Association between serum uric acid level and bone mineral density in Chinese gout patients: a cross-sectional study
- 1Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
- 2Department of Endocrinology and Metabolism, Affiliated Hospital of Qingdao University, Qingdao, China
Abstract
Background: Previous studies have suggested that elevated levels of serum uric acid (sUA) exert significant protective effects against osteoporosis in healthy individuals. However, the effects of sUA levels on bone mineral density (BMD) and bone turnover markers (BTMs) in gout patients, as well as the risk factors for osteopenia in this population, remain unclear. Our study aimed to analyse the risk factors for osteopenia in gout patients and investigate the effects of sUA levels on bone metabolism.
Methods: Patients were categorized into two groups based on their BMD, including the low BMD group (comprising both osteopenia and osteoporosis patients, given the small number of individuals in the osteoporosis subgroup) and the normal BMD group. We compared their clinical characteristics, incorporated sUA into a logistic regression analysis and applied restricted cubic splines (RCSs) to evaluate potential nonlinear dose-response relationships. Multivariate linear regression models were subsequently used to investigate the associations between sUA levels and BMD. Furthermore, subgroup analyses were performed.
Results: Compared with patients in the normal BMD group, patients in the low BMD group were older and had significantly greater sUA levels but lower BMI values ( P < 0.05). Logistic regression analysis revealed that high sUA levels were an independent risk factor for osteopenia. RCS analyses revealed a linear relationship between sUA levels and the risk of osteopenia. Multivariate linear regression analyses adjusted for sex, age, body mass index (BMI), and other potential confounders demonstrated a significant negative correlation between sUA levels and BMD at all skeletal sites. Furthermore, subgroup analyses revealed an inverse association between sUA levels and lumbar spine BMD in participants with a BMI <28 kg/m ² and those aged ≥ 50 years.
Conclusion: Among hospitalized patients with stable-stage gout, sUA levels were negatively associated with BMD in gout patients . Higher sUA levels (particularly > 9.4 mg/dL) were linked to a greater likelihood of low BMD, especially in older and nonobese individuals.
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BibTeX
@article{liu2026association,
title = {{Association between serum uric acid level and bone mineral density in Chinese gout patients: a cross-sectional study}},
author = {Tian Liu and Qing Wang and Fei Yan and Ying Gong and Xiaoyu Cheng and Lidan Ma and Ruixia Sun and Qing He},
journal = {PeerJ},
year = {2026},
month = oct,
doi = {10.7717/peerj.21878},
url = {https://peerj.com/articles/21878},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association between serum uric acid level and bone mineral density in Chinese gout patients: a cross-sectional study
AU - Tian Liu
AU - Qing Wang
AU - Fei Yan
AU - Ying Gong
AU - Xiaoyu Cheng
AU - Lidan Ma
AU - Ruixia Sun
AU - Qing He
PY - 2026
DA - 2026/10/26
JO - PeerJ
DO - 10.7717/peerj.21878
UR - https://peerj.com/articles/21878
AB - Background: Previous studies have suggested that elevated levels of serum uric acid (sUA) exert significant protective effects against osteoporosis in healthy individuals. However, the effects of sUA levels on bone mineral density (BMD) and bone turnover markers (BTMs) in gout patients, as well as the risk factors for osteopenia in this population, remain unclear. Our study aimed to analyse the risk factors for osteopenia in gout patients and investigate the effects of sUA levels on bone metabolism. Methods: Patients were categorized into two groups based on their BMD, including the low BMD group (comprising both osteopenia and osteoporosis patients, given the small number of individuals in the osteoporosis subgroup) and the normal BMD group. We compared their clinical characteristics, incorporated sUA into a logistic regression analysis and applied restricted cubic splines (RCSs) to evaluate potential nonlinear dose-response relationships. Multivariate linear regression models were subsequently used to investigate the associations between sUA levels and BMD. Furthermore, subgroup analyses were performed. Results: Compared with patients in the normal BMD group, patients in the low BMD group were older and had significantly greater sUA levels but lower BMI values ( P < 0.05). Logistic regression analysis revealed that high sUA levels were an independent risk factor for osteopenia. RCS analyses revealed a linear relationship between sUA levels and the risk of osteopenia. Multivariate linear regression analyses adjusted for sex, age, body mass index (BMI), and other potential confounders demonstrated a significant negative correlation between sUA levels and BMD at all skeletal sites. Furthermore, subgroup analyses revealed an inverse association between sUA levels and lumbar spine BMD in participants with a BMI <28 kg/m ² and those aged ≥ 50 years. Conclusion: Among hospitalized patients with stable-stage gout, sUA levels were negatively associated with BMD in gout patients . Higher sUA levels (particularly > 9.4 mg/dL) were linked to a greater likelihood of low BMD, especially in older and nonobese individuals.
SN - 2167-8359
ER -