The effectiveness and safety of specific dietary supplements in modulating uric acid levels, oxidative stress, and lipid metabolism in patients: a network meta-analysis of 13 interventions.

Background: Hyperuricemia and gout have garnered increasing attention as significant health concerns in recent years, often associated with damage to multiple bodily systems. Consequently, the reduction of uric acid levels has become particularly crucial. The utilization of dietary supplements presents potential adjunctive treatment options for individuals with gout. Certain dietary supplements are purported to aid in the reduction of uric acid levels and are highly preferred by patients due to their affordability, ease of use, and accessibility. The aim of this article was to compare the efficacy and safety of dietary supplements in modulating uric acid, oxidative stress, and lipid metabolism in patients with hyperuricemia or gout, using a comprehensive network meta-analysis (NMA) approach.

Methodology: A comprehensive search was performed across both Chinese and English databases to identify randomized controlled trials (RCTs) examining the efficacy of dietary supplements in reducing uric acid levels. Network meta-analysis was conducted using Stata 16.0 software, while RevMan 5.3 software was employed to assess the quality of the literature and evaluate the risk of bias.

Result: A total of 30 RCTs, encompassing 44,972 patients, were conducted. The findings of the study indicated that folic acid (mean difference [MD] = -57.62 μmol/L, 95% confidence interval [CI] [-107.14, -8.1]) and probiotics (MD = -42.52 μmol/L, 95% CI [-81.95, -3.09]) significantly reduced uric acid levels compared to conventional therapy. Furthermore, Vitamin C (MD = -0.92 nmmol/ml, 95% CI [-1.54, -0.31]) and Vitamin E (MD = -1.05 nmmol/ml, 95% CI [-2.01, -0.1]) were effective in reducing oxidative stress-related malondialdehyde (MDA) levels. In terms of lipid metabolism improvement, DKB114 (MD = -0.45 mmol/L, 95% CI [-0.9, -0.001]) and curcumin (MD = -0.54 mmol/L, 95% CI [-0.89, -0.18]) demonstrated statistically significant reductions in low-density lipoprotein (LDL) levels. Analysis of subgroups revealed that administration of 500 mg of vitamin C resulted in a significant reduce in uric acid levels when compared to conventional treatment (MD =  - 21.67 μmol/L, 95% CI [- 43.01, - 0.33]), indicating statistically significant differences. The safety profile of all dietary supplements has generally been demonstrated to be favorable.

Conclusion: Dietary supplements hold significant potential for managing gout and hyperuricemia, as well as improving patients' metabolic status. Future research should focus on larger-scale studies to further explore these findings.