The Effect of Statin Therapy on Serum Uric Acid Levels: A Systematic Review and Meta-analysis


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Abstract

Background:Elevated concentrations of serum uric acid (SUA) are associated with several conditions, including cardiovascular disease. The present study aimed to estimate the impact of statin therapy on SUA levels through a systematic review and meta-analysis of clinical trials.

Methods:PubMed, Embase, Web of Science, and Scopus were searched on January 14, 2022, to identify eligible clinical trials. The intervention group received statins as monotherapy or in combination with other drugs, and the control group received non-statins or placebo. Studies reporting SUA levels before and after treatment were selected for further analysis. Finally, the data were pooled, and the mean changes in SUA, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides were reported.

Results:Out of 1269 identified studies, 23 were included in the review. A total of 3928 participants received statin therapy, and 1294 were included in control groups. We found a significant reduction in SUA levels following statin therapy (mean difference (MD) = -26.67 µmol/L with 95% confidence interval (CI) [-44.75, -8.60] (P =0.004)). Atorvastatin (MD = -37.93 µmol/L [-67.71, -8.15]; p < 0.0001), pravastatin (MD = -12.64 µmol/L [-18.64, -6.65]; p < 0.0001), and simvastatin (MD = -5.95 µmol/L [-6.14, -5.80]; p < 0.0001), but not rosuvastatin, were significantly associated with a reduction in SUA levels. An analysis comparing different types of statins showed that pravastatin 20-40 mg/day could significantly reduce SUA when compared to simvastatin 10-20 mg/day (-21.86 µmol/L [-36.33,-7.39]; P =0.003).

Conclusion:Statins were significantly associated with a decrease in SUA levels, particularly atorvastatin, which was found to be most effective in lowering SUA. Atorvastatin may be the most appropriate cholesterol-lowering agent for patients with or at risk of hyperuricemia.

About the authors

Abolfazl Akbari

Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences

Email: info@benthamscience.net

Mahya Razmi

Student Research Committee, Faculty of Paramedical Sciences,, Mashhad University of Medical Sciences

Email: info@benthamscience.net

Mahdi Rafiee

Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences

Email: info@benthamscience.net

Gerald Watts

Department of Cardiology, School of Medicine, Perth, Australia and Lipid Disorders Clinic, Cardiometabolic Services, Royal Perth Hospital, University of Western Australia

Email: info@benthamscience.net

Amirhossein Sahebkar

Applied Biomedical Research Center, Mashhad University of Medical Sciences

Author for correspondence.
Email: info@benthamscience.net

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