Bidirectional Association Between Gout and Parkinson’s Disease: A Systematic Review and Meta-Analysis

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Background: Parkinson's disease (PD) and gout are common chronic disorders with potentially shared biological mechanisms involving urate metabolism, inflammation, and oxidative stress. However, epidemiological findings remain inconsistent. This systematic review and meta-analysis evaluated the bidirectional association between gout and PD. Methods: A systematic search of PubMed/Medline, Embase, and the Cochrane Library was conducted from database inception to January 2026. Observational studies evaluating the association between gout and PD were included. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using random-effects models. Statistical significance was defined as p<0.05. The review was prospectively registered in PROSPERO (CRD420261439697). Results: Six cohort studies were included. In pooled analyses, gout was not associated with subsequent PD risk (HR=1.02, 95% CI 0.93–1.12; p=0.70). Sex-stratified analyses also demonstrated no significant associations among women (HR=1.10, 95% CI 0.93–1.30; p=0.27) or men (HR=0.99, 95% CI 0.92–1.07; p=0.79). Evidence regarding the reverse association was limited to a single nationwide cohort study, which reported a lower subsequent risk of gout among individuals with PD (HR=0.51, 95% CI 0.43–0.60; p<0.00001). Similar findings were observed among women (HR=0.56, 95% CI 0.43–0.72) and men (HR=0.47, 95% CI 0.39–0.57). Conclusion: Gout was not associated with subsequent PD risk. Evidence from a single nationwide cohort suggests that PD may be associated with a reduced risk of subsequent gout. Further large-scale prospective studies are needed to clarify the relationship between PD, gout, and urate metabolism.

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