Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.
Front Public Health. 2022 May 31;10:906760. doi: 10.3389/fpubh.2022.906760. eCollection 2022.
The relationship between uric acid (UA) and diabetic retinopathy (DR) remains ambiguous, and the results of current studies on the UA levels in patients with DR are conflicting. A meta-analysis was performed to provide a better understanding of the relationship between UA levels and DR.
PubMed, Web of Science, Embase, and the Cochrane Library databases were searched until December 11, 2021 to identify eligible studies, that compared the UA levels of the case group (patients with DR) and control group (controls with diabetes and healthy participants). The weighted mean difference (WMD) with a 95% confidence interval (CI) was used to evaluate the difference in UA levels between the case and control groups.
Twenty-one studies involving 4,340 patients with DR and 8,595 controls (8,029 controls with diabetes and 566 healthy participants) were included in this meta-analysis. We found that patients with DR had significantly higher UA levels than those in the controls with diabetes (WMD = 36.28; 95% CI: 15.68, 56.89; < 0.001) and healthy participants (WMD = 70.80; 95% CI: 19.85, 121.75; = 0.006). There was an obvious heterogeneity among the 21 studies ( = 97%, < 0.001). Subgroup analyses of different phases of DR showed that UA levels were significantly increased in participants with proliferative diabetic retinopathy (PDR) (WMD = 46.57; 95% CI: 28.51, 64.63; < 0.001) than in controls with diabetes; however, the difference is not statistically significant when comparing UA levels in patients with non-proliferative diabetic retinopathy (NPDR) and controls with diabetes (WMD = 22.50; 95% CI: -6.07, 51.08; = 0.120). In addition, UA levels were higher in participants with a body mass index (BMI) ≥25.0 kg/m and over 15 years of diabetes. Univariate meta-regression analysis revealed that BMI ( = 0.007, Adj = 40.12%) and fasting blood glucose (FBG) ( = 0.040, Adj = 29.72%) contributed to between-study heterogeneity.
In conclusion, our study provides evidence that UA levels are higher in patients with DR than those in the controls, but this difference is not statistically significant in the early phases. UA might be a potential biomarker for identifying disease severity in patients with DR, rather than predicting the onset of DR among patients with diabetes. However, more prospective and high-quality clinical evidence is required to confirm these present findings.
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=297708.
尿酸（UA）与糖尿病视网膜病变（DR）之间的关系仍不明确，目前关于 DR 患者 UA 水平的研究结果存在冲突。本研究进行了荟萃分析，以期更好地了解 UA 水平与 DR 之间的关系。
检索 PubMed、Web of Science、Embase 和 Cochrane Library 数据库，截至 2021 年 12 月 11 日，以确定比较病例组（DR 患者）和对照组（糖尿病伴或不伴 DR 的患者和健康参与者）UA 水平的研究。采用均数差值（WMD）及其 95%置信区间（CI）评估病例组与对照组之间 UA 水平的差异。
本荟萃分析纳入了 21 项研究，共涉及 4340 例 DR 患者和 8595 例对照组（8029 例糖尿病伴或不伴 DR 的患者和 566 例健康参与者）。我们发现，DR 患者的 UA 水平明显高于糖尿病对照组（WMD=36.28；95%CI：15.68，56.89； < 0.001）和健康对照组（WMD=70.80；95%CI：19.85，121.75； = 0.006）。21 项研究存在明显的异质性（ = 97%， < 0.001）。DR 不同分期的亚组分析显示，增殖性糖尿病视网膜病变（PDR）患者的 UA 水平明显高于糖尿病对照组（WMD=46.57；95%CI：28.51，64.63； < 0.001）；而非增殖性糖尿病视网膜病变（NPDR）患者与糖尿病对照组之间的 UA 水平差异无统计学意义（WMD=22.50；95%CI：-6.07，51.08； = 0.120）。此外，UA 水平在 BMI≥25.0 kg/m 2 和糖尿病病程>15 年的患者中更高。单变量荟萃回归分析显示，BMI（ = 0.007，Adj = 40.12%）和空腹血糖（FBG）（ = 0.040，Adj = 29.72%）是造成异质性的原因。
综上所述，本研究表明，DR 患者的 UA 水平高于对照组，但在疾病早期，这种差异无统计学意义。UA 可能是一种潜在的生物标志物，可用于识别 DR 患者的疾病严重程度，而不是预测糖尿病患者 DR 的发病。然而，需要更多前瞻性和高质量的临床证据来证实这些发现。
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=297708.
