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

Xiaocong Yao,Lin Chen,Zhongxin Zhu,Huihui Xu

doi:10.1155/2020/3082318

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.

Highlights

Over the last decade, the proportion of elderly individuals in the general population has been steadily increasing worldwide
E clinical assessment of risk factors of osteoporosis contributes to identifying candidates who would benefit from bone mineral density (BMD) screening, using dual-energy X-ray absorptiometry (DEXA), for effective early intervention to reduce the incidence of fragility fractures
Between 1999 and 2001, the 704 Multichannel Analyzer or Roche Hitachi Model 917 were used to measure serum uric acid (sUA), with the Beckman Synchron LX20 used since 2002. e outcome variable was lumbar BMD, measured by DEXA. e following categorical variables were included in our analysis as covariates: sex, race/ethnicity, level of education, alcohol consumption, smoking behavior, physical activity, and use of calcium supplementation. e continuous covariates were included in our analysis: age, poverty to income ratio, waist circumference (WC), C-reactive protein (CRP), blood urea nitrogen (BUN), total protein, total cholesterol, serum phosphorus, and serum calcium. e detailed information on sUA, lumbar BMD, and covariates are publicly available at http://www.cdc.gov/nchs/nhanes/

Summary

Introduction

The proportion of elderly individuals in the general population has been steadily increasing worldwide. Individuals over the age of 60 years make up >11% of the global population, with this proportion expected to increase to about 22% by 2050 [1]. E clinical assessment of risk factors of osteoporosis contributes to identifying candidates who would benefit from BMD screening, using dual-energy X-ray absorptiometry (DEXA), for effective early intervention to reduce the incidence of fragility fractures. In this regard, there is ongoing research interest in identifying novel, as well as less well-studied biomarkers of osteoporosis, such as serum uric acid (sUA). Due to its antioxidant properties, UA is considered to contribute to greater BMD by inhibiting osteoclastic bone resorption and promoting osteoblastic differentiation [10]

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