Association Between Creatinine and Lung Cancer Risk in Men Smokers: A Comparative Analysis with Antioxidant Biomarkers from the KCPS-II Cohort
Bilirubin, albumin, and uric acid are established endogenous antioxidant biomarkers, whereas the antioxidant role of creatinine has not yet been fully clarified. As a byproduct of creatine metabolism, creatinine may reflect underlying metabolic activity and redox balance, particularly under conditio...
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MDPI AG
2025-05-01
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| Series: | Antioxidants |
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| Online Access: | https://www.mdpi.com/2076-3921/14/5/584 |
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| author | Jong-Won Shin Thien-Minh Nguyen Sun-Ha Jee |
| author_facet | Jong-Won Shin Thien-Minh Nguyen Sun-Ha Jee |
| author_sort | Jong-Won Shin |
| collection | DOAJ |
| description | Bilirubin, albumin, and uric acid are established endogenous antioxidant biomarkers, whereas the antioxidant role of creatinine has not yet been fully clarified. As a byproduct of creatine metabolism, creatinine may reflect underlying metabolic activity and redox balance, particularly under conditions of oxidative stress such as cigarette smoking. This study aimed to evaluate the associations between serum creatinine and other antioxidant biomarkers and lung cancer risk, stratified by smoking status. We analyzed 83,371 cancer-free men from the Korean Cancer Prevention Study II (KCPS II) cohort. During a mean follow-up of 13.5 years, 533 incident lung cancer cases were identified. Serum creatinine, total bilirubin, albumin, and uric acid were measured. Smoking status classified participants as never-, former, and ever-smokers, with ever-smokers including both current and former smokers. Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), stratified by smoking status. Biomarkers were also analyzed by quartiles and linear trends. A single standard deviation increase in serum creatinine was significantly and inversely associated with lung cancer risk among former smokers (HR: 0.774, 95% CI: 0.620 to 0.967) and ever-smokers (HR: 0.823, 95% CI: 0.716 to 0.945). Total bilirubin also showed significant inverse associations in former smokers (HR: 0.826, 95% CI: 0.705 to 0.967) and ever-smokers (HR: 0.785, 95% CI: 0.708 to 0.870). Albumin was inversely associated only with ever-smokers (HR: 0.878, 95% CI: 0.807 to 0.955), while uric acid showed inverse associations with both former smokers (HR: 0.832, 95% CI: 0.699 to 0.989) and ever-smokers (HR: 0.847, 95% CI: 0.760 to 0.944). None of the biomarkers showed significant associations among never-smokers. Serum creatinine and other endogenous antioxidant biomarkers were inversely associated with lung cancer risk, particularly in individuals with a history of smoking exposure. |
| format | Article |
| id | doaj-art-b262c99aae7740399513e9a160d48b49 |
| institution | DOAJ |
| issn | 2076-3921 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antioxidants |
| spelling | doaj-art-b262c99aae7740399513e9a160d48b492025-08-20T03:14:39ZengMDPI AGAntioxidants2076-39212025-05-0114558410.3390/antiox14050584Association Between Creatinine and Lung Cancer Risk in Men Smokers: A Comparative Analysis with Antioxidant Biomarkers from the KCPS-II CohortJong-Won Shin0Thien-Minh Nguyen1Sun-Ha Jee2Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of KoreaDepartment of Epidemiology and Health Promotion, Institute for Health Promotion, School of Public Health, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03772, Republic of KoreaDepartment of Epidemiology and Health Promotion, Institute for Health Promotion, School of Public Health, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03772, Republic of KoreaBilirubin, albumin, and uric acid are established endogenous antioxidant biomarkers, whereas the antioxidant role of creatinine has not yet been fully clarified. As a byproduct of creatine metabolism, creatinine may reflect underlying metabolic activity and redox balance, particularly under conditions of oxidative stress such as cigarette smoking. This study aimed to evaluate the associations between serum creatinine and other antioxidant biomarkers and lung cancer risk, stratified by smoking status. We analyzed 83,371 cancer-free men from the Korean Cancer Prevention Study II (KCPS II) cohort. During a mean follow-up of 13.5 years, 533 incident lung cancer cases were identified. Serum creatinine, total bilirubin, albumin, and uric acid were measured. Smoking status classified participants as never-, former, and ever-smokers, with ever-smokers including both current and former smokers. Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), stratified by smoking status. Biomarkers were also analyzed by quartiles and linear trends. A single standard deviation increase in serum creatinine was significantly and inversely associated with lung cancer risk among former smokers (HR: 0.774, 95% CI: 0.620 to 0.967) and ever-smokers (HR: 0.823, 95% CI: 0.716 to 0.945). Total bilirubin also showed significant inverse associations in former smokers (HR: 0.826, 95% CI: 0.705 to 0.967) and ever-smokers (HR: 0.785, 95% CI: 0.708 to 0.870). Albumin was inversely associated only with ever-smokers (HR: 0.878, 95% CI: 0.807 to 0.955), while uric acid showed inverse associations with both former smokers (HR: 0.832, 95% CI: 0.699 to 0.989) and ever-smokers (HR: 0.847, 95% CI: 0.760 to 0.944). None of the biomarkers showed significant associations among never-smokers. Serum creatinine and other endogenous antioxidant biomarkers were inversely associated with lung cancer risk, particularly in individuals with a history of smoking exposure.https://www.mdpi.com/2076-3921/14/5/584creatinineantioxidantslung neoplasmssmokingbiomarkers |
| spellingShingle | Jong-Won Shin Thien-Minh Nguyen Sun-Ha Jee Association Between Creatinine and Lung Cancer Risk in Men Smokers: A Comparative Analysis with Antioxidant Biomarkers from the KCPS-II Cohort Antioxidants creatinine antioxidants lung neoplasms smoking biomarkers |
| title | Association Between Creatinine and Lung Cancer Risk in Men Smokers: A Comparative Analysis with Antioxidant Biomarkers from the KCPS-II Cohort |
| title_full | Association Between Creatinine and Lung Cancer Risk in Men Smokers: A Comparative Analysis with Antioxidant Biomarkers from the KCPS-II Cohort |
| title_fullStr | Association Between Creatinine and Lung Cancer Risk in Men Smokers: A Comparative Analysis with Antioxidant Biomarkers from the KCPS-II Cohort |
| title_full_unstemmed | Association Between Creatinine and Lung Cancer Risk in Men Smokers: A Comparative Analysis with Antioxidant Biomarkers from the KCPS-II Cohort |
| title_short | Association Between Creatinine and Lung Cancer Risk in Men Smokers: A Comparative Analysis with Antioxidant Biomarkers from the KCPS-II Cohort |
| title_sort | association between creatinine and lung cancer risk in men smokers a comparative analysis with antioxidant biomarkers from the kcps ii cohort |
| topic | creatinine antioxidants lung neoplasms smoking biomarkers |
| url | https://www.mdpi.com/2076-3921/14/5/584 |
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