Top

Archives of Osteoporosis

Published in:

01-12-2022 | Osteoporosis | Original Article

Association between serum uric acid level and bone mineral density at multiple skeletal sites in middle-aged and elderly men: a cross-sectional study of a healthy population in Taiwan

Authors: Zih-Cen Lin, Jhu-Fong Wu, Chiung-Yun Chang, Kuan-Ming Lai, Hsin-Yi Yang

Published in: Archives of Osteoporosis | Issue 1/2022

Abstract

Summary

This study revealed that serum uric acid (sUA) levels were not associated with bone mineral density (BMD) at different skeletal sites in middle-aged and elderly men, even adjusting for confounding variables. Nevertheless, a positive association was only found between sUA levels and BMD at all skeletal sites in the normal BMI group.

Introduction

Previous studies have reported an association between serum uric acid (sUA) levels and bone mineral density (BMD). However, their findings are controversial and limited to adult men in the general population. This study was aimed at examining the association between sUA levels and BMD at multiple skeletal sites in middle-aged and elderly men.

Methods

A cross-sectional analysis of BMD at different skeletal sites and sUA levels was conducted on 918 men (age: 50.83 ± 7.95) using data from the Ditmanson Research Database. The participants were categorized into four groups based on quartiles of the sUA level, and BMD were assessed using dual-energy X-ray absorptiometry. Multivariate linear regression models were utilized to investigate the association between sUA levels and BMD. Further, subgroup analyses were performed.

Results

After adjusting for potential confounding factors, sUA as a continuous variable was significantly associated with BMD at the femoral neck only (β, 95% confidence interval: 0.007 [0.001–0.013]). However, in the categorical analysis, no significant differences were detected in terms of BMD at different skeletal sites across the different sUA quartile groups. Moreover, if the body mass index (BMI) was < 24 kg/m² for each unit increase in sUA level, the spine, femoral neck, and total hip BMD increased by 0.014, 0.013, and 0.015 g/cm², respectively.

Conclusion

The sUA level was not associated with BMD at different skeletal sites in middle-aged and elderly men. Nevertheless, a positive association was only found between sUA levels and BMD at all skeletal sites in the normal weight group.

Liu N, Xu H, Sun Q, Yu X, Chen W, Wei H, Jiang J, Xu Y, Lu W (2021) The role of oxidative stress in hyperuricemia and zanthine oxidoreductase (XOR) inhibitors. Oxid Med Cell Longev 2021:1470380. https://doi.org/10.1155/2021/1470380CrossRefPubMedPubMedCentral

Sundstrom J, Sullivan L, D’Agostino RB, Levy D, Kannel WB, Vasan RS (2005) Relations of serum uric acid to longitudinal blood pressure tracking and hypertension incidence. Hypertension 45(1):28–33. https://doi.org/10.1161/01.HYP.0000150784.92944.9aCrossRefPubMed

Soltani Z, Rasheed K, Kapusta DR, Reisin E (2013) Potential role of uric acid in metabolic syndrome, hypertension, kidney injury, and cardiovascular diseases: is it time for reappraisal? Curr Hypertens Rep 15:175–181CrossRefPubMedPubMedCentral

Wu AH, Gladden JD, Ahmed M, Ahmed A, Filippatos G (2016) Relation of serum uric acid to cardiovascular disease. Int J Cardiol 213(3):4–7. https://doi.org/10.1007/s11906-013-0344-5CrossRefPubMed

Nejatinamini S, Ataie-Jafari A, Qorbani M, Nikoohemat S, Kelishadi R, Asayesh H, Hosseini S (2015) Association between serum uric acid level and metabolic syndrome components. J Diabetes Metab Disord 14:70. https://doi.org/10.1186/s40200-015-0200-zCrossRefPubMedPubMedCentral

Ali N, Perveen R, Rahman S et al (2018) Prevalence of hyperuricemia and the relationship between serum uric acid and obesity: a study on Bangladeshi adults. PLoS One 13:e0206850. https://doi.org/10.1371/journal.pone.0206850CrossRefPubMedPubMedCentral

