Serum uric acid and risk of death from cancer, cardiovascular disease or all causes in men

Objective Although many epidemiological studies have suggested that increased serum uric acid levels are a risk factor for mortality, this relationship remains uncertain. This cohort study examined the effects of serum uric acid level on death from cancer, atherosclerotic cardiovascular disease (ASCVD) or all causes in men. Method A 9-year, prospective cohort study was carried out with 22 698 Korean men, aged 30 to 77 years, who received health insurance from the National Health Insurance Corporation and who underwent biennial, secondary medical evaluations in 1992-1996. The main outcome measures were death from cancer, ASCVD or all causes, compared by quintiles of serum uric acid level. At baseline, the mean (SD) level of serum uric acid was 354.4 (98.1) mumol/l. Results During 199 746 person-years of follow-up, there were 387 cancer deaths, 323 ASCVD (99 ischaemic heart disease, 192 stroke) deaths and 1625 all-cause deaths. In multivariate Cox proportional hazards models, having controlled for age, current smoking, diabetes, hypertension and hypercholesterolaemia, uric acid levels were not associated with mortality from cancer, ASCVD or all causes. However, for those with diabetes, uric acid levels were associated with mortality from all causes even after full adjustment of the covariates. When the interaction term was included in the multivariate model, there was significant interactive effect of uric acid with diabetes (RR=1.26, 95% confidence interval 1.02-1.55) on the risk of all cause of death, whereas the effects of uric acid itself did not attain significance. Conclusion These findings indicate that uric acid level is not an independent risk factor for death from cancer, ASCVD or all causes. (C) 2004 The European Society of Cardiology.