Fenofibrate is a marketed fibric acid derivative for lipid-lowering in patients with lipid disorders. Numerous studies have proven fenofibrate had a certain effect on serum uric acid, here we conducted this study to quantitatively assess the effect of fenofibrate intervention in modulating serum uric acid concentration and the influence on serum creatinine. The PubMed, Embase and Cochrane were systematically searched for randomized controlled trials update to January, 2020. Primary endpoints focused on serum uric acid concentration and serum creatinine concentration. The pooled effects were calculated as weighted mean difference (WMD) by a random-effects model. Finally, 9 studies representing 487 patients were included in the meta-analysis. The meta-analysis demonstrated that fenofibrate significantly reduced serum uric acid levels (WMD –1.32 mg/dL, 95%CI –1.61 to –1.03, p < 0.001) and an elevated level in serum creatinine (WMD 0.09 mg/dL, 95%CI 0.02 to 0.15, p < 0.001) following fenofibrate therapy compared with placebo. The present study provided strong evidence that fenofibrate intervention exerted a significant reduction on serum uric acid and a mild increase on serum creatinine. Meta-analysis suggested that there were no significant association between the serum uric acid lowering effect with either dose or treatment duration. Overall, our meta-analysis ascertained that fenofibrate have potential therapeutic effects in patients with lipid metabolic abnormalities but with mid nephrotoxicity. There is strong evidence to provide future direction of practical application and clinical researches of fenofibrate.

非诺贝特是一种已上市的贝特酸衍生物，用于血脂紊乱患者的降脂。大量研究证明非诺贝特对血尿酸有一定作用，本研究定量评估非诺贝特干预调节血尿酸浓度的作用及对血肌酐的影响。系统检索了 PubMed、Embase 和 Cochrane，以获取更新至 2020 年 1 月的随机对照试验。主要终点集中在血清尿酸浓度和血清肌酐浓度。通过随机效应模型将汇总效应计算为加权平均差 (WMD)。最后，代表 487 名患者的 9 项研究被纳入荟萃分析。荟萃分析表明，非诺贝特可显着降低血清尿酸水平 (WMD –1.p <0.001）和血清肌酸酐水平升高（WMD 0.09毫克/分升，95％CI 0.02至0.15，p <0.001）以下的非诺贝特治疗与安慰剂相比。本研究提供了强有力的证据，表明非诺贝特干预显着降低了血清尿酸，并轻微增加了血清肌酐。荟萃分析表明，血清尿酸降低效果与剂量或治疗持续时间之间没有显着关联。总体而言，我们的荟萃分析确定非诺贝特对脂质代谢异常但具有中等肾毒性的患者具有潜在的治疗作用。有力的证据为非诺贝特的实际应用和临床研究提供了未来的方向。