Gout is not associated with the risk of fracture: a meta-analysis

Abstract

Background Numerous quantitatively based studies measuring the association between gout and the risk of fractures remain inconclusive. In order to determine whether gout could increase the risk of fractures, a meta-analysis was performed systematically. Methods Electronic databases, MEDLINE/PubMed, Embase, and Cochrane Library were systematically searched to identify studies evaluating the association of gout and the risk of fractures. No restrictions on language, publication date, or journal of publication were imposed. Meta-analysis was performed to pool the outcome estimates of interest such as fracture incidence, fracture risk, and fracture risk in different sites and at different time points in the follow-up period. Results Screening determined that seven studies involving a total of 684,964 participants (151,002 in the gout group and 533,962 in the control group) were deemed viable for inclusion in the meta-analysis. The results of the analysis showed that gout would not significantly have a relatively higher risk of any fracture (RR = 1.11, 95% CI 0.98–1.26). Subgroup analysis showed consistent results for sexuality (female: RR = 1.13, 95% CI 0.93–1.37; male: RR = 0.99, 95% CI 0.91–1.07) and several occurring sites (humerus, wrist, vertebra, hip, upper limbs, and lower limbs). Additionally, the results demonstrated that urate-lowering drugs prescribed early during disease had neither adverse nor beneficial effect on the long-term risk of fractures (RR = 0.89, 95% CI 0.76–1.05). Conclusions This meta-analysis confirmed that gout was not associated with an increased risk of fractures. Urate-lowering drugs prescribed early during the course of disease had neither adverse nor beneficial effect on the long-term risk of fractures. Electronic supplementary material The online version of this article (10.1186/s13018-019-1317-4) contains supplementary material, which is available to authorized users.

Case report of a tibial fracture in a patient suffering from gout: An atypical site, the importance of differential diagnosis

“…Although reported articles have demonstrated an increased prevalence of fractures especially in certain categories of gout patients [6] , the authors generally agree that the disease is not associated with an increased fracture risk, and that medical therapy aimed at reducing uric acid has no obvious benefit in preventing significant skeletal events [7] , [8] , [9] .…”

Gouty Arthropathy: Review of Clinical Manifestations and Treatment, with Emphasis on Imaging

“…Gout has been associated with diabetes, obesity, hyperlipidemia, metabolic syndrome, insulin resistance, hypertension, renal disease, stroke, neurodegenerative diseases, and cardiac disease, and can lead to premature death [ 1 , 7 , 13 , 17 , 22 , 23 , 35 , 39 , 41 , 42 , 43 , 44 , 45 , 46 ]. Gout is not associated with an increased risk of fractures [ 47 ].…”

Potential Association of Osteoporosis and Not Osteoporotic Fractures in Patients with Gout: A Longitudinal Follow-Up Study

“…Likewise, an extensive primary care medical data-based study in the United Kingdom reported no impact of gout on vertebral or non-vertebral fractures [ 19 ]. A meta-analysis concluded no definite identifiable risk for osteoporotic fractures at any site following gout in either males or females [ 20 ]. While most epidemiological studies have brought into focus the possible hazard for osteoporotic fractures following gout [ 11 , 16 , 17 , 18 , 19 , 20 ], data on incident osteoporosis that can increase fracture susceptibility are scarce [ 21 , 22 ].…”

“…A meta-analysis concluded no definite identifiable risk for osteoporotic fractures at any site following gout in either males or females [ 20 ]. While most epidemiological studies have brought into focus the possible hazard for osteoporotic fractures following gout [ 11 , 16 , 17 , 18 , 19 , 20 ], data on incident osteoporosis that can increase fracture susceptibility are scarce [ 21 , 22 ]. Fewer than ten studies have been published on gout and the subsequent development of osteoporosis [ 21 , 22 ] or fracture [ 11 , 16 , 17 , 18 , 19 , 20 ] since 2016, of which only two cohort studies dealt with osteoporosis risk [ 21 , 22 ], which has yet to be reproduced in combined analyses with both osteoporosis and vertebral and non-vertebral osteoporotic fractures in enough longstanding follow-up data.…”