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Objective. To assess the associations between serum uric acid (SUA) level and mortality.Methods. The study included 354 110 subjects without a history of gout and whose SUA levels were tested at Chang Gung Memorial Hospital in Taiwan. Cox regression models were used to estimate hazard ratios and 95% CIs for mortality in six predefined SUA strata (≤0.17, 0.18–0.29, 0.30–0.41, 0.42–0.53, 0.54–0.65 and ≥0.66 mmol/l), after adjusting for age, sex, SUA stratum, estimated glomerular filtration rate, fasting glucose, total cholesterol and history of hypertension, diabetes mellitus, coronary heart disease, stroke, heart failure or chronic kidney disease.Results. There were 33 562 all-cause deaths during the study period. Crude all-cause mortality rates across the SUA strata were 52.5, 19.7, 17.4, 20.0, 28.0 and 41.1 deaths per 1000 person-years. Using the stratum 3 of SUA as a reference, the age- and sex-adjusted hazard ratios (95% CIs) across SUA strata were 2.79 (2.62, 2.96), 1.32 (1.28, 1.36), 1.00, 1.10 (1.07, 1.14), 1.42 (1.37, 1.48) and 2.12 (2.01, 2.23) for all-cause mortality; 2.24 (1.93, 2.59), 1.18 (1.10, 1.27), 1.00, 1.21 (1.14, 1.29), 1.74 (1.60, 1.88) and 2.53 (2.28, 2.81) for cardiovascular mortality and 3.41 (3.11, 3.73), 1.48 (1.42, 1.55), 1.00, 0.88 (0.84, 0.92), 0.91 (0.85, 0.98) and 1.23 (1.11, 1.36) for cancer-related mortality.Conclusion. Individuals with SUA levels at either extremes are at higher risk for all-cause and cardiovascular mortality. SUA levels of 0.30–0.41 mmol/l were associated with the lowest mortality rate and should be regarded as optimal. [ABSTRACT FROM PUBLISHER]

Abstract: Objective: Few studies have investigated the association between gout and cancer. The present study examined the relative risk of cancer in a nationwide cohort. Methods: The primary data source was the National Health Insurance database of Taiwan. Data recorded between 2000 and 2008 for subjects≥20 years and with no history of malignancy were included for the analysis. A gout case definition was defined by records of gout diagnosis and anti-gout treatment (urate-lowering drugs, including allopurinol, benzbromazone, probenacid and sulfinpyrazone, and colchicine). Cox proportional hazards models were used to examine the association between gout and cancer. Results: A total of 694,361 patients (355,278 men, 339,083 women) were included; among them, 25,943 had a history of gout. Mean age (±standard deviation) was 42.3±16.3 years. During 5,471,272 patient-years of follow-up, cancer was detected in 24,088 patients (1745 with gout and 22,343 controls). The most cancers were liver, lung, and colonic cancers. The overall incidence of cancer was significantly higher among gout patients than controls (8.7 vs. 4.2 cases per 1000 patient-years, P <0.001). After adjustment for age and sex, gout was found to be associated with a hazard ratio (HR) of 1.15 (95% confidence interval [CI], 1.10–1.21; P <0.001) for cancer. Gout was most closely associated with prostate cancer, with an age- and sex-adjusted HR of 1.71 (1.45–2.02). On the other hand, gout tended to have an inverse, albeit insignificant, association with breast cancer (adjusted HR, 0.81; 95% CI, 0.63–1.04). Conclusion: Gout was associated with increased risk of cancer, particularly that of prostate cancer in males. [Copyright &y& Elsevier]

Résumé: Objectifs: Peu d’études se sont intéressées à l’association entre goutte et cancer. Cette étude examine le risque relatif de cancers au sein d’une cohorte nationale. Méthodes: La base de données de l’assurance maladie nationale de Taïwan constituait la source de données primaires. Les données recueillies de 2000 à 2008 chez des sujets âgés de plus de 20ans et sans antécédent de cancer ont été inclues dans l’analyse. La définition des cas de la goutte correspondait aux dossiers mentionnant un diagnostic de goutte et les traitements adaptés (médicaments hypo-uricémiants, incluant allopurinol, benzbromarone, probénécide et sulfinpyrazone, ainsi que la colchicine). Un modèle de régression de Cox (modèle à risques proportionnels) a été utilisé pour estimer l’association entre goutte et cancer. Résultats: Un total de 694361 patients (355278hommes, 339083femmes) ont été inclus ; parmi eux, 25943présentaient un antécédent de goutte. L’âge moyen (±écart-type) était de 42,3±16,3ans. Pendant les 5471272années-patients de suivi, un cancer a été détecté chez 24088patients (1745 atteints de goutte et 22343 témoins). La plupart des cancers concernaient le foie, le poumon et le côlon. L’incidence globale du cancer était significativement plus élevée parmi les patients goutteux que parmi les témoins (8,7 vs 4,2 cas par 1000 années-patients, p <0,001). Après ajustement sur l’âge et le sexe, la goutte s’est révélée associée au cancer avec un « hazard ratio » (HR) (rapport des risques instantanés) de 1,15 (intervalle de confiance à 95 % [IC], 1,10–1,21 ; p <0,001). La goutte était associée dans la majeure partie des cas au cancer de la prostate, avec un HR ajusté sur l’âge et le sexe de 1,71 (1,45–2,02). D’un autre côté, la goutte tendait à une association inverse, bien que négligeable, avec le cancer du sein (HR ajusté, 0,81 ; IC 95 %, 0,63–1,04). Conclusion: La goutte était associée à un risque de cancer plus élevé, notamment celui de la prostate chez les hommes. [Copyright &y& Elsevier]