{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:52:40Z","timestamp":1760151160890,"version":"build-2065373602"},"reference-count":40,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Introduction: Certain metabolic parameters increase the risk of esophageal cancer. This study investigated the association between the variability in metabolic parameters and esophageal cancer incidence using large nationally representative data. Methods: Using the health checkup and claims data provided by the Korean National Health Insurance Service (NHIS), we included 8,376,233 subjects who underwent NHIS-provided health checkups between 2009 and 2010 (index year) and two or more health checkups within five years before the index year. Hazard ratios (HRs) and 95% confidence intervals (CIs) for esophageal cancer were obtained using Cox proportional hazards models according to the quartiles of variability of each metabolic parameter: fasting blood glucose (FBG), weight, systolic blood pressure (SBP), and total cholesterol (TC) as well as a cumulative number of high-variability parameters. Results: A total of 6,455 cases of esophageal cancer occurred during a mean (\u00b1SD) follow-up of 8.8 (\u00b11.1) years. The following metabolic parameters were used, with an adjusted HR and 95% CI: FBG (1.11, 1.03\u20131.18), weight (1.15, 1.07\u20131.23), SBP (1.08, 1.01\u20131.16), and TC (1.23, 1.15\u20131.32). The risk of esophageal cancer was higher in the highest quartile of variability than the lower quartiles. The risk of esophageal cancer gradually increased with a greater number of high-variability parameters: 1.08 (1.02\u20131.15), 1.22 (1.14\u20131.31), and 1.33 (1.21\u20131.46) for 1, 2, and 3\u20134 high-variability parameters (vs. none). Conclusions: A high variability of metabolic parameters was associated with an increased esophageal cancer risk. Further studies are needed to replicate our findings in other populations.<\/jats:p>","DOI":"10.3390\/jpm12030375","type":"journal-article","created":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T08:17:03Z","timestamp":1646122623000},"page":"375","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association of Metabolic Parameter Variability with Esophageal Cancer Risk: A Nationwide Population-Based Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Ji Eun","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyungdo","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juhwan","family":"Yoo","sequence":"additional","affiliation":[{"name":"Department of Biomedicine & Health Science, The Catholic University of Korea, Seoul 06591, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yohwan","family":"Yeo","sequence":"additional","affiliation":[{"name":"Department of Family Medicine\/Supportive Care Center, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In Young","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Kangbuk Samsung Hospital, Seoul 03181, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Belong","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyuktae","family":"Kwon","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8128-8920","authenticated-orcid":false,"given":"Dong Wook","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Family Medicine\/Supportive Care Center, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Korea"},{"name":"Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul 06355, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong Ho","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul 06351, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5879-6879","authenticated-orcid":false,"given":"Yong-Moon","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Huang, J., Koulaouzidis, A., Marlicz, W., Lok, V., Chu, C., Ngai, C.H., Zhang, L., Chen, P., Wang, S., and Yuan, J. (2021). Global Burden, Risk Factors, and Trends of Esophageal Cancer: An Analysis of Cancer Registries from 48 Countries. 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