{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:55:33Z","timestamp":1790571333476,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100008005","name":"Yonsei University College of Medicine","doi-asserted-by":"publisher","award":["2026\u201032\u20100061"],"award-info":[{"award-number":["2026\u201032\u20100061"]}],"id":[{"id":"10.13039\/501100008005","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Pancreatic cancer remains one of the most lethal malignancies due to late diagnosis and limited opportunities for prevention. Cardiovascular\u2013kidney\u2013metabolic (CKM) syndrome reflects the cumulative burden of metabolic, renal, and cardiovascular dysfunction, but its association with pancreatic cancer risk has not been well established. We investigated this relationship in a large prospective cohort from the UK Biobank.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Participants without pancreatic cancer at baseline (2006\u20132010) were followed through national cancer and mortality registries until 31 December 2022. CKM syndrome was categorised into five stages (0\u20134) according to American Heart Association criteria. Incident pancreatic cancer was identified using ICD\u20109 and ICD\u201010 codes. Fine\u2013Gray subdistribution hazard models accounting for death were used to estimate subdistribution hazard ratios (SHRs) and 95% confidence intervals (CIs), with prespecified subgroup analyses performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 326,148 participants, 1234 incident pancreatic cancer cases were identified over a mean follow\u2010up of 13.5\u00a0years (SD 2.0). Incidence rates increased progressively from 9.0 to 48.6 per 100,000 person\u2010years across CKM stages. Compared with CKM stage 0, multivariable\u2010adjusted SHRs for pancreatic cancer were 1.97 (95% CI 1.28\u20133.02) for stage 1, 2.02 (1.42\u20132.87) for stage 2, and 2.08 (1.42\u20133.04) for stages 3\u20134 (\n                      <jats:italic>p<\/jats:italic>\n                      for trend &lt;\u00a00.001). Associations were generally consistent across subgroup analyses according to age, sex, smoking status, and alcohol consumption, without statistically significant interaction effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Advanced CKM syndrome was independently associated with higher pancreatic cancer risk, supporting its potential role in risk stratification and early detection strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dmrr.70214","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:39:00Z","timestamp":1785843540000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiovascular\u2013Kidney\u2013Metabolic Syndrome Severity and Risk of Pancreatic Cancer in a Large Prospective Cohort"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9844-4747","authenticated-orcid":false,"given":"Munseok","family":"Choi","sequence":"first","affiliation":[{"name":"Division of HBP Surgery, Department of Surgery Yonsei University College of Medicine Yongin Severance Hospital  Yongin Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8764-7995","authenticated-orcid":false,"given":"Seok\u2010Jae","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Biomedical Systems Informatics Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9021-3856","authenticated-orcid":false,"given":"Yu\u2010Jin","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Yonsei University College of Medicine Severance Hospital  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5382-4658","authenticated-orcid":false,"given":"Chang Moo","family":"Kang","sequence":"additional","affiliation":[{"name":"Division of HBP Surgery, Department of Surgery Yonsei University College of Medicine Severance Hospital  Seoul Republic of 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