Castro Verônica Moreira Ferreira de, Melo Angelita Cristine de, Belo Vinícius Silva, Chaves Valéria Ernestânia
Laboratory of Physiology, Federal University of São João del-Rei, Divinópolis, Minas Gerais, Brazil.
Research Group on Epidemiology and Public Health, Federal University of São João del-Rei, Divinópolis, Minas Gerais, Brazil; Research Group on Clinical Pharmacy, Federal University of São João del-Rei, Divinópolis, Minas Gerais, Brazil.
Clin Biochem. 2017 Dec;50(18):1289-1297. doi: 10.1016/j.clinbiochem.2017.07.013. Epub 2017 Jul 25.
Although uric acid is not part of any definition of metabolic syndrome, a number of studies have shown strong associations between the concentration of uric acid and metabolic syndrome or its components. The purpose of this systematic review with meta-analysis was to evaluate, using prospective interventional studies, the effects of allopurinol therapy and uric acid normalization on serum concentrations of triacylglycerol, total-cholesterol, LDL-cholesterol and HDL-cholesterol in hyperuricemic subjects. A systematic search of the PubMed and Scopus databases was performed following the guidelines described in the PRISMA statement. Seven studies were included in the meta-analysis, including six randomized controlled trials and one controlled before-and-after study. Despite differences in the follow-up periods (4, 12 and 24weeks) and allopurinol dose (100-300mg/day), all the studies showed decreases in the mean serum uric acid level (95% confidence interval: -2.61 to -1.55 (4weeks), -2.94 to -1.09 (12weeks) and -2.59 to -1.22 (24weeks); p<0.05). However, no effect was observed based on differences in mean serum triacylglycerol and total- and LDL-cholesterol concentrations, independent of the follow-up period. Allopurinol therapy during weeks 4 and 12 induced a decrease in the mean HDL-cholesterol level (95% confidence interval: -7.22 to -0.47 (4weeks) and -7.18 to -0.32 (12weeks); p<0.05). This review suggests that allopurinol and uric acid normalization does not improve serum lipid levels, although larger and longer trials of higher quality are needed to confirm this.
尽管尿酸并非代谢综合征任何定义的一部分，但多项研究表明尿酸浓度与代谢综合征或其组分之间存在密切关联。本项进行了荟萃分析的系统评价旨在通过前瞻性干预研究，评估高尿酸血症患者中使用别嘌醇治疗及尿酸正常化对血清三酰甘油、总胆固醇、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇浓度的影响。按照PRISMA声明中所述的指南，对PubMed和Scopus数据库进行了系统检索。荟萃分析纳入了7项研究，包括6项随机对照试验和1项前后对照研究。尽管随访期（4周、12周和24周）和别嘌醇剂量（100 - 300mg/天）存在差异，但所有研究均显示平均血清尿酸水平下降（95%置信区间：4周时为-2.61至-1.55，12周时为-2.94至-1.09，24周时为-2.59至-1.22；p<0.05）。然而，无论随访期长短，平均血清三酰甘油、总胆固醇和低密度脂蛋白胆固醇浓度均未观察到差异。第4周和第12周期间的别嘌醇治疗导致平均高密度脂蛋白胆固醇水平下降（95%置信区间：4周时为-7.22至-0.47，12周时为-7.18至-0.32；p<0.05）。本综述表明，尽管需要更大规模、更长时间且质量更高的试验来证实，但别嘌醇及尿酸正常化并不能改善血脂水平。
