Study Finds Link Between Baseline Uric Acid Levels and Prostate Cancer Prognosis

Past research has shown that higher uric acid (UA) levels contribute to cancer growth in patients with prostate cancer (PCa), and a recent study published in Cancer Medicine demonstrated a link between PCa mortality and above or below average UA levels.

Researchers examined health data from patients with PCa who received any sort of androgen depravation therapy (ADT) from December 1993 through March 2021 with data gathered from the Clinical Data Analysis and Reporting system, which is a prospective population-based database with information regarding patients who attend public health care institutions in Hong Kong, China. Any patients who were missing baseline UA level information were excluded.

Of the 13,537 identified patients with PCa who received ADT, 4126 were eligible for this study. Patients had a median age of approximately 76 years. The study authors noted that the “normal” UA range in men falls between 0.24-0.51 mmol/L. In their research, they separated patients into two groups: those with median UA levels above 0.51 mmol/L (labeled “high levels”) and those with median UA levels below 0.24 mmol/L (labeled “low levels”).

Four subgroup analyses were conducted in these respective groups, including the assessment of UA effects on PCa by age (categorized by patients above 75 years and patients below 75 years), prior diagnosis of gout (which may be a confounder connected to UA levels), the use of any UA-lowering medications, and an exploration of UA levels in patients with non-metastatic PCa compared with metastatic PCa.

Over a median follow-up time of 3.1 years, 2691 (65.2%) patients died from a mix of PCa- and non-PCa–related factors. Among those patients, 1036 deaths were due to PCa-related factors and 1655 deaths were attributed to non-PCa–related causes.

In patients with UA levels at or above the mean (≥ 0.401 mmol/L; n = 1852), higher UA levels correlated with a higher risk of PCa-related mortality (HR per SD increase, 1.35; 95% CI, 1.21-1.51; P < .001). The subgroup analyses suggest the stratified variables had no significant impact on the relationship between above-mean UA levels and PCa-mortality risk.

In patients with UA levels below the mean (n = 2274), lower levels were also associated with higher PCa-related mortality risks (HR, 0.78, 0.67-0.92; P = .003). Similarly, the previously stratified variables did not have any significant impact on below-mean UA levels and PCa-mortality risk.

The authors encountered some limitations in their research. In their observations, they found that many patients did not qualify for their study. They added that no staging data were available and that adjudication of individual data was impossible.

One of the strengths of this study, however, comes from its use of population-based data. These findings, as the authors assert, “suggest that baseline UA level may be used for prognosticating patients with PCa receiving ADT, warranting similar investigations in broader cohorts of patients with PCa.”

Researchers concluded that although there was no significant link between UA-lowering medication and patient prognosis in these cases, further studies should be conducted to examine more deeply how these medications can influence PCa-related outcomes.

Reference

Lee YHA, Chan JSK, Leung CH, et al. Association between serum uric acid and prostate cancer mortality in androgen deprivation therapy: a population-based cohort study. Cancer Med. Published online July 16, 2023. doi:10.1002/cam4.6344.