Nicola Veronese1,2, Sara Carraro3, Giulia Bano3, Caterina Trevisan3, Marco Solmi4,5, Claudio Luchini5,6, Enzo Manzato3,7, Riccardo Caccialanza8, Giuseppe Sergi3, Davide Nicetto9, Emanuele Cereda8. 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.
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.
Authors: A Mantovani; R Rigolon; A Civettini; B Bolzan; G Morani; S Bonapace; C Dugo; G Zoppini; E Bonora; G Targher Journal: J Endocrinol Invest Date: 2017-07-15 Impact factor: 4.256
Authors: D Simon; J Haschka; C Muschitz; A Kocijan; A Baierl; A Kleyer; G Schett; S Kapiotis; H Resch; M Sticherling; J Rech; R Kocijan Journal: Osteoporos Int Date: 2020-01-10 Impact factor: 4.507
Authors: Maria Pallayova; Marek Brenisin; Alina Putrya; Martin Vrsko; Sylvia Drazilova; Martin Janicko; Maria Marekova; Daniel Pella; Andrea Madarasova Geckova; Peter Urdzik; Peter Jarcuska; HepaMeta Team Journal: Int J Environ Res Public Health Date: 2020-10-21 Impact factor: 3.390