Serum uric acid and risk of cancer mortality in a large prospective male cohort
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To examine the prognostic role of serum uric acid (SUA) for cancer mortality in apparently healthy men across a wide age range.
Prospective data from a large cohort of 83,683 male Austrian adults with a median follow-up of 13.6 years was analyzed. Cox proportional hazards models, adjusted for established risk factors, were calculated to evaluate SUA as a predictive marker for fatal cancer events.
High SUA (>6.71 mg/dl) was independently associated with increased risk of mortality from all cancers, showing a clear dose–response relationship (p for trend < 0.0001); the adjusted hazard ratio for the highest versus lowest quintile of SUA was 1.41 (1.22–1.62). In subgroup analyses this hazard ratio increased to 1.53 (1.29–1.80) for participants aged <65 years. When considering the time interval between baseline SUA measurement and subsequent death, SUA levels were more predictive for “late deaths”, occurring 10 or more years after screening (HR 1.65 [1.35–2.03], p < 0.0001), in comparison to deaths within 10 years after SUA measurement. In cancer site-specific analyses, SUA was significantly associated with deaths from malignant neoplasms of digestive organs (p = 0.03) and respiratory system and intrathoracic organs (p < 0.0001). Elevated SUA was further independently related to an increased risk of all-cause mortality (p < 0.0001).
Our results are contrary to the proposed antioxidant, inhibitory effect of SUA against cancer and rather suggest high SUA to be a valuable long-term surrogate parameter, indicative for a life-style at increased risk for the development of cancer.
KeywordsCancer mortality Serum uric acid Risk factor Epidemiology
Members of the VHM&PP study group are Paul Gmeiner MD, Wolfgang Metzler MD, Elmar Stimpfl (Agency for Preventive- and Social Medicine, Bregenz, Austria), Jochen Klenk MSc, and Stephan K Weiland MD MSc† (Department of Epidemiology, University of Ulm, Germany). We would like to thank all the participants and physicians of the VHM&PP. We are grateful to the Government of the State of Vorarlberg, Austria for funding the program and thank Elmar Bechter MD and Hans-Peter Bischof MD at the Health Department of the Vorarlberg State Government.
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