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A systematic review and meta-analysis of the correlation between hyperuricemia and thyroid nodules in adults.

Background
In recent years, thyroid nodules have gradually become one of the important factors endangering people's health, and we hope to recognize the association between hyperuricemia and thyroid nodulogenesis by this meta-analysis study.


Methods
Literatures related to hyperuricemia and thyroid nodules were searched in the Chinese biomedical databases Chinese National Knowledge Infrastructure (CNKI), VIP, Wanfang, and the Chinese Biomedical Literature Database (CBM), as well as the English databases PubMed, EMBASE, and the Cochrane Library from establishment of the databases to September 2021. Duplicate literatures were identified using Endnote X9 software and excluded. All studies were screened according to the inclusion and exclusion criteria, and the quality of the included literature was assessed. Data were recorded and meta-analyzed using the Stata 15.1 software. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated using the fixed effects or random effects models. Finally, sensitivity analyses were performed to assess the reliability of the results. Funnel plots were constructed to evaluate the publication bias of the literatures.


Results
A total of 16 articles, with a total sample size of 126,907, were included in this study. Meta-analysis showed that there was no correlation between the incidence of thyroid nodules and the presence or absence of hyperuricemia in the overall population. Interestingly, hyperuricemia was found to be a protective factor for the incidence of thyroid nodules in the male population (OR =0.91; 95% CI: 0.86 to 0.97; P<0.05). However, hyperuricemia was identified as a risk factor for the incidence of thyroid nodules in the female population (OR =1.14; 95% CI: 1.04 to 1.25; P<0.05).


Discussion
Serum uric acid has a bidirectional regulatory effect in different genders and female patients should be wary of secondary thyroid nodules.