Published online Nov 28, 2020. doi: 10.3748/wjg.v26.i44.7061
Peer-review started: August 31, 2020
First decision: September 30, 2020
Revised: October 10, 2020
Accepted: October 26, 2020
Article in press: October 26, 2020
Published online: November 28, 2020
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 vs 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 vs lowest quartile HR 3.09, 95%CI: 1.28-7.46), but a U-shaped association with the liver cancer risk was observed (P-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.
Core Tip: Serum uric acid has an effect on hepatobiliary-pancreatic cancer, specifically when stratified by gender. In males, high uric acid level is a risk factor for gallbladder cancer and has a U-shape association with liver cancer risk. In females, uric acid is positively associated with the risk of pancreatic cancer. In clinical and public health practice, management of either high or low uric acid levels may contribute to the prevention of hepatobiliary-pancreatic cancer.