Positive association between serum uric acid and bone mineral density in Chinese type 2 diabetes mellitus stratified by gender and BMI

Abstract

Accumulating evidence has demonstrated that serum uric acid (UA), a natural powerful antioxidant, plays a beneficial role in bone health in the general population. However, few reports are available on the association between serum UA and bone in patients with type 2 diabetes mellitus (T2DM). We therefore investigated whether the benefit of serum UA for bone health was still present in those patients. 626 males and 609 postmenopausal females with T2DM were enrolled in this cross-sectional study. Serum UA concentrations and bone mineral density (BMD) measured at lumbar spine, femoral neck and total hip by dual-energy X-ray absorptiometry were obtained from all subjects. Meanwhile, data on osteoporosis prevalence, glucose metabolism, bone turnover markers and other serum biochemical indexes were collected. After adjustment for potential confounders, the results suggested that serum UA was positively associated with BMD in patients with normal weight, but this positive association varied by gender and skeletal sites in overweight T2DM patients [body mass index (BMI) ≥ 25 kg/m]. Moreover, significantly lower odds ratios (ORs) for osteoporosis were found in postmenopausal patients with the highest UA tertile and male patients with medium UA tertile [adjusted OR 0.315, 95% confidence interval (CI) 0.170-0.581 for postmenopausal patients; adjusted OR 0.464, 95% CI 0.225-0.955 for male patients]. The positive association between serum UA and BMD found in Chinese T2DM patients may imply that relatively high UA is a protective factor for bone in these patients. Large intervention studies are needed to further confirm the outcomes and provide possible explanations.

Effects of vitamin B 12 , folate, uric acid, and serum biomarkers of inflammation on bone mineral density in postmenopausal women

“…In a recent study by Xu et al . [ 35 ] a positive association between UA and BMD was demonstrated. The authors suggested that relatively high UA might be a protective factor for bone health in postmenopausal diabetic women.…”

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

“…The prevalence of hyperuricemia in children and adolescents varies among countries, and largely depends on age, sex, ethnicity, and region (17). In addition, concentration of UA is strongly influenced by age, sex, body mass index (BMI), body composition, and other factors that also influence BMD (10,18,19). Therefore, based on the national population, we performed a cross-sectional study with a much larger sample to determine the association of sUA with BMD in adolescents.…”

Serum Uric Acid Status and Its Association with Bone Mineral Density in the Elderly People Aged 60 Years and More

“…A large cross-sectional study of healthy postmenopausal women showed higher risk of osteoporosis in the lowest quartile of serum UA by 40% as compared to the highest quartile (7). Nonetheless, the association between serum UA and BMD is influenced by sex and site of BMD measurement (7, 9-11). Since many elderly people have coexistence of two or more common chronic medical conditions such as obesity, diabetes, and metabolic syndrome, these conditions which are also prevalent in the general population of northern Iran, may directly or indirectly confound the association between serum UA and BMD in the elderly people (13-18).…”