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Association between serum uric acid levels and COPD: a meta-analysis and mendelian randomization study
Aiju Su1, Yunpeng Xu2, Xue Han1
1The First Clinical Medical College of Lanzhou University, Lanzhou, People's Republic of China.
BMC Pulmonary Medicine
|July 10, 2026
Summary
Serum uric acid (SUA) is higher in chronic obstructive pulmonary disease (COPD) patients, particularly during exacerbations. However, genetically predicted higher SUA may offer a protective effect against COPD, suggesting a complex relationship.
Area of Science:
- Pulmonary Medicine
- Genetics
- Biochemistry
Background:
- Chronic obstructive pulmonary disease (COPD) is a significant global health issue.
- The association between serum uric acid (SUA) and COPD is not well-established.
- Contradictory findings necessitate further investigation into this relationship.
Purpose of the Study:
- To investigate the observational association between SUA and COPD.
- To explore the potential causal link between SUA and COPD using Mendelian randomization (MR).
- To clarify the complex role of SUA in COPD pathogenesis and progression.
Main Methods:
- Systematic literature search of observational studies (PubMed, Embase, etc.) up to December 2025.
- Meta-analysis of 22 studies (3739 COPD patients, 2778 controls) using random-effects models.
- Two-sample bidirectional Mendelian randomization (MR) analysis utilizing GWAS summary data.
Main Results:
- Meta-analysis revealed significantly higher SUA levels in COPD patients compared to controls (MD: 1.19 mg/dL).
- Elevated SUA was observed in acute exacerbations (AECOPD) and severe COPD.
- MR analysis indicated a causal protective effect of genetically predicted higher SUA on COPD risk (OR: 0.883, P=0.004).
Conclusions:
- Observational data show elevated SUA in COPD, but MR suggests a protective genetic role.
- The relationship between SUA and COPD is complex, potentially involving reverse causality.
- Further diverse population studies are needed to confirm findings and guide clinical management.
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