Sleep and Breathing

, Volume 23, Issue 4, pp 1047–1057 | Cite as

A meta-analysis of the association between gout, serum uric acid level, and obstructive sleep apnea

  • Tingting Shi
  • Min Min
  • Chenyu Sun
  • Ce Cheng
  • Yun Zhang
  • Mingming Liang
  • Feras Kamel Rizeq
  • Yehuan SunEmail author
Sleep Breathing Physiology and Disorders • Review


Previous epidemiological investigations have evaluated the association between gout, serum uric acid levels, and obstructive sleep apnea syndrome (OSAS), but with inconsistent results. We conducted this meta-analysis aiming at providing clear evidence about whether OSAS patients have higher serum uric acid levels and more susceptible to gout. Relevant studies were identified via electronic databases from inception to December 17, 2018. Study selection was conducted according to predesigned eligibility criteria, and two authors independently extracted data from included studies. The hazard ratio (HR) and weighted mean difference (WMD) and their corresponding 95% confidence interval (CI) were derived using random-effects models. We conducted meta-, heterogeneity, publication bias, sensitivity, and subgroup analyses. Eighteen studies, involving a total of 157,607 individuals (32,395 with OSAS, 125,212 without OSAS) and 12,262 gout cases, were included. Results show that serum uric acid levels are elevated in patients with OSAS (WMD = 52.25, 95% CI 36.16–64.33); OSAS did not reach statistical significance as a predictor of gout (but there was a trend, HR = 1.25, 95% CI 0.91–1.70) and that the association between OSAS and serum uric acid was quite robust. OSAS may be a potential risk factor for hyperuricemia and the development of gout and thus, effective OSAS therapy may present as a valuable preventive measure against gout. Still, it is vital to undertake clinical studies with better designing to corroborate these associations and shed new light on it.


Obstructive sleep apnea syndrome OSAS Serum uric acid level Gout 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human and animals participants performed by any of the authors.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Epidemiology and Health Statistics, School of Public HealthAnhui Medical UniversityHefeiChina
  2. 2.The First Affiliated Hospital of Anhui Medical UniversityHefeiChina
  3. 3.Arizona College of Osteopathic MedicineMidwestern UniversityGlendaleUSA
  4. 4.Avalon University School of MedicineWillemstadCuraçao
  5. 5.Center for Evidence-Based PracticeAnhui Medical UniversityHefeiChina

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