Serum uric acid and incident osteoporotic fractures in old people: The PRO.V.A study

Veronese, Nicola; Bolzetta, Francesco; Rui, Marina De; Maggi, Stefania; Noale, Marianna; Zambon, Sabina; Corti, Maria Chiara; Toffanello, Elena Debora; Baggio, Giovannella; Perissinotto, Egle; Crepaldi, Gaetano; Manzato, Enzo; Sergi, Giuseppe

doi:10.1016/j.bone.2015.06.005

Cited by 30 publications

(31 citation statements)

References 26 publications

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“…Second, SUA levels have been directly associated with body mass index, which seems to be significantly associated with BMD values . Finally, higher SUA levels were found correlated with lower levels of bone resorption markers and 25OHD , but it emerged from some studies (also included in our meta‐analysis) that subjects with higher SUA levels have a worse renal function and higher serum PTH levels, two well‐known risk factors for osteoporosis and fractures. So further studies are needed to better clarify the confounding effect of these factors.…”

Section: Discussionmentioning

confidence: 78%

“…The pooled adjusted HRs [median number of adjustments = 14 (range: 6–20)] for the number of new fractures during the follow‐up are given in Table . In the analysis on the both genders together, an increase of one SD in SUA levels corresponded to a 17% reduction in the number of new fractures during the follow‐up (three studies ; HR = 0·83; 95% CI: 0·74–0·92; P = 0·001; I 2 = 0%). The results for men alone were similar, while the estimates could not be computed for women alone (no studies available).…”

Section: Resultsmentioning

confidence: 96%

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Hyperuricemia protects against low bone mineral density, osteoporosis and fractures: a systematic review and meta‐analysis

Veronese

Carraro

Bano

et al. 2016

Eur J Clin Investigation

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Section: Discussionmentioning

confidence: 78%

Section: Resultsmentioning

confidence: 96%

Hyperuricemia protects against low bone mineral density, osteoporosis and fractures: a systematic review and meta‐analysis

Veronese

Carraro

Bano

et al. 2016

Eur J Clin Investigation

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“…Another longitudinal study of 16,078 Korean men aged 50 years or older suggested a similar association between sUA and incident osteoporotic fracture (HR = 0.83, 95% CI 0.70–0.99) . However, an Italian cohort study of 3099 men and women aged 65 years or older showed no association between sUA level and incident fracture risk . The differences across these studies may be, at least partly, related to different age and sex distributions of the study cohorts and the definitions of the fracture outcomes.…”

Section: Discussionmentioning

confidence: 99%

Gout and the Risk of Non-vertebral Fracture

Kim

Paik

et al. 2016

Journal of Bone and Mineral Research

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Prior studies suggest an association between osteoporosis, systemic inflammation and pro-inflammatory cytokines such as IL-1 and IL-6. Conflicting findings exist on the association between hyperuricemia and osteoporosis. Furthermore, it remains unknown whether gout, a common inflammatory arthritis, affects fracture risk. Using data from a US commercial health plan (2004–2013), we evaluated the risk of non-vertebral fracture (i.e. forearm, wrist, hip and pelvis) in patients with gout versus those without. Gout patients were identified with ≥2 diagnosis codes and ≥1 dispensing for a gout-related drug. Non-gout patients, identified with ≥2 visits coded for any diagnosis and ≥1 dispensing for any prescription drugs, were free of gout diagnosis and received no gout-related drugs. Hip fracture was the secondary outcome. Fractures were identified with a combination of diagnosis and procedure codes. Cox proportional hazards models compared the risk of non-vertebral fracture in gout patients versus non-gout, adjusting for over 40 risk factors for osteoporotic fracture. Among gout patients with baseline serum uric acid (sUA) measurements available, we assessed the risk of non-vertebral fracture associated with sUA. We identified 73,202 gout and 219,606 non-gout patients, matched on age, sex, and the date of study entry. The mean age was 60 years and 82% were men. Over the mean 2-year follow-up, the incidence rate of non-vertebral fracture per 1,000 person-years was 2.92 in gout and 2.66 in non-gout. The adjusted hazard ratio (HR) was 0.98 (95%CI 0.85–1.12) for non-vertebral fracture and 0.83 (95%CI 0.65–1.07) for hip fracture in gout versus non-gout. Subgroup analysis (n=15,079) showed no association between baseline sUA and non-vertebral fracture (HR 1.03, 95%CI 0.93–1.15), adjusted for age, sex, comorbidity score and number of any prescription drugs. Gout was not associated with a risk of non-vertebral fracture. Among patients with gout, sUA was not associated with the risk of non-vertebral fracture.

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“…Several studies found that higher serum urate (which is a major risk factor for gout) is associated with higher bone mineral density and a lower risk of fracture [10][11][12][13][14]; one recent study showed no relationship between serum urate and fracture rates in older people [21], another recent study found that higher urate was associated with higher fracture rates in men [22]. Gout, ascertained by any use of allopurinol in a large Danish registry, was associated with higher fracture rates in men but not women [23].…”

Section: Discussionmentioning

confidence: 99%