Prevalence and risk factors of hyperuricemia and gout in patients with type 2 diabetes mellitus: a systematic review and meta-analysis.

BACKGROUND

Type 2 diabetes mellitus (T2DM) is one of the most common metabolic diseases worldwide. hyperuricemia (HUA) and gout are common comorbidities in T2DM patients. This systematic review and meta-analysis aimed to estimate the global prevalence of HUA and gout in patients with T2DM and to identify associated risk factors.

METHODS

A systematic search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library to identify observational studies on HUA/gout in patients with T2DM. Two researchers independently performed literature screening, data extraction, and quality assessment. The quality of included studies was assessed using the Newcastle-Ottawa Scale and the AHRQ Scale. Statistical analyses were performed using Stata 12.0 software. A random-effects model was used to pool prevalence estimates, with subgroup and sensitivity analyses to explore heterogeneity. Publication bias was assessed using Egger's test.

RESULTS

Eighty-seven studies comprising 977,573 T2DM patients were included. The pooled prevalence of HUA was 22.0% (95% CI: 20.1-24.0%, 95% PI: 4.9-39.2%), and that of gout was 6.0% (95% CI: 4.4-7.5%). Meta-regression identified geographic region as a significant source of heterogeneity, with the highest HUA prevalence in Africa and North America, and lowest in South America. Risk factors for HUA included impaired renal function, obesity, dyslipidemia, hypertension, metabolic syndrome, and alcohol consumption, while elevated HbA1c was inversely associated with HUA. Male sex was a significant risk factor for gout.

CONCLUSION

The prevalence of HUA and gout is significantly higher in patients with T2DM than in the general population. Impaired renal function, obesity, dyslipidemia, hypertension, MetS, and alcohol consumption are the primary risk factors. Routine serum uric acid monitoring and early screening for high-risk individuals should be incorporated into the clinical management of T2DM.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261359583, identifier CRD420261359583.