Bone mineral density 23Bone loss 24 Uric acid 25 Body composition 26 Fat mass 27Objective: Oxidative stress has been linked to osteoporosis. Serum uric acid (UA), a strong endogenous anti-28 oxidant, has been associated with higher bone mineral density (BMD), lower bone turnover and lower prev-29 alence of fractures in a large cross-sectional study of men. Whether this relationship is present in women and 30 how UA relates to changes in BMD longitudinally has not been examined.31 Methods: A sample of 356 peri-and postmenopausal women, mean age 60.5 years was studied. Each individ-32 ual had baseline BMD and body composition measurements by dual energy x-ray absorptiometry (DXA) and 33 at least one repeat measure, on average 9.7 years later. Annual rate of change in BMD (A%ΔBMD) was calcu-34 lated. UA was measured at each DXA visit. Calciotropic hormones and bone turnover markers were measured 35 at the final visit only.36 Results: Cross-sectional data analyses revealed that women with higher UA levels had significantly higher 37 absolute BMD measures at all skeletal sites. These women also had higher measures of body weight and its 38 components such as lean mass (LM) and fat mass (FM). Results of multiple regression analyses showed a 39 positive association between UA and BMD that remained significant even after accounting for possible con-40 founders including LM and FM. Regression analyses of the longitudinal BMD data demonstrated significant 41 associations between serum UA levels and annual rates of change in BMD at all skeletal sites. After adjust-42 ment associations remained significant for lumbar spine, forearm and whole body BMD but not for hip BMD.43 Conclusion: Higher serum UA levels appear to be protective for bone loss in peri-and postmenopausal women 44 and this relationship is not affected by changes in body composition measures.45

IntroductionThe Global Burden of Disease Study 2010 estimated the worldwide health burden of 291 diseases and injuries and 67 risk factors by calculating disability-adjusted life years (DALYs). Osteoporosis was not considered as a disease, and bone mineral density (BMD) was analysed as a risk factor for fractures, which formed part of the health burden due to falls. Objectives To calculate (1) the global distribution of BMD, (2) its population attributable fraction (PAF) for fractures and subsequently for falls, and (3) the number of DALYs due to BMD. Methods A systematic review was performed seeking population-based studies in which BMD was measured by dual-energy X-ray absorptiometry at the femoral neck in people aged 50 years and over. Age-and sex-specific mean ± SD BMD values (g/cm 2

Increased sunlight exposure did not reduce vitamin D deficiency or falls risk in frail older people. This public health strategy was not effective most likely due to poor adherence to the intervention.

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