Table 3.

Hazard ratios for death among pancreatic cancer case patients by prediagnostic levels of plasma metabolites stratified by time between blood collection and cancer diagnosis

Blood collection to cancer diagnosis		HR (95% CI)*
		Isocitrate		Aconitate		Citrate/(isocitrate+aconitate)
	No. of cases	Extreme quartiles	Per SD	Extreme quartiles	Per SD	Extreme quartiles	Per SD
0-<5 y	143	2.32 (1.29 to 4.18)	1.40 (1.11 to 1.78)	2.73 (1.49 to 5.00)	1.49 (1.15 to 1.93)	0.26 (0.14 to 0.51)	0.69 (0.55 to 0.88)
P†		.004		.002		.002
5-<10 y	162	2.32 (1.06 to 5.09)	1.42 (1.04 to 1.94)	2.45 (1.10 to 5.49)	1.62 (1.18 to 2.24)	0.48 (0.21 to 1.08)	0.76 (0.57 to 1.02)
P†		.02		.003		.05
≥10 y	179	1.58 (0.71 to 3.50)	1.14 (0.82 to 1.61)	1.11 (0.48 to 2.56)	0.98 (0.64 to 1.50)	1.01 (0.47 to 2.17)	0.87 (0.60 to 1.25)
P†		.28		.87		.38

* Hazard ratios (95% confidence intervals) for the comparison of the fourth quartile to the first quartile (referent) or per standard deviation change of the metabolite from Cox regression models adjusted for age at diagnosis (years, continuous), cohort (Health Professionals Follow-up Study, Nurses’ Health Study, Physicians’ Health Study, Women’s Health Initiative; also adjusts for sex), race/ethnicity (white, black, other, missing), stage at diagnosis (localized, locally advanced, metastatic, unknown), fasting time (<4, 4–8, 8–12, ≥12 hours, missing), and year of diagnosis (1984–1995, 1996–2005, 2006–2010). CI = confidence interval; HR = hazard ratio.

† P _trend calculated by entering the log-transformed metabolite as a continuous variable in Cox regression models. All P values are two-sided.