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...

Full description

Saved in:
Bibliographic Details
Main Authors: Jong-Won Shin, Thien-Minh Nguyen, Sun-Ha Jee
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Antioxidants
Subjects:
Online Access:https://www.mdpi.com/2076-3921/14/5/584
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849711293908385792
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
work_keys_str_mv AT jongwonshin associationbetweencreatinineandlungcancerriskinmensmokersacomparativeanalysiswithantioxidantbiomarkersfromthekcpsiicohort
AT thienminhnguyen associationbetweencreatinineandlungcancerriskinmensmokersacomparativeanalysiswithantioxidantbiomarkersfromthekcpsiicohort
AT sunhajee associationbetweencreatinineandlungcancerriskinmensmokersacomparativeanalysiswithantioxidantbiomarkersfromthekcpsiicohort