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
ARTICLE HIGHLIGHTS
Research background

In 2018, new cases of hepatobiliary-pancreatic (HBP) cancer reached 1.85 million and identifying high-risk populations has become an urgent public health issue. As one of the important metabolites of the human body, serum uric acid (SUA) is considered to be related to cancer risk, but there is controversy about its role in specific cancers.

Research motivation

Because of the dual effect of SUA on cancer risk, the associations between SUA levels and the HBP cancer risk remain unclear.

Research objectives

To evaluate the associations between SUA levels and incidence of hepatobiliary-pancreatic cancer based on the UK Biobank cohort and to investigate the gender differences.

Research methods

This is a prospective cohort study from the UK Biobank. We estimated the hazard ratios and 95% confidence intervals between SUA levels and hepatobiliary-pancreatic cancer by using multiple adjusted Cox regression models adjusted for potential confounders. In addition, we also conducted a sensitivity analysis to verify the stability of our results.

Research results

We included 444462 participants free of cancer. With a median of 6.6 yrs of follow-up, 920 participants developed liver, gallbladder, biliary tract or pancreatic cancer. The risk of pancreatic cancer increases with the SUA levels; however, after the gender-stratified analysis, the association only occurred among the females. Both too high and too low SUA levels are the risk factors of liver cancer among the males. For gallbladder cancer, the positive association with SUA levels was identified among the males. Regarding biliary tract cancer, there is not sufficient evidence for biliary tract cancer and SUA levels.

Research conclusions

SUA is likely to have gender-specific effects on HBP cancer. In clinical and public health practice, controlling SUA levels in an appropriate range may help prevent HBP cancer.

Research perspectives

In the future, more research is needed to investigate the association between the SUA levels and other specific-site cancer risk and the underlying mechanism.