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Gómez-de-Tejada-Romero MJ, Murias-Henríquez C, Saavedra-Santana P, Sablón-González N, Abreu DR, Sosa-Henríquez M. Influence of serum uric acid on bone and fracture risk in postmenopausal women. Aging Clin Exp Res 2024; 36:156. [PMID: 39085733 PMCID: PMC11291523 DOI: 10.1007/s40520-024-02819-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024]
Abstract
AIMS Uric acid has been associated with several metabolic conditions, including bone diseases. Our objective here was to consider the relationship between serum uric acid levels and various bone parameters (bone mineral density, ultrasonographic parameters, vitamin D, PTH and serum calcium), as well as the prevalence and risk of fragility fracture. METHODS An observational and cross-sectional study carried out on 679 postmenopausal women, classified into 3 groups according to their serum uric acid levels, in whom bone densitometry, calcaneus ultrasounds, PTH, vitamin D and serum calcium analysis were done. Bone fractures were collected through the clinical history and lateral spinal X-ray. RESULTS Higher uric acid levels were found in women with older age, high BMI, diabetes, and high blood pressure. Higher levels of PTH and serum calcium were also observed, but did not effect on vitamin D. Serum uric acid was positively related to densitometric and ultrasonic parameters and negatively associated with vertebral fractures. CONCLUSIONS In the population of postmenopausal women studied, sUA levels were correlated with BMD, BUA, and QUI-Stiffness, and this correlation was independent of age and BMI. In addition, sUA was associated with a decrease in vertebral fractures. These results imply a beneficial influence of sUA on bone metabolism, with both a quantitative and qualitative positive effect, reflected in the lower prevalence of vertebral fractures.
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Affiliation(s)
| | - Carmen Murias-Henríquez
- University of Las Palmas de Gran Canaria, Osteoporosis and Mineral Metabolism Research Group. Las Palmas de Gran Canaria, Canaria, Spain
| | - Pedro Saavedra-Santana
- University of Las Palmas de Gran Canaria, Osteoporosis and Mineral Metabolism Research Group. Las Palmas de Gran Canaria, Canaria, Spain
| | - Nery Sablón-González
- University of Las Palmas de Gran Canaria, Osteoporosis and Mineral Metabolism Research Group. Las Palmas de Gran Canaria, Canaria, Spain
| | - Delvys Rodríguez Abreu
- University of Las Palmas de Gran Canaria, Osteoporosis and Mineral Metabolism Research Group. Las Palmas de Gran Canaria, Canaria, Spain
| | - Manuel Sosa-Henríquez
- University of Las Palmas de Gran Canaria, Osteoporosis and Mineral Metabolism Research Group. Las Palmas de Gran Canaria, Canaria, Spain.
- Canary Health Service, Insular University Hospital, Bone Metabolic Unit, Las Palmas de Gran Canaria, Canaria, Spain.
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Liu Y, Feng J, Ji P, Chen W, Yang R, Zhang J. Association between gout and the risk of osteoporosis and fractures: a meta-analysis. Z Rheumatol 2024; 83:191-199. [PMID: 37759097 DOI: 10.1007/s00393-023-01432-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/29/2023]
Abstract
OBJECTIVE The relationship between gout and osteoporosis is poorly clarified, and the association between gout and fractures incidence remains controversial. Hence, in the present study, we aimed to comprehensively evaluate the available literature to elucidate whether gout is associated with an increased risk of both osteoporosis and fractures. MATERIALS AND METHODS We conducted an exhaustive search of pertinent literature published until 20 March 2023, in well-recognized databases, namely Medline, Embase and Cochrane Library, focusing on examining the association between gout and the risk of osteoporosis or fracture. Meta-analysis was performed to aggregate the relative risks (RR) using random- or fixed-effects models. Sensitivity analyses were conducted iteratively, whereby each study was removed sequentially to gauge its impact on the overall outcome. Publication bias was assessed using Egger's and Begg's tests. This study was registered with PROSPERO (registry number: CRD42022376822). RESULTS Herein, we included 10 observational studies comprising a total of 1,606,095 participants. An independent population sample of four studies validated the significant association between gout and osteoporosis (RR = 1.25, 95% confidence interval [CI] 1.05-1.48), with the results demonstrating robustness. However, our analysis did not detect any association between gout and fracture risk when compared with the control group (RR = 1.09, 95%CI 0.99-1.19), along with high heterogeneity (p for heterogeneity = 0.000; I2 = 79.7%). Further subgroup analysis revealed that gout is positively associated with fracture risk in the Chinese population (RR = 1.17, 95%CI 1.14-1.21), with no evidence of heterogeneity (p for heterogeneity = 0.420; I2 = 0.00%). CONCLUSION Our meticulous evaluation of the available literature indicates that gout has no discernible impact on fracture incidence, although it is positively associated with an enhanced risk of osteoporosis. Therefore, it is imperative to prioritize preventive measures to prevent osteoporotic complications in individuals diagnosed with gout.
