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Eur J Clin Invest. 2016 Nov;46(11):920-930. doi: 10.1111/eci.12677. Epub 2016 Oct 5.

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

Author information

1
Geriatrics Section, Department of Medicine, University of Padova, Padova, Italy. ilmannato@gmail.com.
2
Institute for Clinical Research and Education in Medicine (IREM), Padova, Italy. ilmannato@gmail.com.
3
Geriatrics Section, Department of Medicine, University of Padova, Padova, Italy.
4
Institute for Clinical Research and Education in Medicine (IREM), Padova, Italy.
5
Department of Neurosciences, University of Padova, Padova, Italy.
6
Department of Pathology and Diagnostics, Verona University and Hospital Trust, Verona, Italy.
7
National Research Council, Aging Branch, Institute of Neuroscience, Padova, Italy.
8
Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
9
Azienda Provinciale per i Servizi Sanitari (APSS) Trento, Trento, Italy.

Abstract

BACKGROUND:

Serum uric acid (SUA) accounts for about 50% of extracellular antioxidant activity, suggesting that hyperuricemia may have a protective role in diseases characterized by high levels of oxidative stress, such as osteoporosis. We aimed to meta-analyse data regarding bone mineral density (BMD), osteoporosis and fractures in people with higher SUA vs. lower SUA concentrations.

MATERIALS AND METHODS:

Two investigators conducted a literature search using PubMed and Scopus, without language restrictions. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were used for BMD; risk ratios (RRs) and adjusted odds ratios (ORs) for cross-sectional data. Most possible adjusted hazard ratios (HRs) were used to assess the association between baseline SUA and incident fractures.

RESULTS:

Of 1405 initial hits, 19 studies were eligible including a total of 55 859 participants. Subjects with higher SUA levels had significantly higher BMD values for the spine (six studies; SMD = 0·29; 95% CI: 0·22-0·35; I2 = 47%), total hip (seven studies; SMD = 0·29; 95% CI: 0·24-0·34; I2 = 33%) and femoral neck (six studies; SMD = 0·25; 95% CI: 0·16-0·34; I2 = 71%). Simple correlation analyses substantially confirmed these findings. An increase of one standard deviation in SUA levels reduced the number of new fractures at follow-up (three studies; HR = 0·83; 95% CI: 0·74-0·92; I2 = 0%). No significant differences between men and women emerged, although data about women were limited.

CONCLUSIONS:

Hyperuricemia was found independently associated with BMD and fractures, supporting a protective role for uric acid in bone metabolism disorders.

KEYWORDS:

Bone mineral density; fractures; hyperuricemia; osteoporosis; uric acid

PMID:
27636234
DOI:
10.1111/eci.12677
[Indexed for MEDLINE]

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