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

Abstract

Despite convincing experimental evidence, epidemiological studies on the effects of serum uric acid (SUA) on bone health are still conflicting since factors influencing SUA bioavailability have not been adequately considered. To shed some light on this issue, we investigated the impact of adiposity and menopause status on the relationship between SUA and bone health. We examined SUA in relation to bone mineral density (BMD) at different skeletal sites and with markers of bone metabolism in 124 pre-menopausal and 234 post-menopausal women and assessed whether adiposity, evaluated by anthropometry and dual x-ray absorptiometry (DXA), might have a discriminant role. After conservative adjustment (covariates: age, hormones treatment, smoking and time since menopause), SUA showed a significant and positive association with total hip BMD (β = 0.220, p < 0.01) among postmenopausal women, maintained also after adjustment for legs adiposity. Notably, stratification for waist circumference quartiles revealed that the correlation between SUA and total hip BMD was significant (r = 0.444, p = 0.001) in the highest quartile (91–100 cm). Our results suggest that SUA might be beneficial for bone health in postmenopausal women being characterized by a more android fat distribution, ascribing to SUA a discriminant role during menopause transition, potentially relevant also for men.

Serum Uric Acid Level Is Positively Associated With Higher Bone Mineral Density at Multiple Skeletal Sites Among Healthy Qataris

“…Similarly in another cross-sectional study, BMI and adiposity were independently associated with BMD as they attenuated the association between SUA and BMD to marginal significance after adjustment ( 23 ). Such finding was also confirmed in other studies ( 24 , 25 ). In the study conducted by Han et al.…”

“…The study also confirmed no significant association between SUA and total body BMD in young adults, women, non-obese, and smokers. This finding is supported by several epidemiological studies using different study designs and population samples ( 23 , 24 , 26 – 40 ) as listed in Table 2 . These epidemiological studies aimed to elucidate the relation between SUA and bone health.…”

“…Similarly in another cross-sectional study, BMI and adiposity were independently associated with BMD as they attenuated the association between SUA and BMD to marginal significance after adjustment (23). Such finding was also confirmed in other studies (24,25). In the study conducted by Han et al on a group of Chinese postmenopausal women, SUA was significantly associated with lumber BMD after adjustments for the aforementioned factors in addition to blood pressure, alcohol intake, milk intake, and calcium supplements (26).…”

“…Many cross-sectional studies have confirmed the positive association between SUA and BMD in both genders and all age groups after adjustment for potential confounders (28,36,38). In other cross-sectional studies, the positive association was dependant on a significant interaction of SUA level with age and vitamin C level (40), central adiposity, or obesity among postmenopausal women (23,24,26). other crosssectional studies have suggested an additional protective effect of SUA against the development of osteoporosis or osteoporotic fractures (27,30,32,33,37,39).…”

The Association between Serum Uric Acid and Bone Mineral Density in Older Adults

“…Heterogeneity between these studies, including differences in the study design, study sample, distribution of race, and the confounding variables controlled for, may explain the controversial findings between studies. In our study, we controlled for WC rather than body mass index (BMI), as WC is a stronger predictor of sUA and BMD than BMI, as recently reported [ 31 ]. We note that we further performed subgroup analyses for more appropriate representation of the data set as recommended by the STROBE statement [ 32 ].…”