Interplay between fat, muscle, bone mass, and oteophytes and risk for tophaceous gout

Abstract

Tophaceous gout is a common arthritis caused by the deposition of urate crystals and is related to limited joint function. Although there are reports that uric acid (UA) is associated with bone mineral density (BMD), little is known about the relationship between UA, osteophytes, and muscle. This cross-sectional case–control study was performed in patients with tophaceous gout. The control group included patients without gout. All subjects underwent BMD and body composition analyses. Age, sex, alcohol consumption, smoking, and radiography of both knees were recorded. Adjusted ORs for tophaceous gout were calculated using the logistical regression models. A total of 150 male patients were enrolled, including 65 individuals with tophaceous gout and 85 without gout. The mean age of the patients with tophaceous gout was 59.94±12.40 years, while that of individuals without gout was 61.29±11.57 years (p=0.492). Patients with tophaceous gout have a higher mean body mass index, fat mass, appendicular lean mass, BMD, and osteophytes. Multiple logistic regression analysis revealed that fat mass (OR 2.01, 95% CI 1.27 to 3.18), appendicular lean mass (OR 4.27, 95% CI 1.86 to 9.83), and osteophytes (OR 5.88, 95% CI 1.72 to 20.13) were significantly associated with tophaceous gout. In the current study, higher fat mass, high muscle mass, and osteophyte formation were found to increase the risk of tophaceous gout, as the association is the most than can be inferred from a cross-sectional study. Therefore, reducing body fat and weight management may prevent tophaceous gout.

Association between serum uric acid level and bone mineral density in men more than 50 years of age

“…It stimulates osteoclast differentiation and suppresses osteoblast differentiation via ERK and ERK-dependent NF-Kb activation demonstrated in experiment, resulting in bone loss (10). In addition, it promotes myofibrillar proteolysis and muscle atrophy (17,(37)(38)(39). The result of our study can be explained by the antioxidant effect of uric acid, which reduces oxidative stress-related bone loss (5,8,14).…”

“…The subgroup analysis indicated that mechanical muscle force affects on bone strength; moreover it is affected by how much body mass is supported by the muscle and bone ( 16 ). In addition, the muscle-derived mechanical loading and cytokines via the endocrine and paracrine pathway stimulate bone development and maintenance ( 17 , 38 ).…”

Prevalence and factors associated to diffuse idiopathic skeletal hyperostosis in gout

“…Although mostly associated to aging, DISH has been also associated to metabolic disturbances such as overweight, hyperuricemia and diabetes [4], and also to the metabolic syndrome [5]. There is some evidence on the association of DISH with gout [5][6][7] and with the development of tophaceous gout [8,9]. This study intended to evaluate the prevalence of DISH in patients with gout, the presence of spinal and peripheral joint involvement, and the association of DISH with comorbid conditions associated to gout, clinical characteristics of gout severity, and concomitant calcium pyrophosphate arthritis (CPPA).…”