Rehabilitation and Nursing School, Hangzhou Vocational & Technical College, Hangzhou, Zhejiang, 310018, China.
School of Pharmacy, Hangzhou Normal University, Hangzhou, Zhejiang, 310023, China.
BMC Med. 2024 Nov 15;22(1):536. doi: 10.1186/s12916-024-03758-5.
The relationship between serum urea concentration and cancer in patients with metabolic syndrome (MetS) remains unclear. This study aimed to investigate the association between serum urea concentration and 16 site-specific cancers, overall cancer incidence, and cancer mortality in individuals with MetS.
We analysed the data of 108,284 individuals with MetS obtained from the UK Biobank. The Cox proportional hazards model was used to determine the association between serum urea concentration at recruitment and cancer. The Benjamini-Hochberg correction was used to account for multiple comparisons.
Over the median follow-up period of 11.86 years, 18,548 new incident cases of cancer were documented. There were inverse associations of urea concentration with overall cancer incidence, and the incidence of oesophageal and lung cancers, with respective hazard ratios (95% confidence intervals) [HR (95% CI)] for the highest (Q4) vs lowest (Q1) urea quartiles of 0.95 (0.91-0.99), 0.68 (0.50-0.92), and 0.76 (0.64-0.90). However, high serum urea concentrations increased the male prostate cancer risk (HR 1.15; 95% CI 1.02-1.30). Although the Cox model indicated a protective effect of higher urea levels against stomach (HR 0.67; 95% CI 0.45-0.98; p = 0.040; FDR 0.120) and colorectal cancer (HR 0.86; 95% CI 0.74-0.99; p = 0.048; FDR 0.123), no strong evidence of association was found after applying the Benjamin-Hochberg correction. Moreover, across the median follow-up period of 13.77 years for cancer mortality outcome, 5034 cancer deaths were detected. An "L-shaped" nonlinear dose-response relationship between urea concentration and cancer mortality was discovered (p-nonlinear < 0.001), and the HR (95% CI) for urea concentration Q4 vs Q1 was 0.83 (0.77-0.91).
Serum urea concentration can be considered as a valuable biomarker for evaluating cancer risk in individuals with MetS, potentially contributing to personalised cancer screening and management strategies.
血清尿素浓度与代谢综合征（MetS）患者癌症之间的关系尚不清楚。本研究旨在探讨血清尿素浓度与 16 个特定部位癌症、总体癌症发病率以及 MetS 患者癌症死亡率之间的关系。
我们分析了来自英国生物库的 108284 名 MetS 患者的数据。使用 Cox 比例风险模型确定招募时血清尿素浓度与癌症之间的关系。采用 Benjamini-Hochberg 校正来解释多重比较。
在中位随访期 11.86 年内，记录了 18548 例新的癌症发病病例。尿素浓度与总体癌症发病率以及食管癌和肺癌的发病率呈负相关，最高（Q4）与最低（Q1）四分位血清尿素浓度的风险比（95%置信区间）[HR（95%CI）]分别为 0.95（0.91-0.99）、0.68（0.50-0.92）和 0.76（0.64-0.90）。然而，高血清尿素浓度增加了男性前列腺癌的风险（HR 1.15；95%CI 1.02-1.30）。虽然 Cox 模型表明较高的尿素水平对胃癌（HR 0.67；95%CI 0.45-0.98；p=0.040；FDR 0.120）和结直肠癌（HR 0.86；95%CI 0.74-0.99；p=0.048；FDR 0.123）有保护作用，但在应用 Benjamin-Hochberg 校正后，没有发现与这些癌症有强烈的关联。此外，在癌症死亡率的中位随访期 13.77 年内，检测到 5034 例癌症死亡。发现尿素浓度与癌症死亡率之间存在一种“L 型”非线性剂量反应关系（p-非线性<0.001），尿素浓度 Q4 与 Q1 的 HR（95%CI）为 0.83（0.77-0.91）。
血清尿素浓度可作为评估 MetS 患者癌症风险的有价值的生物标志物，可能有助于制定个性化的癌症筛查和管理策略。
Zotero 插件
