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Mol Neurobiol (2016) 53:10451051 DOI 10.1007/s12035-014-9075-0
Serum Uric Acid Levels and Diabetic Peripheral Neuropathy in Type 2 Diabetes: a Systematic Review and Meta-analysis
Shuai Yu & Ying Chen & Xu Hou & Donghua Xu & Kui Che &
Changgui Li & Shengli Yan & Yangang Wang & Bin Wang
Received: 27 October 2014 /Accepted: 29 December 2014 /Published online: 12 January 2015 # Springer Science+Business Media New York 2015
Abstract Previous studies suggested a possible association between serum uric acid levels and peripheral neuropathy in patients with type 2 diabetes, but no definite evidence was available. A systematic review and meta-analysis of relevant studies were performed to comprehensively estimate the association. Pubmed, Web of Science, Embase, and China Biology Medicine (CBM) databases were searched for eligible studies. Study-specific data were combined using random-effect or fixed-effect models of meta-analysis according to between-study heterogeneity. Twelve studies were finally included into the meta-analysis, which involved a total of 1388 type 2 diabetic patients with peripheral neuropathy and 4746 patients without peripheral neuropathy. Meta-analysis showed that there were obvious increased serum uric acid levels in diabetic patients with peripheral neuropathy (weighted mean difference [WMD]=50.03 mol/L, 95 % confidence interval [95%CI] 22.1477.93, P=0.0004). Hyperuricemia was also significantly associated with increased risk of peripheral neuropathy in patients with type 2 diabetes (risk ratio [RR]=2.83, 95%CI 2.133.76, P<0.00001). Meta-analysis of two studies
with adjusted risk estimates showed that hyperuricemia was independently associated with increased risk of peripheral neuropathy in type 2 diabetic patients (RR=1.95, 95%CI1.233.11, P=0.005). Type 2 diabetic patients with peripheral neuropathy have obvious increased serum uric acid levels, and hyperuricemia is associated with increased risk of peripheral neuropathy. Further prospective cohort studies are needed to validate the impact of serum uric acid levels on peripheral neuropathy risk.
Keywords Diabetic peripheral neuropathy . Uric acid . Hyperuricemia
Introduction
Diabetic peripheral neuropathy (DPN) is a common complication in patients with diabetes, and it affects more than 30 % of patients with type 2 diabetes mellitus [1, 2]. DPN can result in decreased sensation, decreased motility, and increased disability [1, 3, 4]. In addition, DPN is also significantly associated with increased risks of subsequently cardiovascular diseases and mortality [5]. Distal symmetrical polyneuropathy (DSP) is the most common manifestation of DPN [1]. Currently, there...