Is there a relationship between serum uric acid and prostate-specific antigen in middle-aged and elderly Chinese men?

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.