Chronic Obstructive Pulmonary Disease is Associated with a Higher Level of Serum Uric Acid. A Systematic Review and Meta-Analysis

Abstract

Introduction: Recent studies have suggested that patients with chronic obstructive pulmonary disease (COPD) may have a higher level of serum uric acid compared with individuals without COPD, although the data are still limited. The current systematic review and meta-analysis was conducted to summarize all available data. Material and methods: A systematic review was performed using the MEDLINE and EMBASE databases from their inception to July 2019. Studies that were eligible for the meta-analysis must have consisted of two groups of participants, patients with COPD and individuals without COPD. The eligible studies must have reported either mean or median level of serum uric acid and its standard deviation (SD) or interquartile range of participants in both groups. Mean serum uric acid level and SD of participants in both groups were extracted from each study and the mean difference (MD) was calculated. Pooled MD was then computed by combining MDs of each study using random effects model. Results: A total of eight studies with 1,612 participants met the eligibility criteria and were included in the data analysis. The serum uric acid level among patients with COPD was significantly higher than individuals without COPD with the pooled MD of 0.91 mg/dL (95% CI: 0.45-1.38; I 2 = 89%). Conclusions: The current study found a significantly higher level of serum uric acid among patients with COPD than individuals without COPD.

Serum Uric Acid as a Potential Biomarker in Patients With Rheumatoid Arthritis-associated Interstitial Pneumonia (RA-ILD)

“…UA is an antioxidant that is remarkable in the airway mucous membrane, and its actual role, especially in the regulation of lung function, has attracted attention in various diseases [16,30]. The present study showed that the level of UA was signi cantly associated with RA and the presence of ILD in RA, and a higher UA level was measured in the serum of individuals with RA.…”

Betel Nut Chewing Was Associated with Obstructive Lung Disease in a Large Taiwanese Population Study

“…A meta-analysis by Wattanachayakul et al also found an average 1 mg/dl higher uric acid level in COPD patients than in healthy individuals, whereas Peioto et al observed a decrease in uric acid level in patients with a low purine diet [32]. These results suggest that hyperuricemia can result from increased purine catabolism due to tissue hypoxia in COPD patients [33] since tissue hypoxia can stimulate the biosynthesis of purine nucleotides [34,35]. Shaaban reported that modifications of purine with pyrazole moiety resulted in antioxidant activity and that this had potential in anticancer therapy [36].…”

“…Shaaban reported that modifications of purine with pyrazole moiety resulted in antioxidant activity and that this had potential in anticancer therapy [36]. Another hypothesis is that an elevated level of uric acid acts as an antioxidant in ROS-activated COPD patients [33]. The mechanism of hyperuricemia in COPD patients has yet to be clarified.…”

Expert consensus for the diagnosis and treatment of patient with hyperuricemia and high cardiovascular risk: 2021 update

“…As described in a previous document [1], sUA is considered an independent factor in the development of a wide variety of vascular disorders: hypertension [54], metabolic syndrome [55,56], coronary artery disease [57], diabetes [58], cerebrovascular disease [59,60], CKD [61], as well as other CVD [62,63] and -conversely -these comorbidities increase the incidence of HU [64]. It is worth paying attention to other conditions, both those from the genre of metabolic syndrome (e.g., non-alcoholic fatty liver, non-alcoholic steatohepatitis) and those whose presence may affect the clinical course of disorders in the cardiovascular system (e.g., COPD [65] or incident asthma in men [66]).…”