Association between blood heavy metal concentrations and hyperuricemia: A systematic review and meta-analysis

Exposure to heavy metals is regarded as a potential contributor to the development of hyperuricemia (HU). However, related research findings are inconsistent. This systematic review and meta-analysis aimed to explore the association between blood concentrations of heavy metals (such as lead, cadmium, manganese, mercury) and HU. PubMed, EMBASE, Web of Science, and Cochrane Library databases were searched to collect related studies up to June 2024. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated utilizing a random-effects model or a fixed-effects model. Sensitivity analysis was conducted, while publication bias was assessed using funnel plots and Egger's test. A total of 19 eligible studies were included. The meta-analysis indicated a significant association between blood lead levels and the risk of HU (OR: 1.88; 95% CI: 1.22-2.92; P<0.005). Blood levels of cadmium (OR: 1.31; 95% CI: 0.68-2.52; non-significant), manganese (OR: 1.04; 95% CI: 0.88-1.22; non-significant), and mercury (OR: 1.55; 95% CI: 0.70-3.44; non-significant) were not significantly associated with the risk of HU. In conclusion, this study demonstrates a significant positive association between blood lead levels and the risk of HU. No significant association is found between blood levels of cadmium, manganese, and mercury and the risk of HU.