Gout is not associated with a lower risk of Parkinson's disease: A systematic review and meta-analysis.
BACKGROUND
Uratic acid is a potent anti-oxidant and hyperuricemia is well-linked to a lower risk of Parkinson's disease (PD), one of the most common neurodegenerative disorders. However, data on gout, the major complication of hyperuricemia, remain unclear.


METHODS
Two investigators independently searched published studies indexed in MEDLINE, and EMBASE from inception to April 2015 using the terms for gout combined with the terms for PD. The inclusion criteria were as follows: (1) cohort or case-control study evaluating the risk of PD among patients with gout (2) odds ratio, relative risk, hazard ratio or standardized incidence ratio were provided (3) subjects without gout and subjects with PD were used as controls in cohort and case-control study, respectively. RevMan 5.3 software was used to perform the statistical analysis. Point estimates and standard errors were extracted from individual studies and were combined by generic inverse variance method of DerSimonian and Laird. Statistical heterogeneity was assessed using the Cochran's Q test and I(2) statistics.


RESULTS
Three case-control studies and two cohort studies were identified and included in the data analysis. The pooled risk ratio of PD in patients with gout was 0.93 (95% CI, 0.79 to 1.09). The statistical heterogeneity was high with an I(2) of 87%. The results were not significantly different between males and females (RR 0.89; 95% CI, 0.57 to 1.39 and RR 0.95; 95% CI, 0.76 to 1.19, respectively).


CONCLUSIONS
This study did not provide support for an inverse relationship between gout and risk of PD.
Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA; Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. Electronic address: P.Ungprasert@gmail.com.
Patompong
P
Ungprasert
Division of Pulmonology and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Narat
N
Srivali
Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Charat
C
Thongprayoon
D000368:Aged; D005260:Female; D006073:Gout / Q000453:epidemiology*; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000453:epidemiology*
Epidemiology; Gout; Meta-analysis; Parkinson's disease