Pan Zhe, Huang Mingkai, Fang Ming, Xie Xu, Huang Ze
The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, 511436, PR China.
Endocrine. 2020 Aug;69(2):286-293. doi: 10.1007/s12020-020-02281-w. Epub 2020 Apr 13.
There are multiple risk factors have different influence on the disorder. However, the risk of hyperuricemia and gout in different socioeconomic status (SES) remains unclear. Recent studies provided results that contradicted to former studies. We aimed to perform a systematic review and meta-analysis of evidence to date and to assess the associations between SES and hyperuricemia or gout worldwide.
We searched MEDLINE, EMBASE, and Web of Science databases to identify studies that investigated the association between SES and hyperuricemia or gout. Studies that presented risk estimates were included. We conducted meta-analyses using random effects to combine unadjusted and adjusted effect estimates.
Data from 14 studies were included, 9 provided data about hyperuricemia and 5 provided gout. Overall, there was an association between higher educational level and a higher risk of hyperuricemia (POR = 1.38, 95% CI 1.04-1.73) but lower risk of gout (POR = 0.59, 95% CI 0.47-0.71). Subgroup meta-analysis showed no association between all SES measures and hyperuricemia or gout in males or females.
Our study suggested that the associations between SES and hyperuricemia gout are different. Higher educational level was related to a higher risk of hyperuricemia but lower risk of gout. Given the limitations of our study, future studies are needed to investigate specific mechanisms underlying the relationship among SES differences in hyperuricemia and gout. Strategies to prevent and control SES inequalities in hyperuricemia and gout should be explored and adopted.
多种风险因素对该疾病有不同影响。然而,不同社会经济地位(SES)人群发生高尿酸血症和痛风的风险仍不明确。近期研究结果与之前的研究相互矛盾。我们旨在对现有证据进行系统综述和荟萃分析,以评估全球范围内SES与高尿酸血症或痛风之间的关联。
我们检索了MEDLINE、EMBASE和科学网数据库,以识别调查SES与高尿酸血症或痛风之间关联的研究。纳入呈现风险估计值的研究。我们使用随机效应模型进行荟萃分析,以合并未调整和调整后的效应估计值。
纳入了14项研究的数据,其中9项提供了有关高尿酸血症的数据,5项提供了痛风的数据。总体而言,受教育程度较高与高尿酸血症风险较高相关(比值比[POR]=1.38,95%置信区间[CI]为1.04-1.73),但与痛风风险较低相关(POR=0.59,95%CI为0.47-0.71)。亚组荟萃分析显示,在男性或女性中,所有SES指标与高尿酸血症或痛风之间均无关联。
我们的研究表明,SES与高尿酸血症和痛风之间的关联有所不同。受教育程度较高与高尿酸血症风险较高相关,但与痛风风险较低相关。鉴于我们研究的局限性,则需要未来的研究来探讨SES差异与高尿酸血症和痛风之间关系的具体机制。应探索并采用预防和控制高尿酸血症和痛风中SES不平等的策略。