Abstract
OBJECTIVE: This meta-analysis aimed to investigate the association between sugar-sweetened beverages (SSBs), fructose, and the risk of gout and hyperuricemia. METHODS: Following PRISMA guidelines, we systematically searched PubMed, EMBASE, and Cochrane Library for observational studies from inception to March 2025. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using random/fixed-effects models. Subgroup analyses explored sex. Heterogeneity (I (2)) and publication bias were assessed. RESULTS: A total of 22 studies (235,790 participants) were included. SSB intake significantly increased the risk of hyperuricemia (OR = 1.33, 95% CI: 1.23-1.44) and gout (OR = 1.21; 95% CI 1.11-1.32). Fruit juice (FJ) showed a modest association with hyperuricemia (OR = 1.15, 95% CI: 1.02-1.29) and an increased risk of gout (OR = 1.28; 95% CI 0.96-1.72). Fructose consumption was strongly associated with increased gout risk (OR = 1.66, 95% CI: 1.27-2.18), but its relationship with hyperuricemia was inconsistent (OR = 1.12, 95% CI: 0.85-1.46). DSD showed a modest association with gout (OR = 1.14; 95% CI 0.95-1.35). Subgroup analysis revealed SSB and FJ consumption associated with elevated risks of hyperuricemia in males (SSBs: 1.37; FJ: 1.15) compared to females (SSBs: 1.29; FJ: 1.13). CONCLUSIONS: SSB consumption is associated with increased risks of hyperuricemia and gout, particularly in males. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=1040227, PROSPERO (Unique Identifier: CRD420251040227).