Associations of serum uric acid and gamma-glutamyltransferase with cancer in the Vorarlberg Health Monitoring and Promotion Programme (VHM&PP) – a short review

Abstract

Th e Vorarlberg Health Monitoring and Promotion Programme (VHM&PP), based on prospectively gathered, repeated routine health examination data from a cohort of more than 175,000 adults, is one of the largest ongoing population-based risk factor surveillance programmes worldwide. Among others, the so far widely unknown associations of serum uric acid (SUA) and gamma-glutamyltransferase (GGT) with cancer were investigated. Both SUA and GGT are known to be related to the metabolic syndrome and furthermore considered as markers of oxidative stress. After controlling for several confounding factors, it was found that elevated SUA levels were statistically signifi cantly related to overall cancer mortality and several site-specifi c malignancies in both men and women. Additionally, a J-shaped eff ect of SUA levels on risk of overall cancer incidence appeared in men, with signifi cantly increased cancer risk at high levels of SUA. Likewise, in accordance with some experimental evidence, among men and women elevated GGT increased cancer risk overall and for several lifestyle-related malignancies. On the basis of these fi ndings, and considering the routine measurement in clinical practice, SUA and GGT might function as a valuable marker to identify patients with an increased risk to develop malignant diseases.

Serum uric acid levels and cancer mortality risk among males in a large general population-based cohort study

“…Based on the concentrations, some studies reported a U-shaped or J-shaped association between SUA and cancer mortality [ 3 , 24 , 25 ]. Kua et al [ 3 ] reported a U-shaped association between SUA and all-cause and cancer mortality, with a negative association between SUA levels and mortality when the SUA levels range from 0.3 to 0.4 mmol/l, which is equivalent to 5–6.9 mg/dl The vast majority of our population (59.1 %) had SUA levels between 5 and 6.9 mg/dl; thus, our negative association is in accordance with the results of Kua et al [ 3 ].…”

Lifestyle-related biomarkers and endometrial cancer survival: Elevated gamma-glutamyltransferase as an important risk factor

“…VHM&PP is one of the world's largest population-based risk factor surveillance programmes [20] and several general relationships of body mass index, glucose, triglycerides, cholesterol, GGT, and serum uric acid with cancer have already been reported [18,[21][22][23][24]. Since 1985 all adults in the region were invited to participate and repeated routine health examinations are subsequently performed by trained physicians.…”

“…Also, experimental models have elucidated the ability of cellular GGT to modulate crucial redox-sensitive functions, such as antioxidant/ antitoxic defences and cellular proliferative/apoptotic balance, and its role in tumour progression, invasion, and drug resistance has been proposed [9][10][11]. Furthermore, the impact of GGT on the incidence, metastasis, and recurrence of various malignancies is increasingly becoming evident [18,28,29].…”

“…appeared to be independent factors involved in cancer incidence, with elevated levels related to higher cancer risks [18]. The potential effect of lifestyle-related biomarkers, particularly on the survival of endometrial cancer patients, is still unclear.…”