Original Article
Serum Uric Acid Levels in Relation to Bone-Related Phenotypes in Men and Women

https://doi.org/10.1016/j.jocd.2012.05.008Get rights and content

Abstract

Serum uric acid levels have recently been found to be associated with bone mineral density (BMD) in elderly males. The purpose of the present study was to investigate the relationship between bone-related phenotypes and serum uric acid levels in young and middle-aged males and females. Subjects consisted of 1320 males and 485 females aged 25–54 yr. Bone densitometry and quantitative ultrasonometry (QUS) were performed on each subject. Serum uric acid and biochemical markers of bone turnover were measured in fasting serum samples. When adjusted for covariates including age, body weight, and serum creatinine in multiple linear regression models, it was found that there was a positive association between uric acid levels and BMD in males at the lumbar spine (p < 0.05). The association between uric acid levels and BMD was found in females after controlling for age, body weight, and serum creatinine at the femoral neck, but in the opposite direction (p < 0.05). Uric acid levels were related to the stiffness index (SI) as assessed by QUS in males, independent of age, body weight, and serum creatinine (p < 0.05). No association between uric acid and SI in females was found. The present study demonstrated a positive association in males between serum uric acid levels and BMD, and SI from QUS, suggesting a beneficial influence of uric acid on both the quantity and quality of bone in males.

Introduction

Uric acid is traditionally believed to be a metabolic waste of purine metabolism, with no significant biological function in humans. However, it has been suggested that uric acid possesses antioxidant properties 1, 2. Oxidative stress plays an important role in a number of illnesses, including hypertension (3), diabetes (4), and chronic kidney disease (5). A number of antioxidants, including vitamins C and E, have been shown to potentially affect such disorders favorably. Likewise, there is an evidence that uric acid also has a favorable effect in cases of thromboembolic stroke 6, 7.

Oxidative stress may increase the propensity for age-related bone loss (8). In this regard, a recent study in elderly males demonstrated a positive association between serum uric acid levels and bone mineral density (BMD), independent of other associated factors including age and body mass index (9). The finding is intriguing and suggests a probable role of uric acid in bone metabolism. Nevertheless, it is unclear at a present if there is an association between uric acid and bone-related phenotypes in younger age groups, and if there is any gender difference. Toward this end, the present study investigated the association between bone-related phenotypes and serum uric acid levels in young and middle-aged males and females.

Section snippets

Materials and Methods

The study was part of a health survey of employees of the Electricity Generating Authority of Thailand (EGAT). Institutional Review Board approval was obtained prior to commencement of the study, and all subjects gave informed consent. Survey data were collected by using a self-administered questionnaire, physical examination, electrocardiography, chest radiography, and blood analysis. Fasting blood samples were obtained and sent for uric acid analysis. Blood samples for procollagen I

Results

Table 1 demonstrates the clinical characteristics of the study population. Subjects were mostly males (73.1%), largely because of the demographic structure of the EGAT. When comparing males and females, it was found that males were slightly older, and had significantly higher BMD at the femoral neck and total femur but not at the lumbar spine. No difference was found in terms of SI as measured by QUS. Serum uric acid levels were significantly higher in males.

There were correlations between uric

Discussion

In the present study, we demonstrated a relationship in males between serum uric acid levels and BMD at the lumbar spine, a skeletal site rich in trabecular bone. Although our study population was younger in age, our finding is in keeping with a previous study in elderly males (9). This suggests that the influence of uric acid on bone, if causal in nature, is likely to begin at a younger age and could probably affect the attainment of peak bone mass. However, whether uric acid is causally

Acknowledgments

This study was supported by the project for Higher Education Research Promotion and National Research University Development, Office of the Higher Education Commission, and the Thailand Research Fund. We thank Roche Diagnostics (Thailand) Ltd. for providing the serum CTX and serum total P1NP assays used in this study.

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  • Association of serum uric acid with bone mineral density and clinical fractures in Chinese type 2 diabetes mellitus patients: A cross-sectional study

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    Yet, some recent observational studies have shown the contrary. Sritara et al. and Mehta et al. found that serum UA concentrations were inversely associated with BMD at the femoral neck (FN) after controlling for covariates in females aged 25–54 y, and higherserum UA concentrations were associated with an increased risk of hip fractures in community-dwelling elderly men, respectively [21, 22]. Recent studies reported that serum UA concentration has no relationship with BMD values at various skeletal sites and the onset of new osteoporotic fractures after adjustment for potential confounders in young and middle-aged, and elderly men and pre-menopausal women, and post-menopausal women not treated with estrogen or withT2DM [23–26], and confirmed the conclusion in a rodent model of chronic mild hyperuricemia [25].

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Conflicts of interest: None.

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