Objective:

To estimate the global prevalence of hyperuricemia (HUA) and gout in patients with type 2 diabetes mellitus (T2DM) and to identify associated risk factors.

Approach:

• Study Selection: A systematic search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library to identify observational studies on HUA/gout in T2DM patients. Two researchers independently performed literature screening, data extraction, and quality assessment.
• Statistical Analysis: 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.

Key Findings:

• The pooled prevalence of HUA in T2DM patients was 22.0% (95% CI: 20.1-24.0%).
• The pooled prevalence of gout in T2DM patients was 6.0% (95% CI: 4.4-7.5%).
• Geographic region was identified as a significant source of heterogeneity, with the highest HUA prevalence in Africa and North America, and the lowest in South America.
• Risk factors for HUA included impaired renal function, obesity, dyslipidemia, hypertension, metabolic syndrome, and alcohol consumption.
• Male sex was a significant risk factor for gout.
• Elevated HbA1c was inversely associated with HUA.

Interpretation:

The prevalence of HUA and gout is significantly higher in patients with T2DM compared to the general population, with specific risk factors identified.

Limitations:

• The study only included observational studies, which may limit the strength of causal inferences.
• Potential publication bias was assessed but not quantified.

Conclusion:

Routine serum uric acid monitoring and early screening for high-risk individuals should be incorporated into the clinical management of T2DM.

Sources:

• Systematic Review Registration