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Meta-Analysis
. 2016 Jan 27:6:19520.
doi: 10.1038/srep19520.

Hyperuricemia and the risk for coronary heart disease morbidity and mortality a systematic review and dose-response meta-analysis

Min Li  1 , Xiaolan Hu  2 , Yingli Fan  3 , Kun Li  1 , Xiaowei Zhang  1 , Wenshang Hou  1 , Zhenyu Tang  1
Affiliations
Meta-Analysis

Hyperuricemia and the risk for coronary heart disease morbidity and mortality a systematic review and dose-response meta-analysis

Min Li et al. Sci Rep. .

Abstract

Considerable controversy exists regarding the association between hyperuricemia and coronary heart disease (CHD). Therefore, we performed a systematic review and dose-response meta-analysis of prospective studies to examine the controversy. Prospective cohort studies with relative risks (RRs) and 95% confidence intervals (CIs) for CHD according to serum uric acid levels in adults were eligible. A random-effects model was used to compute the pooled risk estimate. The search yielded 29 prospective cohort studies (n = 958410 participants). Hyperuricemia was associated with increased risk of CHD morbidity (adjusted RR 1.13; 95% CI 1.05 to 1.21) and mortality (adjusted RR 1.27; 95% CI 1.16 to 1.39). For each increase of 1 mg/dl in uric acid level, the pooled multivariate RR of CHD mortality was 1.13 (95% CI 1.06 to 1.20). Dose-response analysis indicated that the combined RR of CHD mortality for an increase of 1 mg uric acid level per dl was 1.02 (95% CI 0.84 to 1.24) without heterogeneity among males (P = 0.879, I(2) = 0%) and 2.44 (95% CI 1.69 to 3.54) without heterogeneity among females (P = 0.526, I(2) = 0%). The increased risk of CHD associated with hyperuricemia was consistent across most subgroups. Hyperuricemia may increase the risk of CHD events, particularly CHD mortality in females.

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Figures

Figure 1
Figure 1
Process of literature search and study selection. CHD: coronary heart disease.
Figure 2
Figure 2
Random effects analysis of multivariate risks of coronary heart disease morbidity associated with hyperuricemia. F: female, M: male, RR: relative risk. CI: confidence interval.
Figure 3
Figure 3
Random effects analysis of multivariate risks of coronary heart disease mortality associated with hyperuricemia
Figure 4
Figure 4
Random effects analysis of multivariate risks of coronary heart disease mortality associated with an increase of 1 mg/dl in serum uric acid level. Combined: studies which did not have sex specific data
See this image and copyright information in PMC

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