Background
Although obesity is a known risk factor for pancreatic cancer, the role of dynamic weight fluctuations remains unclear. We examined whether body mass index (BMI) variability is associated with pancreatic cancer risk in a large South Korean cohort.
Methods
We analyzed data from 232,322 participants in the Korean National Health Insurance Service database who underwent three health examinations between 2002 and 2007. Participants were followed from 2008 until pancreatic cancer diagnosis, death, or the end of the study period in 2019. BMI variability, assessed using average successive variability, was categorized into tertiles. We used Cox proportional hazards models to calculate adjusted hazard ratios and 95% confidence intervals after adjusting for potential confounders. Sensitivity analyses were performed to verify the robustness of our findings.
Results
In the overall cohort, BMI variability showed no significant association with pancreatic cancer risk. However, a statistically significant interaction by sex was observed (P for interaction=0.029), yielding higher risk estimates among male participants.
Conclusion
Although BMI variability lacked a significant overall association with pancreatic cancer risk, the attenuation of this risk after longer washout periods suggests the potential influence of preclinical weight changes. Nevertheless, the observed effect modification by sex indicates that BMI variability may retain clinical relevance for specific demographic groups, particularly male participants. Therefore, BMI variability should be interpreted not as a direct causal risk factor or intervention target, but as a potential clinical marker that warrants closer monitoring in these specific groups.

Background
This study compared chronic diseases and health-related quality of life (HRQoL) in between primary care underserved areas residents and the general population.
Methods
Underserved areas were identified according to accessibility and the time relevance index for primary care. Overall, 279 participants aged ≥60 years from four counties enrolled voluntarily. A total of 1,873 individuals were assigned in the control group using the Korea National Health and Nutrition Examination Survey database. We assessed the differences in prevalence, awareness, and control of hypertension and diabetes and HRQoL using both subjective health status and the Korean version of the EuroQol-5D (EQ-5D) questionnaire using multivariate logistic regression analysis between the two groups.
Results
For hypertension, prevalence did not differ significantly between the two groups, whereas awareness and control were lower in the underserved areas than that in the general population; the adjusted odds ratios (95% confidence interval) were 0.40 (0.25–0.64) and 0.27 (0.18–0.41), respectively. For diabetes, differences in prevalence, awareness, and control were statistically insignificant. The proportion reporting poor subjective health status and problems in four EQ-5D indexes (ability to exercise, daily activities, pain/discomfort, anxiety/depression) was higher in the underserved areas, which also had a lower EQ-5D index, than that in the general population.
Conclusion
Primary care underserved area residents were underdiagnosed and under-controlled for hypertension and reported poorer subjective health and HRQoL compared to the general population. Primary care is the attributable factor to awareness and control of chronic diseases and subjective health and QoL in communities.

Citations

• Measuring the Burden of Disease in Korea Using Disability-Adjusted Life Years (2008–2020)
  Yoon-Sun Jung, Young-Eun Kim, Minsu Ock, Seok-Jun Yoon
  Journal of Korean Medical Science.2024;[Epub]     CrossRef
• The Association with COPD Readmission Rate and Access to Medical Institutions in Elderly Patients
  Tae Wan Kim, Eun Sil Choi, Woo Jin Kim, Heui Sug Jo
  International Journal of Chronic Obstructive Pulmonary Disease.2021; Volume 16: 1599.     CrossRef
• Functional Status and Health-Related Quality of Life in Patients with Peripheral Artery Disease: A Cross-Sectional Study
  Mihui Kim, Yesol Kim, Gi Wook Ryu, Mona Choi
  International Journal of Environmental Research and Public Health.2021; 18(20): 10941.     CrossRef