Chen Ying, Zhang Shu, Wu Juanjuan, Xu Di, Wei Cong, Li Fajiu, Xie Guozhu
Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, Wuhan, China.
Medicine (Baltimore). 2024 Nov 22;103(47):e40591. doi: 10.1097/MD.0000000000040591.
Colorectal cancer (CRC) is a major cause of cancer-related mortality worldwide. Urate, known for its antioxidant properties, may influence CRC risk and prognosis, but research on this is limited. We used Mendelian randomization (MR) analysis to explore the causal relationship between serum urate levels and CRC risk. Additionally, we analyzed National Health and Nutrition Examination Survey data to assess the impact of serum urate on CRC prognosis. MR analysis in the European population indicated that higher serum urate levels are associated with a reduced CRC risk (odds ratios [OR] inverse-variance weighted: 0.90, 95% CI: 0.81-0.99, P = .04; OR MR-Egger: 0.86, 95% CI: 0.75-0.98, P = .03; OR Weighted-Median: 0.85, 95% CI: 0.74-0.96, P = .01; OR Weighted-Mode: 0.83, 95% CI: 0.74-0.94, P = .002). Validation datasets supported this (OR inverse-variance weighted: 0.83, 95% CI: 0.72-0.96, P = .011). However, National Health and Nutrition Examination Survey data showed that higher serum urate levels are linked to poorer CRC outcomes (HR 1.50, 95% CI: 1.08-2.10, P = .02). This study suggests that elevated serum urate levels may reduce CRC risk but are associated with worse prognosis in CRC patients, highlighting its potential as a biomarker for CRC risk and prognosis.
结直肠癌（CRC）是全球癌症相关死亡的主要原因。尿酸以其抗氧化特性而闻名，可能会影响CRC风险和预后，但对此的研究有限。我们使用孟德尔随机化（MR）分析来探讨血清尿酸水平与CRC风险之间的因果关系。此外，我们分析了美国国家健康与营养检查调查数据，以评估血清尿酸对CRC预后的影响。欧洲人群的MR分析表明，较高的血清尿酸水平与降低的CRC风险相关（比值比[OR]逆方差加权：0.90，95%CI：0.81-0.99，P = 0.04；OR MR-Egger：0.86，95%CI：0.75-0.98，P = 0.03；OR加权中位数：0.85，95%CI：0.74-0.96，P = 0.01；OR加权众数：0.83，95%CI：0.74-0.94，P = 0.002）。验证数据集支持这一结果（OR逆方差加权：0.83，95%CI：0.72-0.96，P = 0.011）。然而，美国国家健康与营养检查调查数据显示，较高的血清尿酸水平与较差的CRC预后相关（HR 1.50，95%CI：1.08-2.10，P = 0.02）。这项研究表明，血清尿酸水平升高可能会降低CRC风险，但与CRC患者较差的预后相关，突出了其作为CRC风险和预后生物标志物 的潜力。
