Uric acid lowering improves insulin sensitivity and lowers blood pressure: a meta-analysis of randomized parallel-controlled clinical trials

Afr Health Sci. 2021 Mar;21(1):82-95. doi: 10.4314/ahs.v21i1.13.

Abstract

Objectives: This meta-analysis aimed to investigate whether uric acid lowering treatment can improve β-cell function and insulin sensitivity.

Methods: PubMed, Cochrane Library, EMBASE and China Biology Medicine were searched up to March 1, 2020. Randomized controlled clinical trials of urate lowering therapy in hyperuricemia patients were included in meta-analysis. Effect size was estimated as mean difference with 95% confidence interval (CI).

Results: Our search yielded 7 eligible trials with 503 participants. This meta-analysis showed that uric acid-lowering therapy decreased fasting insulin -1.43 µIU/ml (weighted mean differences (WMD, 95% CI -2.78 to -0.09), homeostasis model assessment of insulin resistance -0.65 (WMD, 95% CI -1.05 to -0.24), systolic blood pressure -2.45 mm Hg (WMD, 95%CI -4.57 to -0.33) and diastolic blood pressure -3.41 mm Hg (WMD, 95%CI -3.87 to -2.95). However, the treatment had no significant effect on fasting plasma glucose (WMD -0.19 mmol/L, 95%CI -0.42 to 0.05), homeostasis model assessment of β-cell function index (WMD -0.02, 95%CI -0.28 to 0.24), total cholesterol (WMD 0.18 mg/dl; 95%CI, -1.39 to 1.75) and triglyceride (WMD 3.15 mg/dl, 95% CI -9.83 to 16.14).

Conclusion: Uric acid-lowering therapies might improve insulin sensitivity and lower blood pressure, but had no significant effect on HOMA-β and serum lipids.

Keywords: Hyperuricemia; insulin sensitivity; uric acid lowering treatment; β-cell function.

Publication types

  • Meta-Analysis

MeSH terms

  • Blood Glucose
  • Blood Pressure / drug effects*
  • Blood Pressure / physiology
  • China
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Fasting
  • Female
  • Humans
  • Hyperuricemia / complications
  • Hyperuricemia / drug therapy*
  • Insulin / administration & dosage
  • Insulin / therapeutic use
  • Insulin Resistance
  • Male
  • Middle Aged
  • Randomized Controlled Trials as Topic
  • Uric Acid / blood
  • Uricosuric Agents / therapeutic use*

Substances

  • Blood Glucose
  • Insulin
  • Uricosuric Agents
  • Uric Acid