Braga F, Pasqualetti S, Ferraro S, Panteghini M (2016) Hyperuricemia as risk factor for coronary heart disease incidence and mortality in the general population: a systematic review and meta-analysis. Clin Chem Lab Med 54(1):7–15. https://doi.org/10.1515/cclm-2015-0523CrossRefPubMed

Han Y, Han K, Han X, Yin Y, Di H, Wu J, Zhang Y, Zeng X (2021) Serum uric acid might be positively associated with hypertension in Chinese adults: an analysis of the China Health and Nutrition Survey. Front Med (Lausanne) 8:755509. https://doi.org/10.3389/fmed.2021.755509CrossRefPubMed

Lv Q, Meng XF, He FF et al (2013) High serum uric acid and increased risk of type 2 diabetes: a systemic review and meta-analysis of prospective cohort studies. PLoS One 8:e56864. https://doi.org/10.1371/journal.pone.0056864CrossRefPubMedPubMedCentral

10.

Kaushal N, Vohora D, Jalali RK, Jha S (2019) Review of the literature examining the association of serum uric acid with osteoporosis and mechanistic insights into its effect on bone metabolism. Endocr Metab Immune Disord Drug Targets 19(3):259–273. https://doi.org/10.2174/1871530318666181102115106CrossRefPubMed

11.

Badila AE, Radulescu DM, Ilie A, Niculescu AG, Grumezescu AM, Radulescu AR (2022) Bone regeneration and oxidative stress: an updated overview. Antioxidants (Basel) 11(2):318. https://doi.org/10.3390/antiox11020318CrossRefPubMed

12.

Domazetovic V, Marcucci G, Iantomasi T, Brandi ML, Vincenzini MT (2017) Oxidative stress in bone remodeling: role of antioxidants. Clin Cases Miner Bone Metab 14:209–216. https://doi.org/10.11138/ccmbm/2017.14.1.209CrossRefPubMedPubMedCentral

13.

Menale C, Robinson LJ, Palagano E et al (2019) Absence of dipeptidyl peptidase 3 increases oxidative stress and causes bone loss. J Bone Miner Res 34:2133–2148. https://doi.org/10.1002/jbmr.3829CrossRefPubMed

14.

Hershfield MS, Roberts LJ 2nd, Ganson NJ, Kelly SJ, Santisteban I, Scarlett E, Jaggers D, Sundy JS (2010) Treating gout with pegloticase, a PEGylated urate oxidase, provides insight into the importance of uric acid as an antioxidant in vivo. Proc Natl Acad Sci U S A 107(32):14351–14356. https://doi.org/10.1073/pnas.1001072107CrossRefPubMedPubMedCentral

15.

Zhang D, Bobulescu IA, Maalouf NM, Adams-Huet B, Poindexter J, Park S, Wei F, Chen C, Moe OW, Sakhaee K (2015) Relationship between serum uric acid and bone mineral density in the general population and in rats with experimental hyperuricemia. J Bone Miner Res 30(6):992–999. https://doi.org/10.1002/jbmr.2430CrossRefPubMed

16.

Li X, Li L, Yang L, Yang J, Lu H (2021) No association between serum uric acid and lumbar spine bone mineral density in US adult males: a cross sectional study. Sci Rep 11(1):15588. https://doi.org/10.1038/s41598-021-95207-zCrossRefPubMedPubMedCentral

17.

Sritara C, Ongphiphadhanakul B, Chailurkit L, Yamwong S, Ratanachaiwong W, Sritara P (2013) Serum uric acid levels in relation to bone-related phenotypes in men and women. J Clin Densitom 16(3):336–340. https://doi.org/10.1016/j.jocd.2012.05.008CrossRefPubMed

18.

Pan WH, Lee MS, Chuang SY, Lin YC, Fu ML (2008) Obesity pandemic, correlated factors and guidelines to define, screen and manage obesity in Taiwan. Obes Rev 9(Suppl 1):22–31. https://doi.org/10.1111/j.1467-789X.2007.00434.xCrossRefPubMed

19.

