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Association between serum uric acid level and bone mineral density at multiple skeletal sites in middle-aged and elderly men: a cross-sectional study of a healthy population in Taiwan

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Abstract

Summary

This study revealed that serum uric acid (sUA) levels were not associated with bone mineral density (BMD) at different skeletal sites in middle-aged and elderly men, even adjusting for confounding variables. Nevertheless, a positive association was only found between sUA levels and BMD at all skeletal sites in the normal BMI group.

Introduction

Previous studies have reported an association between serum uric acid (sUA) levels and bone mineral density (BMD). However, their findings are controversial and limited to adult men in the general population. This study was aimed at examining the association between sUA levels and BMD at multiple skeletal sites in middle-aged and elderly men.

Methods

A cross-sectional analysis of BMD at different skeletal sites and sUA levels was conducted on 918 men (age: 50.83 ± 7.95) using data from the Ditmanson Research Database. The participants were categorized into four groups based on quartiles of the sUA level, and BMD were assessed using dual-energy X-ray absorptiometry. Multivariate linear regression models were utilized to investigate the association between sUA levels and BMD. Further, subgroup analyses were performed.

Results

After adjusting for potential confounding factors, sUA as a continuous variable was significantly associated with BMD at the femoral neck only (β, 95% confidence interval: 0.007 [0.001–0.013]). However, in the categorical analysis, no significant differences were detected in terms of BMD at different skeletal sites across the different sUA quartile groups. Moreover, if the body mass index (BMI) was < 24 kg/m2 for each unit increase in sUA level, the spine, femoral neck, and total hip BMD increased by 0.014, 0.013, and 0.015 g/cm2, respectively.

Conclusion

The sUA level was not associated with BMD at different skeletal sites in middle-aged and elderly men. Nevertheless, a positive association was only found between sUA levels and BMD at all skeletal sites in the normal weight group.

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References

  1. Liu N, Xu H, Sun Q, Yu X, Chen W, Wei H, Jiang J, Xu Y, Lu W (2021) The role of oxidative stress in hyperuricemia and zanthine oxidoreductase (XOR) inhibitors. Oxid Med Cell Longev 2021:1470380. https://doi.org/10.1155/2021/1470380

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Sundstrom J, Sullivan L, D’Agostino RB, Levy D, Kannel WB, Vasan RS (2005) Relations of serum uric acid to longitudinal blood pressure tracking and hypertension incidence. Hypertension 45(1):28–33. https://doi.org/10.1161/01.HYP.0000150784.92944.9a

    Article  CAS  PubMed  Google Scholar 

  3. Soltani Z, Rasheed K, Kapusta DR, Reisin E (2013) Potential role of uric acid in metabolic syndrome, hypertension, kidney injury, and cardiovascular diseases: is it time for reappraisal? Curr Hypertens Rep 15:175–181

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Wu AH, Gladden JD, Ahmed M, Ahmed A, Filippatos G (2016) Relation of serum uric acid to cardiovascular disease. Int J Cardiol 213(3):4–7. https://doi.org/10.1007/s11906-013-0344-5

    Article  CAS  PubMed  Google Scholar 

  5. Nejatinamini S, Ataie-Jafari A, Qorbani M, Nikoohemat S, Kelishadi R, Asayesh H, Hosseini S (2015) Association between serum uric acid level and metabolic syndrome components. J Diabetes Metab Disord 14:70. https://doi.org/10.1186/s40200-015-0200-z

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Ali N, Perveen R, Rahman S et al (2018) Prevalence of hyperuricemia and the relationship between serum uric acid and obesity: a study on Bangladeshi adults. PLoS One 13:e0206850. https://doi.org/10.1371/journal.pone.0206850

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Braga F, Pasqualetti S, Ferraro S, Panteghini M (2016) Hyperuricemia as risk factor for coronary heart disease incidence and mortality in the general population: a systematic review and meta-analysis. Clin Chem Lab Med 54(1):7–15. https://doi.org/10.1515/cclm-2015-0523

