Abstract
Hyperuricemia may be one of the risk factors for the development of prostate cancer. We evaluated the association between serum uric acid (SUA) and elevated prostate-specific antigen (PSA) in the middle-aged and elderly Chinese men, and the adjustment effects of age, glycolipid metabolism and renal function. From January 2019 to December 2024, 967 participants from the middle-aged and elderly Chinese men who attended the urology outpatient clinic of Shuguang Hospital (Shanghai, China) were recruited in this cross-sectional study. Blood samples from participants were collected for the determinations of SUA, PSA, fasting blood glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, creatinine, blood urea nitrogen and glomerular filtration rate. After adjusting for age, glycolipid metabolism and renal function, the odds ratios (95% confidence interval) of elevated PSA across increasing quartiles of SUA were 1.00, 1.42 (0.97-2.08), 1.45 (0.98-2.13) and 1.26 (0.83-1.90), respectively (P for trend = 0.259). The regression spline showed that the risk of elevated PSA tended to a slow but linear increase for SUA levels greater than about 443 μmol/L (P for non-linearity = 0.431). The stratified analyses suggested that the associations were significant for participants at least 75 years (P for trend = 0.015), but not for those less than 68 (P for trend = 0.162) and 68-74 years (P for trend = 0.761). Moreover, HDL-C was significantly interacted with SUA (P for interaction = 0.046). The associations were more evident in participants with high HDL-C levels (P for trend = 0.007) than in those with low (P for trend = 0.943) and median HDL-C levels (P for trend = 0.176). Our study for the first time demonstrates that SUA levels are unlikely to be associated with the risk of elevated PSA in the middle-aged and elderly Chinese men. Yet the associations between SUA and elevated PSA could be significant for participants at least 75 years. Notably, HDL-C may modify the associations.