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Published on: October 23, 2020
Non-linear association between preoperative uric acid levels and female thyroid cancer risk
Shao-Kun Sun1,2, Liang Shen1,2, Li-Wen Zhu1,2
1Kunshan Clinical Innovation Research Center of Nantong University, Suzhou, Jiangsu, China.
Background:
Recent research has revealed a notable association between uric acid (UA) levels and the prognosis of several types of cancer. However, the association between thyroid cancer (TC) and UA remains underexplored. This study examined the association between UA levels and TC risk and identified the optimal predictive UA threshold.
Methods:
This study included 493 individuals with thyroid nodules who underwent surgery at the First People's Hospital of Kunshan from December 2018 to March 2024. UA levels were measured, and TC incidence was confirmed via postoperative pathology or fine-needle aspiration. We employed multivariate logistic regression and a two-piecewise linear regression model to assess the UA-TC association and its threshold effect, respectively, with a focus on females. Receiver operating characteristic (ROC) analysis was performed to assess the predictive utility of UA.
Results:
A positive correlation between UA levels and TC was observed. After adjusting for confounding factors, the odds ratio (OR) for TC at the highest UA levels was 3.52 (95% confidence interval (CI) 1.60-7.74) (p < 0.05). However, in the subgroup analysis by gender, no association was observed between UA and thyroid cancer after adjusting for all factors in the male group, whereas a significant difference was found in the female group (OR = 2.09, 95%CI 1.50-2.92). A non-linear relationship between UA and TC in the female was identified, with a UA level of 7.51 mg/dL serving as the optimal inflection point. Each 1-mg/dL increase in UA was associated with higher thyroid cancer odds (OR = 2.63, 95%CI 1.78-3.89) when the UA < 7.51 mg/dL in the female. ROC analysis revealed that the area under the curve (AUC) for UA combined with all other factors reached 0.946.
Conclusion:
The relationship between UA levels and TC in the female is non-linear. A positive relationship between UA levels and TC in the female was noted for UA concentrations below 7.51 mg/dL. The likelihood of TC peaked at 7.51 mg/dL UA and remained flat thereafter.