    Article  CAS  PubMed  Google Scholar 

  8. Han Y, Han K, Han X, Yin Y, Di H, Wu J, Zhang Y, Zeng X (2021) Serum uric acid might be positively associated with hypertension in Chinese adults: an analysis of the China Health and Nutrition Survey. Front Med (Lausanne) 8:755509. https://doi.org/10.3389/fmed.2021.755509

    Article  PubMed  Google Scholar 

  9. Lv Q, Meng XF, He FF et al (2013) High serum uric acid and increased risk of type 2 diabetes: a systemic review and meta-analysis of prospective cohort studies. PLoS One 8:e56864. https://doi.org/10.1371/journal.pone.0056864

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Kaushal N, Vohora D, Jalali RK, Jha S (2019) Review of the literature examining the association of serum uric acid with osteoporosis and mechanistic insights into its effect on bone metabolism. Endocr Metab Immune Disord Drug Targets 19(3):259–273. https://doi.org/10.2174/1871530318666181102115106

    Article  CAS  PubMed  Google Scholar 

  11. Badila AE, Radulescu DM, Ilie A, Niculescu AG, Grumezescu AM, Radulescu AR (2022) Bone regeneration and oxidative stress: an updated overview. Antioxidants (Basel) 11(2):318. https://doi.org/10.3390/antiox11020318

    Article  CAS  PubMed  Google Scholar 

  12. Domazetovic V, Marcucci G, Iantomasi T, Brandi ML, Vincenzini MT (2017) Oxidative stress in bone remodeling: role of antioxidants. Clin Cases Miner Bone Metab 14:209–216. https://doi.org/10.11138/ccmbm/2017.14.1.209

    Article  PubMed  PubMed Central  Google Scholar 

  13. Menale C, Robinson LJ, Palagano E et al (2019) Absence of dipeptidyl peptidase 3 increases oxidative stress and causes bone loss. J Bone Miner Res 34:2133–2148. https://doi.org/10.1002/jbmr.3829

    Article  CAS  PubMed  Google Scholar 

  14. Hershfield MS, Roberts LJ 2nd, Ganson NJ, Kelly SJ, Santisteban I, Scarlett E, Jaggers D, Sundy JS (2010) Treating gout with pegloticase, a PEGylated urate oxidase, provides insight into the importance of uric acid as an antioxidant in vivo. Proc Natl Acad Sci U S A 107(32):14351–14356. https://doi.org/10.1073/pnas.1001072107

    Article  PubMed  PubMed Central  Google Scholar 

  15. Zhang D, Bobulescu IA, Maalouf NM, Adams-Huet B, Poindexter J, Park S, Wei F, Chen C, Moe OW, Sakhaee K (2015) Relationship between serum uric acid and bone mineral density in the general population and in rats with experimental hyperuricemia. J Bone Miner Res 30(6):992–999. https://doi.org/10.1002/jbmr.2430

    Article  CAS  PubMed  Google Scholar 

  16. Li X, Li L, Yang L, Yang J, Lu H (2021) No association between serum uric acid and lumbar spine bone mineral density in US adult males: a cross sectional study. Sci Rep 11(1):15588. https://doi.org/10.1038/s41598-021-95207-z

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Sritara C, Ongphiphadhanakul B, Chailurkit L, Yamwong S, Ratanachaiwong W, Sritara P (2013) Serum uric acid levels in relation to bone-related phenotypes in men and women. J Clin Densitom 16(3):336–340. https://doi.org/10.1016/j.jocd.2012.05.008

    Article  PubMed  Google Scholar 

  18. Pan WH, Lee MS, Chuang SY, Lin YC, Fu ML (2008) Obesity pandemic, correlated factors and guidelines to define, screen and manage obesity in Taiwan. Obes Rev 9(Suppl 1):22–31. https://doi.org/10.1111/j.1467-789X.2007.00434.x

