C0010 - Long-Term Risk of Pancreatic Cancer in Patients With Prediabetes: A Systematic Review and Meta-Analysis of Prospective Studies

Praneeth Reddy Keesari, MBBS¹, Yashwitha Sai Pulakurthi, MBBS², Vikash Kumar, MD³, Nikhila Appala, MBBS⁴, Navya Sadum, MBBS⁵, Taherunnisa Rida, BS⁶, Satya Sai Venkata Lakshmi Arepalli, MBBS⁷, Jaswanth R. Jasti, MD⁸, Rewanth Katamreddy, MD⁹, Mariam Ashfaque, MBBS¹⁰, Pavana Appala, ¹¹, Rupak Desai, MBBS^12
1Staten Island University Hospital, Staten Island, NY; ²New York Medical College- Saint Michael's Medical Center, Newark, NJ; ³The Brooklyn Hospital Center, Brooklyn, NY; ⁴Kasturba Medical College, Manipal, Karnataka, India; ⁵Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, Telangana, India; ⁶University of Texas at Dallas, Plano, TX; ⁷Apollo Institute of Medical Sciences and Research, Hyderabad, Telangana, India; ⁸University of South Dakota Sanford School of Medicine, Vermillion, SD; ⁹Saint Michael's Medical Center, Newark, NJ; ¹⁰People University of Medical and Health Sciences, Nawabshah, Sindh, Pakistan; ¹¹KMC Manipal, Manipal, Karnataka, India; ¹²Independent Researcher, Atlanta, GA

Introduction: Hyperglycemic states are known to have a bidirectional relationship with pancreatic disorders. The literature remains limited in discussing the role of prediabetic states on intermediate or long-term risk of having pancreatic cancer. Therefore, we conducted this updated meta-analysis to evaluate the risk of Pancreatic cancer among individuals with Prediabetes or impaired fasting glucose.

Methods: We systematically searched PubMed/Medline, EMBASE, Scopus, and Google Scholar to ascertain prospective studies describing pancreatic cancer in prediabetes between May 1, 2012 to May 1, 2022. Random-effects models were used to perform meta-analysis and subgroup analyses. I2 statistics was used to assess heterogeneity. Sensitivity analysis was done using the leave-one-out method.

Results: Five studies (1 USA, 1 UK, 1 Sweden, 1 Korea, 1 Japan) comprising 5,425,111 Prediabetics (mean age 59.3 years) and 16,096,467 normoglycemic patients with a median follow-up of 8.5 years were included in this study. A total of 3343 (0.06%) pancreatic cancer events were noted in the prediabetic group whereas 6212 (0.04%) pancreatic cancer events took place in the normoglycemic group. The unadjusted OR is 1.36 (95%CI 1.05-1.77, p 0.02) (fig 1a) and when adjusted for confounders like age, sex, etc, the overall estimated OR reported was 1.40 (1.23-1.59, p< 0.01) (fig 1b). Sensitivity analysis using the leave one out method did confirm equivalent results(fig 1c). Heterogeneity analysis for unadjusted OR had considerable heterogeneity with an overall I^2 of 94.92% with a P value < 0.01 and for adjusted OR had moderate heterogeneity with an overall I^2 of 66.13% with a p value< 0.01. Subgroup analysis by age showed that studies with older participants of mean/median ages 60 and above had higher odds of 1.83 (95%CI 1.28-2.62, p< 0.01) when compared to studies with relatively younger participants with mean/median ages < 60 years which reported odds of 1.35 (95%CI 1.18-1.55, p< 0.01). The risk of pancreatic cancer among pre diabetics was higher in studies from Japan (OR 1.89, 95%CI 1.15-3.10, p< 0.01) as compared to USA (OR 1.32; 95%CI 1.13-1.53, p< 0.01).

Discussion: This meta-analysis showed a 40% higher risk of pancreatic cancer in patients with prediabetes over a long-term median follow-up of over 8 years. A special screening protocol is warranted for pancreatic cancer screening which could lessen the disease burden including morbidity and mortality in high-risk patients.



Disclosures:


Praneeth Reddy Keesari, MBBS¹, Yashwitha Sai Pulakurthi, MBBS², Vikash Kumar, MD³, Nikhila Appala, MBBS⁴, Navya Sadum, MBBS⁵, Taherunnisa Rida, BS⁶, Satya Sai Venkata Lakshmi Arepalli, MBBS⁷, Jaswanth R. Jasti, MD⁸, Rewanth Katamreddy, MD⁹, Mariam Ashfaque, MBBS¹⁰, Pavana Appala, ¹¹, Rupak Desai, MBBS¹². C0010 - Long-Term Risk of Pancreatic Cancer in Patients With Prediabetes: A Systematic Review and Meta-Analysis of Prospective Studies, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.