Prospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2020; 26(44): 7061-7075
Published online Nov 28, 2020. doi: 10.3748/wjg.v26.i44.7061
Associations between serum uric acid and hepatobiliary-pancreatic cancer: A cohort study
Chong-Fei Huang, Jun-Jun Huang, Ning-Ning Mi, Yan-Yan Lin, Qiang-Sheng He, Ya-Wen Lu, Ping Yue, Bing Bai, Jin-Duo Zhang, Chao Zhang, Teng Cai, Wen-Kang Fu, Long Gao, Xun Li, Jin-Qiu Yuan, Wen-Bo Meng
Chong-Fei Huang, Ning-Ning Mi, Ya-Wen Lu, Ping Yue, Chao Zhang, Teng Cai, Wen-Kang Fu, Long Gao, Wen-Bo Meng, The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China
Chong-Fei Huang, Ning-Ning Mi, Yan-Yan Lin, Ya-Wen Lu, Ping Yue, Bing Bai, Jin-Duo Zhang, Chao Zhang, Teng Cai, Wen-Kang Fu, Long Gao, Wen-Bo Meng, Special Minimally Invasive Surgery Department, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
Chong-Fei Huang, Yan-Yan Lin, Ya-Wen Lu, Ping Yue, Bing Bai, Jin-Duo Zhang, Chao Zhang, Teng Cai, Wen-Kang Fu, Long Gao, Wen-Bo Meng, Institute of Genetics, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, Gansu Province, China
Chong-Fei Huang, Yan-Yan Lin, Ya-Wen Lu, Ping Yue, Bing Bai, Jin-Duo Zhang, Chao Zhang, Teng Cai, Wen-Kang Fu, Long Gao, Xun Li, Wen-Bo Meng, Gansu Province Institute of Hepatopancreatobiliary, Lanzhou 730000, Gansu Province, China
Chong-Fei Huang, Yan-Yan Lin, Ya-Wen Lu, Ping Yue, Bing Bai, Jin-Duo Zhang, Chao Zhang, Teng Cai, Wen-Kang Fu, Long Gao, Xun Li, Wen-Bo Meng, Gansu Province Key Laboratory Biotherapy and Regenerative Medicine, Lanzhou 730000, Gansu Province, China
Jun-Jun Huang, Scientific Research and Planning Department, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
Qiang-Sheng He, Jin-Qiu Yuan, Clinical Research Center and Scientific Research Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, Guangdong Province, China
Xun Li, The Fifth Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
Author contributions: Huang CF, Huang JJ, Mi NN and Lin YY contributed equally to this work; Huang CF, Huang JJ, Mi NN, Lin YY, Meng WB and Yuan JQ designed the prospective study; Meng WB, Li X, Zhang C, Long Gao, Cai T, Huang CF, Huang JJ, Lin YY, Yue P, Fu WK and Bai B collected the data; Mi NN, He QS, Yuan JQ, Lu YW, Zhang JD, Zhang C and Long Gao analyzed the data; all authors participated in the writing and final approval of the manuscript.
Supported by National Natural Science Foundation of China, No. 81872036.
Institutional review board statement: The UK Biobank has received ethical approval from the North West Multi-centre Research Ethics Committee, the England and Wales Patient Information Advisory Group and the Scottish Community Health Index Advisory Group.
Informed consent statement: All participants provided written informed consent prior to enrolment, and the analysis used anonymous data.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: All the data are available at: https://www.ukbiobank.ac.uk/.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Wen-Bo Meng, MD, PhD, Professor, Special Minimally Invasive Surgery Department, The First Hospital of Lanzhou University, No. 1 Donggang West Road, Lanzhou 730000, Gansu Province, China. mengwb@lzu.edu.cn
Received: August 31, 2020
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
Processing time: 88 Days and 1 Hours
Abstract
BACKGROUND

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.

AIM

To investigate the associations between the SUA levels and incidence of hepatobiliary-pancreatic cancer.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

Keywords: Uric acid; Liver neoplasms; Pancreatic neoplasms; Gallbladder neoplasms; Biliary tract neoplasms; Cohort studies

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.