    Article  PubMed  Google Scholar 

  19. Zhang Y, Post WS, Dalal D, Blasco-Colmenares E, Tomaselli GF, Guallar E (2011) Coffee, alcohol, smoking, physical activity and QT interval duration: results from the Third National Health and Nutrition Examination Survey. PLoS One 6(2):e17584. https://doi.org/10.1371/journal.pone.0017584

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Neogi T, Jansen TL, Dalbeth N et al (2015) 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 74(10):1789–1798. https://doi.org/10.1136/annrheumdis-2015-208237

    Article  CAS  PubMed  Google Scholar 

  21. Cinical and Laboratory Standards Institute (CSLI) (2008). Defining, establishing, and verifying reference intervals in the clinical laboratory; aproved guideline—third edition. CLSI Document EP28-A3c.

  22. Mula-Abed WA, Al Rasadi K, Al-Riyami D (2012) Estimated Glomerular Filtration Rate (eGFR): a serum creatinine-based test for the detection of chronic kidney disease and its impact on clinical practice. Oman Med J 27(2):108–113. https://doi.org/10.5001/omj.2012.23

    Article  PubMed  PubMed Central  Google Scholar 

  23. Blake GM, Fogelman I (2007) The role of DXA bone density scans in the diagnosis and treatment of osteoporosis. Postgrad Med J 83(982):509–517. https://doi.org/10.1136/pgmj.2007.057505

    Article  PubMed  PubMed Central  Google Scholar 

  24. Hwang JS, Chan DC, Chen JF, Cheng TT, Wu CH, Soong YK, Tsai KS, Yang RS (2014) Clinical practice guidelines for the prevention and treatment of osteoporosis in Taiwan: summary. J Bone Miner Metab 32(1):10–16. https://doi.org/10.1007/s00774-013-0495-0

    Article  PubMed  Google Scholar 

  25. Heidari B, Hosseini R, Javadian Y, Bijani A, Sateri MH, Nouroddini HG (2015) Factors affecting bone mineral density in postmenopausal women. Arch Osteoporos 10:15. https://doi.org/10.1007/s11657-015-0217-4

    Article  PubMed  Google Scholar 

  26. Li HZ, Chen Z, Hou CL, Tang YX, Wang F, Fu QG (2015) Uric acid promotes osteogenic differentiation and inhibits adipogenic differentiation of human bone mesenchymal stem cells. J Biochem Mol Toxicol 29(8):382–387. https://doi.org/10.1002/jbt.21707

    Article  CAS  PubMed  Google Scholar 

  27. Ahn SH, Lee SH, Kim BJ, Lim KH, Bae SJ, Kim EH, Kim HK, Choe JW, Koh JM, Kim GS (2013) Higher serum uric acid is associated with higher bone mass, lower bone turnover, and lower prevalence of vertebral fracture in healthy postmenopausal women. Osteoporos Int 24(12):2961–2970. https://doi.org/10.1007/s00198-013-2377-7

    Article  CAS  PubMed  Google Scholar 

  28. Hwang J, Hwang JH, Ryu S, Ahn JK (2019) Higher serum uric acid is associated with higher lumbar spine bone mineral density in male health-screening examinees: a cross-sectional study. J Bone Miner Metab 37(1):142–151. https://doi.org/10.1007/s00774-018-0905-4

    Article  CAS  PubMed  Google Scholar 

  29. Yao X, Chen L, Xu H, Zhu Z (2020) The association between serum uric acid and bone mineral density in older adults. Int J Endocrinol 2020:3082318. https://doi.org/10.1155/2020/3082318

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Lane NE, Parimi N, Lui LY, Wise BL, Yao W, Lay YA, Cawthon PM, Orwoll E, Osteoporotic Fractures in Men Study G (2014) Association of serum uric acid and incident nonspine fractures in elderly men: the osteoporotic fractures in men (MrOS) study. J Bone Miner Res 29(7):1701–1707. https://doi.org/10.1002/jbmr.2164

