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

Abstract

Objectives. Uric acid has been found to be potentially protective in bone metabolism. We investigated the relationship between serum uric acid (sUA) and lumbar bone mineral density (BMD) among 4156 participants aged 60 years and over from the National Health and Nutrition Examination Survey (NHANES). Methods. To estimate the association between sUA and lumbar BMD, multivariate logistic regression analyses were conducted. Fitted smoothing curves and generalized additive models were also performed. Results. We found sUA positively correlated with lumbar BMD after adjusting for other confounders. On subgroup analyses, stratified by sex and race/ethnicity, the positive correlation of sUA with lumbar BMD remained in both men and women, as well as in whites and Mexican Americans, but not in blacks. In blacks, the association of sUA with lumbar BMD was an inverted U-shaped curve (inflection point: 7.5 mg/dL). Conclusions. Our study revealed a positive relationship between sUA and lumbar BMD among most old adults. This association followed an inverted U-shaped curve among blacks.

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

“…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)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) as listed in Table 2. These epidemiological studies aimed to elucidate the relation between SUA and bone health.…”

“…Consistently two longitudinal studies had concluded the positive association between SUA and annual rates of change in BMD at different skeletal sites ( 31 ) and lower risk in developing osteoporotic fractures ( 29 ). Interestingly, other studies had additionally confirmed the lack of association between SUA and BMD in young females ( 35 ) and black Americans ( 34 ).…”

Why Does Hyperuricemia Not Necessarily Induce Gout?

“…At the hydrophilic condition, it shows the protective effects of antioxidants [38]. Reducing SUA could decline its protective effect to radiation damage [39], and total bone mineral density [40,41] or a protective effect on bone loss in rheumatoid arthritis [42] ( Figure 1). Beyond its role in protection, over-saturated SUA together with sodium could deposit in joints, soft tissues, bones, skin, etc., as MSU crystals to form tophi and trigger gout flares with episodes of severe pain.…”

“…At the hydrophilic condition, it shows the protective effects of antioxidants [ 38 ]. Reducing SUA could decline its protective effect to radiation damage [ 39 ], and total bone mineral density [ 40 , 41 ] or a protective effect on bone loss in rheumatoid arthritis [ 42 ] ( Figure 1 ).…”

Why Hyperuricemia Does Not Necessarily Induce Gout?

“…At the hydrophilic condition, it shows the protective effects of antioxidant [38]. Reducing SUA could decline the protecting effect to radiation damage [39], and total bone mineral density [40,41] or a protective effect on bone loss in rheumatoid arthritis [42].…”