Zhang Y, Post WS, Dalal D, Blasco-Colmenares E, Tomaselli GF, Guallar E (2011) Coffee, alcohol, smoking, physical activity and QT interval duration: results from the Third National Health and Nutrition Examination Survey. PLoS One 6(2):e17584. https://doi.org/10.1371/journal.pone.0017584CrossRefPubMedPubMedCentral

20.

Neogi T, Jansen TL, Dalbeth N et al (2015) 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 74(10):1789–1798. https://doi.org/10.1136/annrheumdis-2015-208237CrossRefPubMed

21.

Cinical and Laboratory Standards Institute (CSLI) (2008). Defining, establishing, and verifying reference intervals in the clinical laboratory; aproved guideline—third edition. CLSI Document EP28-A3c.

22.

Mula-Abed WA, Al Rasadi K, Al-Riyami D (2012) Estimated Glomerular Filtration Rate (eGFR): a serum creatinine-based test for the detection of chronic kidney disease and its impact on clinical practice. Oman Med J 27(2):108–113. https://doi.org/10.5001/omj.2012.23CrossRefPubMedPubMedCentral

23.

Blake GM, Fogelman I (2007) The role of DXA bone density scans in the diagnosis and treatment of osteoporosis. Postgrad Med J 83(982):509–517. https://doi.org/10.1136/pgmj.2007.057505CrossRefPubMedPubMedCentral

24.

Hwang JS, Chan DC, Chen JF, Cheng TT, Wu CH, Soong YK, Tsai KS, Yang RS (2014) Clinical practice guidelines for the prevention and treatment of osteoporosis in Taiwan: summary. J Bone Miner Metab 32(1):10–16. https://doi.org/10.1007/s00774-013-0495-0CrossRefPubMed

25.

Heidari B, Hosseini R, Javadian Y, Bijani A, Sateri MH, Nouroddini HG (2015) Factors affecting bone mineral density in postmenopausal women. Arch Osteoporos 10:15. https://doi.org/10.1007/s11657-015-0217-4CrossRefPubMed

26.

Li HZ, Chen Z, Hou CL, Tang YX, Wang F, Fu QG (2015) Uric acid promotes osteogenic differentiation and inhibits adipogenic differentiation of human bone mesenchymal stem cells. J Biochem Mol Toxicol 29(8):382–387. https://doi.org/10.1002/jbt.21707CrossRefPubMed

27.

Ahn SH, Lee SH, Kim BJ, Lim KH, Bae SJ, Kim EH, Kim HK, Choe JW, Koh JM, Kim GS (2013) Higher serum uric acid is associated with higher bone mass, lower bone turnover, and lower prevalence of vertebral fracture in healthy postmenopausal women. Osteoporos Int 24(12):2961–2970. https://doi.org/10.1007/s00198-013-2377-7CrossRefPubMed

28.

Hwang J, Hwang JH, Ryu S, Ahn JK (2019) Higher serum uric acid is associated with higher lumbar spine bone mineral density in male health-screening examinees: a cross-sectional study. J Bone Miner Metab 37(1):142–151. https://doi.org/10.1007/s00774-018-0905-4CrossRefPubMed

29.

Yao X, Chen L, Xu H, Zhu Z (2020) The association between serum uric acid and bone mineral density in older adults. Int J Endocrinol 2020:3082318. https://doi.org/10.1155/2020/3082318CrossRefPubMedPubMedCentral

30.

Lane NE, Parimi N, Lui LY, Wise BL, Yao W, Lay YA, Cawthon PM, Orwoll E, Osteoporotic Fractures in Men Study G (2014) Association of serum uric acid and incident nonspine fractures in elderly men: the osteoporotic fractures in men (MrOS) study. J Bone Miner Res 29(7):1701–1707. https://doi.org/10.1002/jbmr.2164CrossRef

31.

