Woan Kim, DO1, Mohannad Abou Saleh, MD1, Farhan M. Qayyum, DO, MA2, Motasem Alkhayyat, MD1, Ashraf Almomani, MD1, Alaa Habash, MD1, Carlos Roberto Simons-Linares, MD, MSc1, Ari Garber, MD2, Prabhleen Chahal, MD1; 1Cleveland Clinic Foundation, Cleveland, OH; 2Cleveland Clinic Foundation, Warrensville Heights, OH
Introduction: Obesity has been linked to several gastrointestinal malignancies, including pancreatic cancer. Very few studies examined the association between obesity and pancreatic cysts (PC). We aim to evaluate the association between obesity and PC, and identify underlying associations using a large population database. Methods: A commercial database (Explorys Inc., Cleveland, OH, USA), a cloud-based platform with longitudinal electronic health record data among multitude of healthcare systems, was utilized for record review. A cohort of patients between 2015-2020 who actively carried the Systematized Nomenclature of Medicine – Clinical Terms diagnosis of obesity (BMI > 30) was identified. Then, the prevalence of a new diagnosis of pancreatic cyst (diagnosed after at least 30 days of obesity diagnosis) within the obese cohort was evaluated. Patients with the diagnoses of pseudocyst of pancreas and pancreatitis were excluded. Potential predictors of obesity and pancreatic cyst included age, race, and gender, as well as other risk factors, which were also analyzed. Results: Among the 39,496,650 active patient records between 2015-2020, 4,163,940 (10.5%) and 25,840 (0.07%) records were identified as having the diagnosis of obesity and PC, respectively. Within the obesity cohort, 3,770 (0.09%) patients were found to have PC after at least 30 days of their obesity diagnosis. Patients with obesity were more likely to have a diagnosis of PC as compared to individuals without obesity [OR: 1.65; 95% CI: 1.59-1.71; P < 0.0001]. When compared to patients with obesity but without PC, obese patients with PC were more likely to be African American and between the ages of 18 and 65 with history of smoking, alcohol use, hypertension, diabetes mellitus type 2, coronary artery disease, and chronic kidney disease (Table 1). The prevalence of PC in obesity over time is presented in Figure. Discussion: This is the largest study to date to describe the association between obesity and PC. There is a modestly increased risk of PC with obesity. Several comorbid conditions were also associated with increased risk of PC in obesity. While increased healthcare utilization is likely in this population, which may explain the increased rate of PC, there are several other factors that may contribute to our findings, including increased levels of growth and sex hormones, changes in adipokines levels, chronic inflammation, increased oxidative stress, and changes in the microbiome, in the obese population.
Table 1. Odds ratio of associated risk factors of pancreatic cyst in obesity.
Figure. Prevalence of pancreatic cyst in obesity over time.
Disclosures: Woan Kim indicated no relevant financial relationships. Mohannad Abou Saleh indicated no relevant financial relationships. Farhan Qayyum indicated no relevant financial relationships. Motasem Alkhayyat indicated no relevant financial relationships. Ashraf Almomani indicated no relevant financial relationships. Alaa Habash indicated no relevant financial relationships. Carlos Roberto Simons-Linares indicated no relevant financial relationships. Ari Garber indicated no relevant financial relationships. Prabhleen Chahal indicated no relevant financial relationships.