Association Between Uric Acid,Cancer Incidence And Mortality In Patients With Type 2 Diabetes:Shanghai Diabetes Registry Study

Aim: Elevated serum uric acid level is often observed in type 2 diabetes or cancer progression. This study aimed to investigate the association between the SUA, cancer incidence and mortality in Chinese patients with type 2 diabetes.Methods: Clinical data were provided by Shanghai Diabetes Registry(SDR). General anthropometric parameters, serum uric acid concentrations and serum lipid profiles were measured at the first visit. Every patient was invited to attend follow‐up visits throughout the research. The first recorded diagnosis of any type of cancer was considered to be the primary outcome. Mortality from all causes was the secondary outcome. The follow‐up rate was 85.4%. All subjects were divided into 4 groups according to the SUA concentration: group 1(1.0 ≤ SUA < 3.0 mg/dl), group 2(3.0 ≤ SUA <5.0 mg/dl), group 3(5.0 ≤ SUA < 7.0 mg/dl), and group 4(SUA ≥ 7.0 mg/dl). Kaplan‐Meier survival curve analyses were used to compare incidence rates using the Log‐rank test. Cox regression analyses were used to assess the relationship between SUA levels and the incidence of cancer.Results: 1. A total of 8,274 patients with type 2 diabetes participated; among them were 4,217 men and 4,057 women. The follow‐up rate was 85.4%. The median level of SUA in male was 5.6(4.6~6.6)mg/dl, higher than SUA level in female, which was 4.8(4.0~5.7)mg/dl(P < 0.05). 2. One hundred and thirty‐three men and 115 women had cancer by the end of the study. The cancer incidence rate was 74.6 per 10,000 patient years in male, 63.2 per 10,000 patient years in female. The three most common types of cancer in male subjects were colorectal cancer, lung cancer, and prostate cancer. For female subjects, the three most common cancers were breast cancer, lung cancer. 3. Kaplan‐Meier survival curve analyses were used to compare incidence rates using the Log‐rank test. In female subjects, the incidence increases in groups with higher SUA levels. The cancer incidence rates in groups 3(80.4) and 4(100.8) were significantly higher than in group 2(P < 0.05). No significant differences were observed in the incidence of cancer in male(P = 0.76). 4. A total of 113 deaths occurred by the end of the study, 103(91.1%) of which were cancer‐related. Sixty men and 53 women died during the course of the study. The risks of overall mortality and death from cancer were not significantly different among the different SUA groups in either sex(Pmale = 0.480, Pfemale = 0.075).Conclusion: In Chinese female diabetic patients, the incidence of cancer increased with SUA levels.