Association of Serum Uric Acid Status With Bone Mineral Density in Adolescents Aged 12–19 Years

Abstract

Aims: Evidence linking serum uric acid (sUA) and bone mineral density (BMD) in adolescents is very limited. To the best of our knowledge, only one report has focused on the relationship between sUA and BMD in adolescents. Thus, this study aimed to determine the association between sUA and total BMD in adolescents aged 12-19 years.Methods: A cross-sectional study was conducted on a sample composed of non-institutionalized US population from the National Health and Nutrition Examination Survey. Weighted multivariate linear regression models were used to evaluate the association between sUA and total BMD. Subgroup analyses were further performed.Results: sUA positively correlated with total BMD in the multiple regression model after adjusting for potential confounders. However, in the subgroup analyses stratified by sex, age, or race/ethnicity, the association between sUA and total BMD followed an inverted U-shaped curve in female adolescents, adolescents aged 16-19 years, and other race/ethnicity. Conclusions: Our results suggested that the correlation between sUA level and total BMD differed by sex. The increased sUA level would be beneficial to bone health in adolescents with low sUA levels, but for female adolescents, a higher sUA level (turning point, 3.9 mg/dL) may have an adverse effect on bone health.

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].…”