血清尿酸水平与 2 型糖尿病患者糖尿病周围神经病变的关系：系统评价和荟萃分析。
Association between serum uric acid levels and diabetic peripheral neuropathy in type 2 diabetes: a systematic review and meta-analysis.
机构信息
Department of Rheumatology, Wangjing Hospital, China Academy of Chinese Medicine Science, Beijing, China.
Robotics Movement Department, Amazon, Boston, MA, United States.
出版信息
Front Endocrinol (Lausanne). 2024 Jul 12;15:1416311. doi: 10.3389/fendo.2024.1416311. eCollection 2024.
BACKGROUND
The evidence supporting a connection between elevated serum uric acid (SUA) levels and diabetic peripheral neuropathy (DPN) is controversial. The present study performed a comprehensive evaluation of this correlation by conducting a systematic review and meta-analysis of relevant research.
METHOD
PubMed, Web of Science (WOS), Embase, and the Cochrane Library were searched for published literature from the establishment of each database to January 8, 2024. In total, 5 cohort studies and 15 cross-sectional studies were included, and 2 researchers independently screened and extracted relevant data. R 4.3.0 was used to evaluate the included literature. The present meta-analysis evaluated the relationship between SUA levels and the risk of DPN in type 2 diabetes (T2DM) by calculating the ratio of means (RoM) and 95% confidence intervals (CIs) using the method reported by JO Friedrich, and it also analyzed continuous outcome measures using standardized mean differences (SMDs) and 95% CIs to compare SUA levels between DPN and non-DPN groups. Funnel plot and Egger's test were used to assess publication bias. Sensitivity analysis was conducted by sequentially removing each study one-by-one.
RESULTS
The meta-analysis included 20 studies, with 12,952 T2DM patients with DPN and 16,246 T2DM patients without DPN. There was a significant correlation between SUA levels and the risk of developing DPN [odds ratio (OR) = 1.23; 95% CI: 1.07-1.41; p = 0.001]. Additionally, individuals with DPN had higher levels of SUA compared to those without DPN (SMD = 0.4; 95% CI: -0.11-0.91; < 0.01).
CONCLUSION
T2DM patients with DPN have significantly elevated SUA levels, which correlate with a heightened risk of peripheral neuropathy. Hyperuricemia (HUA) may be a risk indicator for assessing the risk of developing DPN in T2DM patients.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/PROSPERO, identifier CRD42024500373.
背景
血清尿酸（SUA）水平升高与糖尿病周围神经病变（DPN）之间的关联证据存在争议。本研究通过对相关研究进行系统评价和荟萃分析，对这种相关性进行了全面评估。
方法
检索了 PubMed、Web of Science（WOS）、Embase 和 Cochrane Library 从各数据库建立到 2024 年 1 月 8 日发表的文献。共纳入 5 项队列研究和 15 项横断面研究，由 2 名研究人员独立筛选和提取相关数据。使用 R 4.3.0 评估纳入文献。本荟萃分析通过计算报告的 Jo Friedrich 方法的均值比（RoM）和 95%置信区间（CI）来评估 SUA 水平与 2 型糖尿病（T2DM）患者 DPN 风险之间的关系，并用标准化均数差（SMD）和 95%CI 比较 DPN 和非 DPN 组之间的 SUA 水平，用于连续结局测量。采用漏斗图和 Egger 检验评估发表偏倚。通过依次逐个删除每项研究进行敏感性分析。
结果
荟萃分析纳入了 20 项研究，共纳入了 12952 例 T2DM 合并 DPN 患者和 16246 例 T2DM 无 DPN 患者。SUA 水平与 DPN 发病风险之间存在显著相关性[比值比（OR）=1.23；95%CI：1.07-1.41；p=0.001]。此外，与无 DPN 患者相比，有 DPN 患者的 SUA 水平更高（SMD=0.4；95%CI：-0.11-0.91；<0.01）。
结论
T2DM 合并 DPN 患者的 SUA 水平显著升高，与外周神经病变的风险增加相关。高尿酸血症（HUA）可能是评估 T2DM 患者发生 DPN 风险的一个危险因素。
系统评价注册
https://www.crd.york.ac.uk/PROSPERO，标识符 CRD42024500373。
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