Uric acid and related disorders in the risk of pancreatic diseases: A UK Biobank prospective study.

[BACKGROUND] Pancreatic diseases, such as acute pancreatitis (AP), chronic pancreatitis (CP), and pancreatic cancer (PC) present major clinical challenges with significant health impacts. Serum uric acid (SUA), resulting from purine metabolism, is a significant biomarker reflecting metabolic health. Defined as SUA >7.0 mg/dL, hyperuricemia (HUA) is associated with gout, renal dysfunction, and increased cardiometabolic risk. SUA triggers inflammation and oxidative stress, contributing to pancreatic damage and cancer pathogenesis. This study represents the first European cohort linking uric acid (UA) disorders to pancreatic disease risk.

[METHOD] This prospective cohort study analyzed 363,778 UK Biobank participants over a median follow-up of 14.2 years, identifying 1951 AP, 474 CP, and 2107 PC cases. We analyzed the association between UA disorders and pancreatitis risk using Cox regression, reporting hazard ratios (HR) with 95 % confidence intervals (CI). Cox models evaluated SUA disorders' links to pancreatic diseases (AP, CP, PC), with full adjustment. Both categorical and continuous variables were employed in the Cox analysis, while categorical variables were utilized for the Kaplan-Meier (KM) curves.

[RESULT] For each 1 mg/dL increase in SUA, the risk of AP was significantly increased: HR = 1.062 (95 % CI: 1.020-1.105; P = 0.0036) in the overall population; HR = 1.164 (95 % CI: 1.019-1.330; P = 0.0254) in individuals with HUA; and HR = 1.478 (95 % CI: 1.361-2.913; P = 0.0005) in individuals with gout. Findings were robust in subgroup analyses and after excluding pancreatic disease cases within 2 years of HUA and gout diagnosis.

[CONCLUSION] Our study clarifies the role of SUA in pancreatic health and identifies that individuals with HUA or gout may benefit from pancreatic disease screening.