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Uric Acid associated with low vitamin D – Meta-analysis March 2019

Vitamin D insufficiency and deficiency are associated with a higher level of serum uric acid: A systematic review and meta-analysis.

Mod Rheumatol. 2019 Mar 4:1-6. doi: 10.1080/14397595.2019.1575000
Charoenngam N1, Ponvilawan B2, Ungprasert P3.
1 Department of Medicine, Faculty of Medicine Siriraj Hospital , Mahidol University , Bangkok , Thailand.
2 Department of Pharmacology, Faculty of Medicine Siriraj Hospital , Mahidol University , Bangkok , Thailand.
3 Department of Research and Development, Faculty of Medicine Siriraj Hospital, Clinical Epidemiology Unit , Mahidol University , Bangkok , Thailand.

Vitamin D Life

Gout and Vitamin D has the following summary and image
Reasons to believe that Gout is associated with low vitamin D

  1. Acute gouty arthritis is seasonal. 1998
    Increased by 32% in Spring (when vitamin D levels are the lowest)
  2. Clinical Trials for Gout and Vitamin D
    Study of Vitamin D and Uric Acid Lowering on Kidney and Blood Vessel Function
    Good: 50,000 IU weekly, unfortunately: D2, not D3
  3. Vitamin D reduces Rheumatoid arthritis 101 items
  4. Vitamin D reduces Pain 137 items
  5. Vitamin D reduces Inflammation category listing with 135 items
  6. Higher incidence of gout with age (less vitamin D and gastric acid as you get older)
  7. Increased gout at higher Latitude (Gout and Goutiness a 1899 book
  8. Increased gout with soda pop
    JAMA study from 2010.2 women >2 cans of soda daily 2X more likely to develop gout (Note that soda decreases vitamin D levels)
  9. 2X more Gout if Dark Skin
    WikiPedia gout is twice as likely in African American males as it is in European Americans
  10. Gout and Calcium and vitamin D
    Calcium and Vitamin D. The relationship of gout to calcium and vitamin D is complex.
    Gout is associated with insulin resistance, low vitamin D levels, and inflammation, all of which interfere with muscle synthesis.
    One study has found that patients with gout have lower vitamin D3 levels correlated with higher urate.
  11. Increased gout recently (along with increased number of people being vitamin D deficient)- both blacks and whites
    New Zealand 2009 publication
    Image
    Gout incidence has been increasing (while vitamin D has been decreasing)
    Image
  12. Gout has increased, but appears to be correlated with obesity/ hypertension 2011
    note: both obesity and hypertension are associated with low vitamin D {FONT}

Image


Uric Acid and some Kidney stones

Overview Kidney Stones and vitamin D
Note: A fraction of Kidney stones are associated with Uric Acid (low vitamin D)
Image


Potential causal associations between vitamin D and uric acid: Bidirectional mediation analysis
Sept 2015, free PDF online


INTRODUCTION/OBJECTIVES:
Several epidemiological studies have suggested that patients with vitamin D insufficiency and deficiency tend to have a higher level of serum uric acid compared with those with adequate vitamin D level although the results were inconsistent across the studies. The current systematic review and meta-analysis was conducted with the aim to summarize all the available data.

METHODS:
A systematic review was conducted using MEDLINE and EMBASE database from inception to May 2018 to identify all studies that compared the level of serum uric acid between individuals with normal vitamin D level and patients with vitamin D insufficiency/deficiency. Eligible studies must be cohort or cross-sectional studies that consisted of two groups of adult participants, one with normal level of vitamin D (vitamin D level >30 ng/ml) and one with vitamin D insufficiency (vitamin D level 20-30 ng/ml) or vitamin D deficiency (vitamin D level of <20 ng/ml). Mean serum uric acid level and standard deviation of participants were extracted from each study to calculate mean difference (MD). Pooled MD was then calculated by combining MDs of each study using random-effects model.

RESULTS:
A total of seven cross-sectional studies were eligible for the meta-analyses. Individuals with normal vitamin D level had a significantly lower serum uric acid level than patients with vitamin D insufficiency with the pooled MD of -0.33 mg/dl (95%CI, -0.61, -0.04), and also had a significantly lower serum uric acid level than patients with vitamin D deficiency with the pooled MD of -0.45 mg/dl (95%CI, -0.82, -0.08). The statistical heterogeneity of these meta-analyses was high with the I2 of 78% and 89%, respectively. Funnel plots of both meta-analyses were fairly symmetric and did not provide a suggestive evidence for the presence of publication bias.

CONCLUSION: Both patients with vitamin D insufficiency and patients with vitamin D deficiency had a significantly higher level of serum uric acid compared with individuals with normal vitamin D level.


Created by admin. Last Modification: Saturday March 23, 2019 20:36:16 GMT-0000 by admin. (Version 7)

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