Hyperuricemia protects against low bone mineral density, osteoporosis and fractures: a systematic review and meta‐analysis. (5th October 2016)

• Record Type: Journal Article
• Authors: Veronese, Nicola; Carraro, Sara; Bano, Giulia; Trevisan, Caterina; Solmi, Marco; Luchini, Claudio; Manzato, Enzo; Caccialanza, Riccardo; Sergi, Giuseppe; Nicetto, Davide; Cereda, Emanuele
• Is Part Of: European journal of clinical investigation. Volume 46:Number 11(2016:Nov.)
• Page Start: 920
• Page End: 930
• Publication Date: 2016-10-05
• Subjects: Bone mineral density -- fractures -- hyperuricemia -- osteoporosis -- uric acid; Pathology -- Periodicals; Medical research -- Periodicals; 616.075
• DOI: 10.1111/eci.12677
• Languages: English
• ISSNs: 0014-2972

Abstract

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; I 2 = 47%), total hip (seven studies; SMD = 0·29; 95% CI: 0·24–0·34; I 2 = 33%) and femoral neck (six studies; SMD = 0·25; 95% CI: 0·16–0·34; I 2 = 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; I 2 = 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.