Huang Chong-Fei, Huang Jun-Jun, Mi Ning-Ning, Lin Yan-Yan, He Qiang-Sheng, Lu Ya-Wen, Yue Ping, Bai Bing, Zhang Jin-Duo, Zhang Chao, Cai Teng, Fu Wen-Kang, Gao Long, Li Xun, Yuan Jin-Qiu, Meng Wen-Bo
The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China.
Scientific Research and Planning Department, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China.
World J Gastroenterol. 2020 Nov 28;26(44):7061-7075. doi: 10.3748/wjg.v26.i44.7061.
Uric acid is the end product of purine metabolism. Previous studies have found that serum uric acid (SUA) levels are associated with the total cancer risk. However, due to the dual effect of uric acid on cancer, the relationship between the SUA levels and most specific-site cancer remains unclear.
To investigate the associations between the SUA levels and incidence of hepatobiliary-pancreatic cancer.
In this prospective cohort study, 444462 participants free of cancer from the UK Biobank were included. The SUA levels were measured at baseline, and the incidence of hepatobiliary-pancreatic cancer was determined by contacting the cancer registry. The hazard ratios (HRs) and 95% confidence intervals (CIs) between the SUA levels and hepatobiliary-pancreatic cancer were investigated using multiple adjusted Cox regression models adjusted for potential confounders.
In total, 920 participants developed liver, gallbladder, biliary tract or pancreatic cancer during a median of 6.6 yrs of follow-up. We found that the HR of pancreatic cancer in the highest SUA group was 1.77 (95%CI: 1.29-2.42) compared with that in the lowest group. After stratifying by gender, we further found that SUA was associated with an increased risk of pancreatic cancer only among the females (highest quartile lowest quartile HR 2.04, 95%CI: 1.35-3.08). Among the males, the SUA levels were positively associated with the gallbladder cancer risk (highest quartile lowest quartile HR 3.09, 95%CI: 1.28-7.46), but a U-shaped association with the liver cancer risk was observed (-nonlinear = 0.03).
SUA is likely to have gender-specific effects on hepatobiliary-pancreatic cancer. High SUA levels are a risk factor for pancreatic cancer in females and gallbladder cancer in males. A U-shaped association with the liver cancer risk was identified.
尿酸是嘌呤代谢的终产物。既往研究发现血清尿酸（SUA）水平与总体癌症风险相关。然而，由于尿酸对癌症的双重作用，SUA水平与大多数特定部位癌症之间的关系仍不明确。
探讨SUA水平与肝胆胰癌症发病率之间的关联。
在这项前瞻性队列研究中，纳入了英国生物银行的444462名无癌症参与者。在基线时测量SUA水平，并通过联系癌症登记处确定肝胆胰癌症的发病率。使用针对潜在混杂因素进行调整的多因素Cox回归模型研究SUA水平与肝胆胰癌症之间的风险比（HR）和95%置信区间（CI）。
在中位6.6年的随访期间，共有920名参与者发生了肝癌、胆囊癌、胆管癌或胰腺癌。我们发现，最高SUA组胰腺癌的HR为1.77（95%CI：1.29 - 2.42），而最低组为1。按性别分层后，我们进一步发现，仅在女性中SUA与胰腺癌风险增加相关（最高四分位数对比最低四分位数HR 2.04，95%CI：1.35 - 3.08）。在男性中，SUA水平与胆囊癌风险呈正相关（最高四分位数对比最低四分位数HR 3.09，95%CI：1.28 - 7.46），但与肝癌风险呈U型关联（非线性P = 0.03）。
SUA可能对肝胆胰癌症有性别特异性影响。高SUA水平是女性胰腺癌和男性胆囊癌的危险因素。发现了与肝癌风险的U型关联。