Nabipour I, Sambrook PN, Blyth FM, Janu MR, Waite LM, Naganathan V, Handelsman DJ, Le Couteur DG, Cumming RG, Seibel MJ (2011) Serum uric acid is associated with bone health in older men: a cross-sectional population-based study. J Bone Miner Res 26(5):955–964. https://doi.org/10.1002/jbmr.286CrossRefPubMed

32.

Veronese N, Carraro S, Bano G et al (2016) Hyperuricemia protects against low bone mineral density, osteoporosis and fractures: a systematic review and meta-analysis. Eur J Clin Invest 46(11):920–930. https://doi.org/10.1111/eci.12677CrossRefPubMed

33.

Xiao J, Chen W, Feng X, Liu W, Zhang Z, He L, Ye Z (2017) Serum uric acid is associated with lumbar spine bone mineral density in healthy Chinese males older than 50 years. Clin Interv Aging 12:445–452. https://doi.org/10.2147/CIA.S130690CrossRefPubMedPubMedCentral

34.

Yan DD, Wang J, Hou XH, Bao YQ, Zhang ZL, Hu C, Jia WP (2018) Association of serum uric acid levels with osteoporosis and bone turnover markers in a Chinese population. Acta Pharmacol Sin 39(4):626–632. https://doi.org/10.1038/aps.2017.165CrossRefPubMed

35.

Xiong A, Yao Q, He J, Fu W, Yu J, Zhang Z (2016) No causal effect of serum urate on bone-related outcomes among a population of postmenopausal women and elderly men of Chinese Han ethnicity–a Mendelian randomization study. Osteoporos Int 27(3):1031–1039. https://doi.org/10.1007/s00198-015-3341-5CrossRefPubMed

36.

Chen L, Peng Y, Fang F, Chen J, Pan L, You L (2015) Correlation of serum uric acid with bone mineral density and fragility fracture in patients with primary osteoporosis: a single-center retrospective study of 253 cases. Int J Clin Exp Med 8(4):6291–6294PubMedPubMedCentral

37.

Maggio D, Barabani M, Pierandrei M, Polidori MC, Catani M, Mecocci P, Senin U, Pacifici R, Cherubini A (2003) Marked decrease in plasma antioxidants in aged osteoporotic women: results of a cross-sectional study. J Clin Endocrinol Metab 88(4):1523–1527. https://doi.org/10.1210/jc.2002-021496CrossRefPubMed

38.

Babaei M, Shamsi R, Heidari B, Bijani A, Hosseini SR (2019) Serum uric acid status and its association with bone mineral density in the elderly people aged 60 years and more. Int J Endocrinol Metab 17(3):e80780. https://doi.org/10.5812/ijem.80780

Title: Association between serum uric acid level and bone mineral density at multiple skeletal sites in middle-aged and elderly men: a cross-sectional study of a healthy population in Taiwan
Authors: Zih-Cen Lin
Jhu-Fong Wu
Chiung-Yun Chang
Kuan-Ming Lai
Hsin-Yi Yang
Publication date: 01-12-2022
Publisher: Springer London
Keywords: Osteoporosis
Osteoporosis
Published in: Archives of Osteoporosis / Issue 1/2022
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-022-01186-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Association between serum uric acid level and bone mineral density at multiple skeletal sites in middle-aged and elderly men: a cross-sectional study of a healthy population in Taiwan

Abstract

Summary

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2022

The association of opioid consumption and osteoporosis in old men: Bushehr Elderly Health (BEH) program

Relationship between body mass index and fracture risk at different skeletal sites: a nationwide cohort study

Age-dependent assessment thresholds to optimize patient care in a resource-limited setting: an analysis based on the Sri Lankan FRAX model

Development of a data-driven case-mix adjustment model for comparison of hospital performance in hip fracture care

Implications of FRAX® adjusted for recent fracture on the indication of treatment in an FLS

Prevalence and patterns of anti-osteoporotic drug use based on 2019 real-world nationwide data in Greece