    Article  CAS  Google Scholar 

  31. Nabipour I, Sambrook PN, Blyth FM, Janu MR, Waite LM, Naganathan V, Handelsman DJ, Le Couteur DG, Cumming RG, Seibel MJ (2011) Serum uric acid is associated with bone health in older men: a cross-sectional population-based study. J Bone Miner Res 26(5):955–964. https://doi.org/10.1002/jbmr.286

    Article  CAS  PubMed  Google Scholar 

  32. Veronese N, Carraro S, Bano G et al (2016) Hyperuricemia protects against low bone mineral density, osteoporosis and fractures: a systematic review and meta-analysis. Eur J Clin Invest 46(11):920–930. https://doi.org/10.1111/eci.12677

    Article  CAS  PubMed  Google Scholar 

  33. Xiao J, Chen W, Feng X, Liu W, Zhang Z, He L, Ye Z (2017) Serum uric acid is associated with lumbar spine bone mineral density in healthy Chinese males older than 50 years. Clin Interv Aging 12:445–452. https://doi.org/10.2147/CIA.S130690

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Yan DD, Wang J, Hou XH, Bao YQ, Zhang ZL, Hu C, Jia WP (2018) Association of serum uric acid levels with osteoporosis and bone turnover markers in a Chinese population. Acta Pharmacol Sin 39(4):626–632. https://doi.org/10.1038/aps.2017.165

    Article  CAS  PubMed  Google Scholar 

  35. Xiong A, Yao Q, He J, Fu W, Yu J, Zhang Z (2016) No causal effect of serum urate on bone-related outcomes among a population of postmenopausal women and elderly men of Chinese Han ethnicity–a Mendelian randomization study. Osteoporos Int 27(3):1031–1039. https://doi.org/10.1007/s00198-015-3341-5

    Article  CAS  PubMed  Google Scholar 

  36. Chen L, Peng Y, Fang F, Chen J, Pan L, You L (2015) Correlation of serum uric acid with bone mineral density and fragility fracture in patients with primary osteoporosis: a single-center retrospective study of 253 cases. Int J Clin Exp Med 8(4):6291–6294

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Maggio D, Barabani M, Pierandrei M, Polidori MC, Catani M, Mecocci P, Senin U, Pacifici R, Cherubini A (2003) Marked decrease in plasma antioxidants in aged osteoporotic women: results of a cross-sectional study. J Clin Endocrinol Metab 88(4):1523–1527. https://doi.org/10.1210/jc.2002-021496

    Article  CAS  PubMed  Google Scholar 

  38. Babaei M, Shamsi R, Heidari B, Bijani A, Hosseini SR (2019) Serum uric acid status and its association with bone mineral density in the elderly people aged 60 years and more. Int J Endocrinol Metab 17(3):e80780. https://doi.org/10.5812/ijem.80780

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Acknowledgements

The authors thank the help from the Clinical Data Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, for providing administrative and technical support. This study is based in part on data from the Ditmanson Research Database (DRD) provided by Ditmanson Medical Foundation Chia-Yi Christian Hospital. The interpretation and conclusions contained herein do not represent the position of Ditmanson Medical Foundation Chia-Yi Christian Hospital.

Funding

This study was supported by grants from the Ditmanson Medical Foundation Chia-Yi Christian Hospital Research Program (R109-020).

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Authors and Affiliations

  1. Department of Radiology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan

    Zih-Cen Lin, Jhu-Fong Wu, Chiung-Yun Chang & Kuan-Ming Lai

  2. Department of Medical Research, Clinical Data Center, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan

    Hsin-Yi Yang

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The study was reviewed and approved by the Institutional Review Board of the Ditmanson Medical Foundation Chia-Yi Christian Hospital, Taiwan (CYCH-IRB No: 2019063).

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Lin, ZC., Wu, JF., Chang, CY. et al. Association between serum uric acid level and bone mineral density at multiple skeletal sites in middle-aged and elderly men: a cross-sectional study of a healthy population in Taiwan. Arch Osteoporos 17, 142 (2022). https://doi.org/10.1007/s11657-022-01186-7

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