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Review
. 2020 Jul 9:2020:5470739.
doi: 10.1155/2020/5470739. eCollection 2020.

Diabetes Mellitus Is Associated with a Lower Risk of Gout: A Meta-Analysis of Observational Studies

Xiaoli Li  1   2   3 , Lianju Li  1 , Yuling Xing  2   3 , Tiantian Cheng  3 , Shaohui Ren  4 , Huijuan Ma  2   3   5
Affiliations
Review

Diabetes Mellitus Is Associated with a Lower Risk of Gout: A Meta-Analysis of Observational Studies

Xiaoli Li et al. J Diabetes Res. .

Abstract

Aims: Although several epidemiological studies have investigated the relationship between diabetes mellitus (DM) and the risk of gout, the results are inconsistent. Therefore, we systematically retrospected available observational studies to clarify the impact of DM on the risk of gout.

Methods: Embase, PubMed, Cochrane Library, Scopus, Web of Science, and China National Knowledge Infrastructure were searched for relevant articles from inception to 2 March 2020. The quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. The multivariate adjusted relative risks (aRR) and corresponding 95% confidence intervals (CI) were pooled based on a random-effect model. Cochran's Q test and I 2 were used to evaluate heterogeneity.

Results: Five studies involving 863,755 participants were included in our meta-analysis. DM was associated with a lower risk of gout (aRR: 0.66; 95% CI: 0.59 to 0.73) but had a high heterogeneity (I 2 = 89.2%). Metaregression analysis revealed that the types of DM were the source of heterogeneity. Subgroup analysis by types of DM showed that the risk of gout was significantly lower in type 1 DM (T1DM) (aRR: 0.42; 95% CI: 0.28 to 0.63) than in type 2 DM (T2DM) (aRR: 0.72; 95% CI: 0.70 to 0.74). Furthermore, when stratified according to gender in DM, sex-specific association was found. The inverse association was observed in males only (aRR: 0.57; 95% CI: 0.43 to 0.77) and not in females (aRR: 0.96; 95% CI: 0.87 to 1.05). Further stratified based on glycated hemoglobin (HbA1c) levels in DM, raised A1C levels were associated with a reduced risk of gout in patients with DM.

Conclusions: This meta-analysis indicated that DM was related to a lower risk of gout, and the protective effect of DM on the risk of gout was stronger in males, T1DM, or DM with high HbA1c levels. However, more prospective cohort studies are required to confirm these results.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart of literature selection. CNKI: China National Knowledge Infrastructure; DM: diabetes mellitus.
Figure 2
Figure 2
Forest plot of the risk of gout in patients with DM compared with controls. DM: diabetes mellitus; RR: relative risk; CI: confidence interval.
Figure 3
Figure 3
Subgroup analysis of the risk of gout in individuals with DM: grouped by types of DM. DM: diabetes mellitus; T2DM: type 2 diabetes mellitus; T1DM: type 1 diabetes mellitus; RR: relative risk; CI: confidence interval.
Figure 4
Figure 4
Sex-specific analysis of the risk of gout in individuals with DM. RR: relative risk; CI: confidence interval.
Figure 5
Figure 5
Forest plot of association between HbA1c level and the risk of gout. HbA1c: glycated hemoglobin; RR: relative risk; CI: confidence interval.
See this image and copyright information in PMC

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