Association of serum uric acid levels with osteoporosis and bone turnover markers in a Chinese population

Abstract

Recent evidence shows that uric acid is protective against some neurological diseases, but can be detrimental in many metabolic and cardiovascular disorders. In this study, we examined the association between serum uric acid levels and bone metabolism in Chinese males and postmenopausal females. A total of 943 males and 4256 postmenopausal females were recruited in Shanghai. The levels of serum uric acid and bone turnover markers (BTMs) were detected along with other biochemical traits. In addition, the fat distribution was calculated through MRI and image analysis software, and bone mineral density (BMD) was determined using dual-energy X-ray absorptiometry. For postmenopausal females, the prevalence of osteoporosis was significantly lower in the hyperuricemia group compared with the normouricemic group (P=4.65E-06). In females, serum uric acid level was significantly associated with osteoporosis, with odds ratio (OR) and 95% confidence interval (95% CI) of 0.844 [0.763; 0.933] (P=0.0009) after adjusting for age, body mass index, HbA1c, lean mass, visceral and subcutaneous fat areas, albumin, 25-hydroxyvitamin D3 [25(OH)D3], and parathyroid hormone (PTH). In females, serum uric acid level was positively correlated with the BMD of the femoral neck (β±SE: 0.0463±0.0161; P=0.0042), total hip (β±SE: 0.0433±0.0149; P=0.0038) and L1-4 (β±SE: 0.0628±0.0165; P=0.0001) after further adjusting for age, BMI, HbA1c, lean mass, VFA, SFA, albumin, 25(OH)D3 and PTH. Regarding BTMs, serum uric acid level was negatively correlated with N-terminal procollagen of type I collagen (PINP) in females (β±SE: -0.1311±0.0508; P=0.0100). In summary, our results suggest that uric acid has a protective effect on bone metabolism independent of body composition in Chinese postmenopausal females.

Changes in Adipose Tissue Distribution and Association between Uric Acid and Bone Health during Menopause Transition

“…A cross-sectional study, including 7502 healthy postmenopausal women found that serum SUA levels were positively associated with BMD at all sites [13]. In this line, similar results were those reported by Ishii et al (sample: n = 615) [14] and more recently by Yan et al (sample: n = 4256) [15]. In particular, in the latter study SUA was found to be positively correlated with BMD also in males (sample: n = 943) and associations with similar strengths and direction were reported in two other studies dealing with male subjects [25,26].…”

“…A paradigmatic example in this context is serum uric acid (SUA), the most abundant non-enzymatic endogen antioxidant present in systemic circulation [12]. While recent studies have shown that SUA levels are positively correlated with bone mineral density (BMD) in the general population [13][14][15], contrasting results have been reported suggesting no associations between SUA and bone health markers [16], or marked differences in correlation strength and direction between men and women [17].…”

Expert consensus for the diagnosis and treatment of patient with hyperuricemia and high cardiovascular risk

“…Patients with the highest sUA concentrations had a higher probability to develop dementia (OR 3.32, 95% CI 1.06--10.42) [103]. Contrarily, some studies revealed that HU might reduce the risk of neurological diseases, especially Parkinson's and Alzheimer's disease, vascular and non-vascular dementia [104] or osteoporosis [105]. This so-called "uric acid paradox" has already been widely discussed [4].…”

Identification of the molecular mechanism and diagnostic biomarkers in the thoracic ossification of the ligamentum flavum using metabolomics and transcriptomics

“…It has also been studied in bone formation, by stimulating osteoblasts and osteoclasts. Yan et al suggested that acid was negatively correlated with bone formation markers in postmenopausal females [27]. One possible explanation could be that the low level of uric acid might promote bone formation, especially the heterotopic ossification.…”