Ponvilawan Ben, Charoenngam Nipith, Ungprasert Patompong
Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Int J Rheum Dis. 2020 Feb;23(2):174-180. doi: 10.1111/1756-185X.13740. Epub 2019 Nov 6.
Studies have suggested that primary hyperparathyroidism could be a risk factor for hyperuricemia although the results were not consistent across the studies. This systematic review and meta-analysis was performed in order to identify all available studies and summarize their results together.
A systematic review was performed using EMBASE and MEDLINE from inception to August 2018 to identify all cohort studies that consisted of 2 cohorts, a cohort of patients with primary hyperparathyroidism and a cohort of individuals without hyperparathyroidism. Eligible studies had to provide data on mean serum uric acid level and standard deviation of both cohorts, which would be extracted to calculate mean difference (MD). Pooled MD was then calculated by combining MDs of each study using a random-effects model. Funnel plot was used for evaluation for publication bias.
A total of 9 cohort studies met the inclusion criteria and were included into the meta-analysis. The pooled analysis found that patients with primary hyperparathyroidism had a significantly higher level of serum uric acid than individuals without hyperparathyroidism with the pooled MD of 65.00 μmol/L (95% CI 37.74-92.25). The statistical heterogeneity was high with I of 90%. The funnel plot was relatively symmetric and did not provide evidence for publication bias.
Patients with primary hyperparathyroidism had a significantly higher level of serum uric acid compared to individuals without hyperparathyroidism.
研究表明，原发性甲状旁腺功能亢进可能是高尿酸血症的一个危险因素，尽管各研究结果并不一致。进行这项系统评价和荟萃分析是为了找出所有可用研究并汇总其结果。
使用EMBASE和MEDLINE进行系统评价，检索时间从数据库建立至2018年8月，以找出所有队列研究，这些研究包括两个队列，一个是原发性甲状旁腺功能亢进患者队列，另一个是无甲状旁腺功能亢进个体队列。符合条件的研究必须提供两个队列的血清尿酸平均水平和标准差数据，将提取这些数据以计算平均差值（MD）。然后使用随机效应模型合并每项研究的MD来计算合并MD。采用漏斗图评估发表偏倚。
共有9项队列研究符合纳入标准并被纳入荟萃分析。汇总分析发现，原发性甲状旁腺功能亢进患者的血清尿酸水平显著高于无甲状旁腺功能亢进的个体，合并MD为65.00μmol/L（95%CI 37.74 - 92.25）。统计异质性较高，I²为90%。漏斗图相对对称，未提供发表偏倚的证据。
与无甲状旁腺功能亢进的个体相比，原发性甲状旁腺功能亢进患者的血清尿酸水平显著更高。
