Serum Uric Acid and Risk of Colorectal Adenoma in Apparently Healthy Koreans

Abstract

Purpose: Basic science evidence had suggested anti-oxidative properties of uric acid (UA), however results of previous epidemiologic studies to examine an association between UA and cancer risk or mortality were inconsistent. The aim of this study was to investigate an association between serum UA levels and risk of colorectal adenoma, a precancerous lesion. Methods: A total of 19,970 participants who underwent full colonoscopy were finally included in this study. According to the recent surveillance guideline, colorectal adenoma cases were classified into two groups: low-risk adenoma (n=4,432) and high-risk adenoma (n=653). Using multivariate regression analysis, odds ratio (OR) and 95% confidence interval (CI) were obtained to determine an association between serum UA levels and colorectal adenoma risk. Moreover, we performed additional analysis that combined serum UA levels and some proposed colorectal risk factors to affect oxidative balance status (cigarette smoking, alcohol consumption, and aspirin and/or NSAIDs medication). Results: Elevated serum UA levels were independently associated with risk reduction of the low-risk adenoma, but not of the high-risk adenoma: 3rd quartile (OR: 0.88, 95% CI: 0.80-0.97) and 4th quartile (OR: 0.73, 95% CI: 0.66-0.80). In the additional analysis, higher serum UA levels among non-alcohol consumers was significantly associated with remarkable risk reduction in the high-risk adenoma group: 3rd quartile (OR: 0.53, 95% CI: 0.28-0.97) and 4th quartile (OR: 0.40, 95% CI: 0.21-0.75). Conclusion: Our study firstly demonstrated that elevated serum UA levels could independently reduce the risk of colorectal adenoma, which might indirectly support a potential anti-oxidative influence of UA in the development of colorectal adenoma.Table: Multivariate OR and 95% CI of serum UA levels for colorectal adenoma