多项流行病学研究调查了白蛋白、胆红素和尿酸 (UA) 的循环水平与癌症风险的关系；然而，他们提供的证据却模棱两可。在这项前瞻性病例队列研究中，我们旨在探讨血浆白蛋白、胆红素和尿酸水平与癌症发病率的关系。我们测量了 3,584 例病例和 4,270 名随机选择的参与者的血浆白蛋白、胆红素和 UA 水平，并研究了它们与癌症发病率的关系，中位随访时间为 15.8 年。对于白蛋白，最高四分位数 (Q4) 与最低四分位数 (Q1) 的总癌症调整后风险比 (HR) 和 95% 置信区间 (CI) 为 0.77（95% CI：0.67-0.90，趋势 P：<0.001） 。在排除血浆白蛋白水平较低的肝癌病例后，这种关联性减弱。排除肝癌后，血浆胆红素水平与肝癌呈正相关，但与总癌症呈负相关，调整后的 HR Q4 与 Q1 为 0.86（95% CI：0.74-0.99，趋势 P = 0.015）。血浆UA水平与总癌症风险没有剂量反应性相关。排除肝癌后，较高的血浆胆红素水平与总癌症风险降低相关，这可能归因于胆红素的抗氧化特性。© 作者 2024。由牛津大学出版社代表约翰·霍普金斯大学彭博学院出版公共卫生。版权所有。如需权限，请发送电子邮件至：journals.permissions@oup.com。

Several epidemiological studies have investigated the circulating levels of albumin, bilirubin, and uric acid (UA) in relation to cancer risk; however, they have provided equivocal evidence. In this prospective case-cohort study, we aimed to explore the association of plasma albumin, bilirubin, and UA levels with cancer incidence. We measured the plasma levels of albumin, bilirubin, and UA and investigated their association with cancer incidence in 3,584 cases and 4,270 randomly selected participants with a median follow-up of 15.8 years. The adjusted hazard ratios (HR) and 95% confidence intervals (CI) of total cancer for the highest (Q4) versus lowest quartile (Q1) was 0.77 (95% CI: 0.67-0.90, P for trend: <0.001) for albumin. This association was attenuated after excluding liver cancer cases with lower plasma albumin levels. Plasma bilirubin levels were positively related to liver cancer but inversely to total cancer after excluding liver cancer with adjusted HR Q4 vs. Q1 of 0.86 (95% CI: 0.74-0.99, P for trend = 0.015). Plasma UA levels were not dose-responsively associated with total cancer risk. Higher plasma bilirubin levels were associated with a decreased risk of total cancer after excluding liver cancer, which is likely attributed to the antioxidant properties of bilirubin.© The Author(s) 2024. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.