdominal obesity is more important than general obesity, or whether the associations with anthropometric indices and diabetes are independent of each other.
Methods
We used multivariable Cox proportional hazards models to examine the prospective associations of body composition (allometric fat-mass index (AFI) and allometric lean-mass index (ALI), based on bioelectrical impedance, uncorrelated with each other and with height), waist size (allometric waist-to-hip index (WHI), uncorrelated with weight and height), and diabetes with pancreatic cancer risk in UK Biobank. We tested heterogeneity by sex, age, and follow-up time with the augmentation method (p_het).
Results
During a mean follow-up of 10.4 years, 999 pancreatic cancer cases were ascertained in 427,939 participants. AFI was positively associated with pancreatic cancer risk in participants overall, independent of ALI, WHI, diabetes, and covariates (hazard ratio HR=1.102; 95% confidence interval CI=1.033−1.176 per one standard deviation (SD) increase), more strongly in women aged under 55 years at recruitment (HR=1.457; 95%CI=1.181−1.797; p_het=0.007) and in men only for follow-up 6 years or longer (HR=1.159; 95%CI=1.037−1.295; p_het=0.075). ALI was positively associated with pancreatic cancer risk in participants overall (HR=1.072; 95%CI=1.005−1.145), more specifically in men (HR=1.132; 95%CI=1.035−1.238; p_het=0.091). A positive association of WHI with pancreatic cancer risk was observed only in unadjusted models but was lost after adjustment for smoking status and diabetes. Independent of anthropometric indices, diabetes was associated positively with pancreatic cancer risk in participants overall (HR=1.688; 95%CI=1.365−2.087), but in women only for follow-up under 6 years (HR=2.467; 95%CI=1.477−4.121; p_het=0.042).
Conclusions
General obesity reflected in AFI and ALI, as well as diabetes, but not abdominal obesity, were associated positively with pancreatic cancer risk, independent of each other and of covariates.
Obesity and diabetes are positively associated with pancreatic cancer risk. It is unclear, however, whether fat or fat-free mass play a role in these relationships, whether abdominal obesity is more important than general obesity, or whether the associations with anthropometric indices and diabetes are independent of each other.
Methods
We used multivariable Cox proportional hazards models to examine the prospective associations of body composition (allometric fat-mass index (AFI) and allometric lean-mass index (ALI), based on bioelectrical impedance, uncorrelated with each other and with height), waist size (allometric waist-to-hip index (WHI), uncorrelated with weight and height), and diabetes with pancreatic cancer risk in UK Biobank. We tested heterogeneity by sex, age, and follow-up time with the augmentation method (p_het).
Results
During a mean follow-up of 10.4 years, 999 pancreatic cancer cases were ascertained in 427,939 participants. AFI was positively associated with pancreatic cancer risk in participants overall, independent of ALI, WHI, diabetes, and covariates (hazard ratio HR=1.102; 95% confidence interval CI=1.033−1.176 per one standard deviation (SD) increase), more strongly in women aged under 55 years at recruitment (HR=1.457; 95%CI=1.181−1.797; p_het=0.007) and in men only for follow-up 6 years or longer (HR=1.159; 95%CI=1.037−1.295; p_het=0.075). ALI was positively associated with pancreatic cancer risk in participants overall (HR=1.072; 95%CI=1.005−1.145), more specifically in men (HR=1.132; 95%CI=1.035−1.238; p_het=0.091). A positive association of WHI with pancreatic cancer risk was observed only in unadjusted models but was lost after adjustment for smoking status and diabetes. Independent of anthropometric indices, diabetes was associated positively with pancreatic cancer risk in participants overall (HR=1.688; 95%CI=1.365−2.087), but in women only for follow-up under 6 years (HR=2.467; 95%CI=1.477−4.121; p_het=0.042).
Conclusions
General obesity reflected in AFI and ALI, as well as diabetes, but not abdominal obesity, were associated positively with pancreatic cancer risk, independent of each other and of covariates.
Date Issued
2025-03-01
Date Acceptance
2025-03-11
Citation
Cancer Medicine, 2025, 14 (6)
ISSN
2045-7634
Publisher
Wiley
Journal / Book Title
Cancer Medicine
Volume
14
Issue
6
Copyright Statement
© 2025 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
10.1002/cam4.70809
Subjects
Carcinoma, Pancreatic Ductal
Diabetes Mellitus
Epidemiology
Obesity
Primary Prevention
Risk Factors
Publication Status
Published
Article Number
e70809
Date Publish Online
2025-03-25