Abstract
ObjectivesSerum uric acid has been suggested to be associated with cancer risk. We aimed to study the association between serum uric acid and cancer incidence in a large Swedish cohort.ResultsA positive association was found between uric acid levels and overall cancer risk, and results were similar with adjustment for glucose, triglycerides and BMI. Hazard ratio (HR) for overall cancer for the 4th quartile of uric acid compared to the 1st was 1.08 (95% CI: 1.05–1.11) in men and 1.12 (1.09 – 1.16) in women. Site-specific analysis showed a positive association between uric acid and risk of colorectal, hepatobiliary, kidney, non-melanoma skin, and other cancers in men and of head and neck and other cancers in women. An inverse association was observed for pulmonary and central nervous system (CNS) cancers in men and breast, lymphatic and haematological, and CNS malignancies in women.Materials and MethodsWe included 493,281 persons aged 20 years and older who had a measurement of serum uric acid and were cancer-free at baseline in the AMORIS study. Multivariable Cox proportional hazards regression was used to investigate sex-specific quartiles of serum uric acid in relation to cancer risk in men and women. Analysis was further adjusted for serum glucose, triglycerides and, where available, BMI. Site-specific analysis was performed for major cancers.ConclusionsAltered uric acid levels were associated with risk of overall and some specific cancers, further indicating the potential role of uric acid metabolism in carcinogenesis.
Highlights
Uric acid is the product of the metabolism of dietary or endogenous adenine-based and guanine-based purines, and is excreted by the kidney and gut [1, 2]
A positive association was found between uric acid levels and overall cancer risk, and results were similar with adjustment for glucose, triglycerides and body mass index (BMI)
Hazard ratio (HR) for overall cancer for the 4th quartile of uric acid compared to the 1st was 1.08 in men and 1.12 (1.09 – 1.16) in women
Summary
Uric acid is the product of the metabolism of dietary or endogenous adenine-based and guanine-based purines, and is excreted by the kidney and gut [1, 2]. Uric acid acts as a scavenger of oxygen radicals, and may serve to reduce carcinogenic reactive oxygen species (ROS) [2, 5]. Recent epidemiological studies looking at the association of serum uric acid and cancer incidence have found conflicting results. A cohort study of 83,683 participants in Austria found that high levels of serum uric acid were linked to a higher risk of all cancer mortality [9]. A cohort study of 8,274 participants in China found that incidence of cancer increased with serum uric acid levels, but only in females with diabetes [10]. A recent systematic review and metaanalysis of 17 studies on the link between serum uric acid and cancer incidence and mortality was inconclusive [2]
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