Uric Acid [UA] & PCa Mortality

[pca2004]

I once had a gouty foot. It was self-induced - I was having a brief but intense craving for high-purine foods, particularly anchovies. (Perhaps PCa was driving the craving - lol.) At some point I looked at the PCa / Uric Acid [UA] literature (more than I expected), but it was mixed & failed to impress.

I was going to post an article about a new study, that starts with:

"Researchers examined health data from patients with PCa who received any sort of androgen depravation therapy ..."

Very amusing, but decided to locate the published paper instead [1].

"Adults with PCa who received ADT in Hong Kong between December 1999 and March 2021 were identified. Patients with missing baseline UA were excluded. Patients were followed up until September 2021. The outcome was PCa-related mortality."

"Altogether, 4126 patients (median follow-up 3.1... years) were included."

"A J-shaped relationship was observed between UA levels and the risk of PCa-related mortality (Figure 1). In those with mean/above-mean UA levels (≥0.401 mmol/L; N = 1852), higher UA levels were associated with higher risk of PCa-related mortality (hazard ratio (HR) per SD-increase 1.35 ..." ("SD" = standard deviation)

"As far as we know, this was one of the first studies exploring the prognostic value of baseline UA levels in patients with PCa."

"Mechanistically, in those with mean/above-mean baseline UA levels, the direct association between baseline UA level and PCa-related mortality UA levels may be explained by PCa progression due to UA-induced activin insensitivity, suppressed UA transporter expression, and UA-related intraprostatic inflammation ..."

From a 2016 paper from New Zealand [2]"

"Elevated serum uric acid (SUA) or urate is associated with inflammation and gout. Recent evidence has linked urate to cancers, but little is known about urate effects in prostate cancer. Activins are inflammatory cytokines and negative growth regulators in the prostate. A hallmark of prostate cancer progression is activin insensitivity; however, mechanisms underlying this are unclear. We propose that elevated SUA is associated with prostate cancer counteracting the growth inhibitory effects of activins."

-Patrick

[1] doi.org/10.1002/cam4.6344

[2] pubmed.ncbi.nlm.nih.gov/269...

[Thunderball1]

Very interesting. I have for many years taken allopurinol for UA so UA < 0.4. So if it is controlled <0.4 one is not subject to the negative correlation?

j

[pca2004 in reply to Thunderball1]

Unfortunately,

"... UA-lowering medications did not meaningfully modify the captioned associations in our study. Further studies are needed to investigate more granularly the effects of UA-lowering medications on PCa-related outcomes, and whether UA level is a meaningful treatment target in PCa."

-Patrick

[Thunderball1]

Seems if <0.4 with UA-lowering medication, hazard ratio of 0.75 means 25% reduction in risk.

If >0.4, HR 1.22 means risk is 22% greater.

risk

[Medline]

Serum uric acid levels are lower in newly diagnosed PCa patients [pubmed.ncbi.nlm.nih.gov/300...]. Interestingly, ADT reduces serum uric acid levels [pubmed.ncbi.nlm.nih.gov/305...].