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A systematic review and meta-analysis of the hyperuricemia risk from certain metals

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Abstract

The relationship between exposure to certain metals and the risk of hyperuricemia (HUA) has biological plausibility, yet prior studies have presented inconsistent findings. We aim to clarify the relationship between exposure to certain metals and HUA using a systematic review and meta-analysis approach. We searched the Web of Science, Embase, MEDLINE, Pubmed, Corchrane and China National Knowledge Infrastructure databases from inception through December, 2021 in order to identify studies that assessed the relationships between metals and the risk of HUA. Data were pooled by random-effects models and expressed as pooled odds ratios (OR) and 95% confidence intervals (CIs). The risk of bias was assessed using a tool from Agency for Healthcare Research and Quality (AHRQ). Twenty eligible articles (nineteen cross-sectional studies and one cohort) were included in our analysis, involving 63,283 participants in total. The studies showed that arsenic (pooled OR = 1.702, 95% CI: 1.44, 2.011; n = 6, I2 = 29.5%), calcium (pooled OR = 1.765, 1.111, 2.804; 4, 82.3%), cadmium (pooled OR = 1.199,1.020, 1.410; 11, 38.5%) and lead (pooled OR = 1.564,1.205, 2.030; 11, 72.9%) exposure were, all linked to an increased risk of HUA. Exposure to molybdenum (pooled OR = 0.804, 0.724, 0.975, 3, 0%) was linked to a decreased risk of HUA, however. Exposure to arsenic, calcium, cadmium and lead is associated with an increased risk of HUA. Molybdenum exposure was associated with a decreased prevalence of HUA; however, aluminum, cobalt, copper, iron, magnesium, manganese, mercury, selenium, thallium and zinc are not associated with HUA risk. Further experimental studies are warranted to decipher the mechanisms by which exposure to the above metals affect HUA risk. The findings reinforced the importance of metals in the HUA risk, and provided a reference for legislation to prevent HUA and protect people's health.

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Data availability

All data generated or analyzed during this study can be found at the 3 databases (PubMed, EMBASE, Corchrane and China National Knowledge Infrastructure).

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Acknowledgements

The authors thank AiMi Academic Services (www.aimieditor.com) for the English language editing and review services.

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  1. Min Leng

    Present address: Department of Cardiovascular Medicine, The Affiliated Hospital of Qingdao University, 1677 Wutaishan Road, Qingdao, Shandong Province, China

Authors and Affiliations

  1. Department of Nursing, Qingdao University of Nursing Academy, 308 Ningxia Road, Qingdao, Shandong Province, China

    Tingting Gu & Rongchun Hou

  2. Department of Cardiovascular Medicine, The Affiliated Hospital of Qingdao University, 1677 Wutaishan Road, Qingdao, Shandong Province, China

    Guorong Cao, Nannan Zhang & Ting Xue

  3. The Affiliated Suqian First People‘s Hospital of Nanjing Medical University, Suqian, Jiangsu, China

    Miao Luo

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Contributions

Tingting Gu conceived the study design; Tingting Gu, Guorong Cao, Nannan Zhang, Miao Luo, Ting Xue and Rongchun Hou searched and selected the articles, extracted, analyzed and interpreted the data; Tingting Gu and Guorong Cao drafted the manuscript; Min Leng revised the manuscript critically for important intellectual content. All authors approved the final version of the manuscript and agreed to be responsible for all aspects of the work. The authors had no conflicts of interest.

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Appendix

Appendix

Tables 2 and 3; Figs. 5, 6 and 7

Table 2 Quality assessment of the cross-sectional studies included in the systematic review and meta-analysis
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Table 3 Association between certain metals and risk of HUA in subgroup meta-analyses
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Fig. 5
figure 5

Subgroup analysis based on both gender

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Fig. 6
figure 6

Subgroup analysis based on the single country

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Fig. 7
figure 7

Trim-and-fill analysis estimating the number of possible missing studies for the association between metals and HUA. The squares represent the possible missing studies

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Gu, T., Cao, G., Luo, M. et al. A systematic review and meta-analysis of the hyperuricemia risk from certain metals. Clin Rheumatol 41, 3641–3660 (2022). https://doi.org/10.1007/s10067-022-06362-1

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