Association of Serum Uric Acid Levels in Psoriasis: A Systematic Review and Meta-Analysis

Abstract

High levels of serum uric acid (SUAC) are frequently detected in patients with psoriasis. However, the relationship between psoriasis and hyperuricemia remains unknown. Here we conducted a meta-analysis to identify the SUAC levels in subjects with psoriasis and to determine whether there is an associated risk between psoriasis and hyperuricemia.A comprehensive search of the literature from January 1980 to November 2014 across 7 databases (MEDLINE, Embase, Cochrane Central Register, and 4 Chinese databases) was conducted to determine whether there is an associated risk between psoriasis and hyperuricemia.Among the 170 identified reports, 14 observational studies were included in this meta-analysis. We found a significant higher SUAC level (MD 0.68, 95% CI 0.26-1.09; P = 0.002) in patients with psoriasis in Western Europe, but no significant differences were found between the East Asia and India subgroup (MD 1.22, 95% CI -0.13-2.56; P = 0.08) or the Middle East subgroup (MD 0.48, 95% CI -0.49-1.44; P = 0.33). Similar results were obtained from the meta-analysis of SUAC levels in subjects with severe psoriasis.Our meta-analysis showed that the correlation between psoriasis and hyperuricemia was either ethnicity- or region-dependent and that patients with psoriasis in Western Europe were more likely to have hyperuricemia.

FIGURE 1

Literature search and study selection flowchart.

FIGURE 2

Meta-analysis of the impact on (SUAC of patients with psoriasis compared with controls. The MD in SUAC levels of patients with psoriasis compared with controls. The point estimate (center of each green square) and statistical size (proportional area of the square) are represented. Horizontal lines indicate 95% confidence intervals. The subtotal and total MD (diamond) were calculated using a random-effects model. MD = mean difference, SUAC = serum uric acid concentration.

FIGURE 3

Meta-analysis of the impact on SUAC of patients with severe psoriasis compared to controls. The MD in SUAC levels of patients with severe psoriasis compared to controls. The point estimate (center of each green square) and statistical size (proportional area of the square) are represented. Horizontal lines indicate 95% confidence intervals. The subtotal and total MD (diamond) were calculated using a random-effects model. MD = mean difference, SUAC = serum uric acid concentration.

FIGURE 4

Meta-analysis of the prevalence of hyperuricemia in patients with psoriasis compared to controls in Italy. RR for psoriasis in subjects with hyperuricemia compared with total subjects. The point estimate (center of each blue square) and statistical size (proportional area of the square) are represented. Horizontal lines indicate 95% confidence intervals. The pooled RR (diamond) was calculated using a fixed-effects model. RR = relative risk.