OBJECTIVETo explore the association between serum uric acid (SUA) and all-cause mortality in men.

METHODSIn this prospective cohort study, data being used was derived from the Kailuan study cohort. A total of 81 110 male workers who had taken part in the Kailuan physical examination were enrolled. Subjects with previous myocardial infarction, stroke, cancer, eGFR < 30 ml/(min × 1.73 m(2)) accidental deaths and those ever used drugs that seemed to have showed an effect on blood uric acid, were excluded. All the information was gathered from a unified questionnaire, measured by blood biochemistry and with the mean period of follow up as (47.5 ± 4.3) months. Based on the 2006-2007 SUA value, observed objects were divided into five groups, with multivariate Cox proportional hazard regression analysis used to estimate the relationship between SUA and all-cause mortality in men.

RESULTS1) At the end of the follow-up period in 2010-2011, the number of deaths were 315, 278, 243, 292 and 341 among the different SUA quinte, with incidence rates of all-cause mortality as 2.43%, 2.36%, 1.96%, 2.42% and 2.92%, respectively. 2) Data from the Single factor Cox proportional hazard regression analysis showed that, when comparing with the third quinte, HR values of the all-cause mortality were 1.32 (1.11-1.56), 1.19 (1.00-1.41), 1.20 (1.01-1.43) and 1.41 (1.19-1.66) in other four groups, respectively. 3) When factors were adjusted for age, systolic blood pressure, diastolic blood pressure, body mass index, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low density lipoprotein cholesterol, fasting glucose, high-sensitivity C-reactive protein, smoking history and history of drinking, education, profession, economy, etc., results from the Multiple Cox proportional hazard regression analysis showed the HR values of the all-cause mortality were 1.26 (1.06-1.51), 1.20 (1.01-1.44), 1.25(1.05-1.49), 1.42 (1.19-1.68) in other four groups, respectively, comparing to the third quinte.

CONCLUSIONUsing SUA as the independent risk factor of all-cause mortality, the exceptional levels of SUA were associated with an increasing risk for all-cause mortality while the association of SUA with all-cause mortality appeared an "U" shaped curve.