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Affiliation(s)
- Yani Liu
- Department of General Practice, The Second Affiliated Hospital of Guangxi Medical University, No. 166 Daxuedong Road, 530007, Nanning, China
- Department of General Practice, Affiliated Hospital of Guilin Medical University, 541001, Guilin, China
| | - Jihua Feng
- Department of General Practice, The Second Affiliated Hospital of Guangxi Medical University, No. 166 Daxuedong Road, 530007, Nanning, China
| | - Pan Ji
- Department of General Practice, The Second Affiliated Hospital of Guangxi Medical University, No. 166 Daxuedong Road, 530007, Nanning, China
| | - Wei Chen
- Department of General Practice, The Second Affiliated Hospital of Guangxi Medical University, No. 166 Daxuedong Road, 530007, Nanning, China
| | - Ruiqi Yang
- Department of General Practice, The Second Affiliated Hospital of Guangxi Medical University, No. 166 Daxuedong Road, 530007, Nanning, China
| | - Jianfeng Zhang
- Department of General Practice, The Second Affiliated Hospital of Guangxi Medical University, No. 166 Daxuedong Road, 530007, Nanning, China.
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Smoking and fracture risk in men: a meta-analysis of cohort studies, using both frequentist and Bayesian approaches. Sci Rep 2022; 12:9270. [PMID: 35661791 PMCID: PMC9166727 DOI: 10.1038/s41598-022-13356-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 05/16/2022] [Indexed: 11/15/2022] Open
Abstract
Past studies indicate that men are more likely to smoke and be at higher risk of smoking-related conditions than women. Our research aimed, through meta-analysis, to assess the association between smoking and fracture risk in men. The following databases were searched, including MEDLINE, EMBASE, Scopus, PsycINFO, ISI Web of Science, Google Scholar, WorldCat, and Open Grey, for identifying related studies. A random-effects model was used to pool the confounder-adjusted relative risk (R.R.). Frequentist and Bayesian hierarchical random-effects models were used for the analysis. The heterogeneity and publication bias were evaluated in this study. Twenty-seven studies met the inclusion criteria. Overall, smoking is associated with a significantly increased risk of fracture in both the frequentist approach (R.R., 1.37; 95% confidence interval: 1.22, 1.53) and the Bayesian approach (R.R., 1.36; 95% credible interval: 1.22, 1.54). Significant heterogeneity was observed in the meta-analysis (Higgin's I2 = 83%) and Cochran's Q statistic (p < 0.01). A significant association was also observed in multiple pre-specified sensitivity and subgroup analyses. Similar results were observed in the group containing a large sample size (≥ 10,000 participants), and the group has a small sample size (< 10,000 participants); the pooled R.R was 1.23 (95% confidence interval, 1.07–1.41) and 1.56 (95% confidence interval, 1.37–1.78), respectively. With the Bayesian method, the effect size was 1.23 (95% credible interval, 1.05, 1.45) for the large sample size group and 1.57 (95% credible interval, 1.35, 1.82) for the small sample size group. Smoking is associated with a significant increase in fracture risk for men. Thus, smoking cessation would also greatly reduce fracture risk in all smokers, particularly in men.
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Brozek W, Ulmer H, Pompella A, Nagel G, Leiherer A, Preyer O, Concin H, Zitt E. Gamma-glutamyl-transferase is associated with incident hip fractures in women and men ≥ 50 years: a large population-based cohort study. Osteoporos Int 2022; 33:1295-1307. [PMID: 35059776 DOI: 10.1007/s00198-022-06307-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 01/08/2022] [Indexed: 12/30/2022]
Abstract
UNLABELLED The association of serum gamma-glutamyl-transferase (GGT) with hip fracture risk has not been examined in women and men ≥ 50 years. We show that elevated GGT was associated with increased hip fracture risk, particularly in men. GGT could be a candidate serum marker of long-term hip fracture risk in the elderly. INTRODUCTION We herein examined a possible relation between serum levels of GGT and hip fracture risk in women and men aged ≥ 50 years, which has not been investigated before. METHODS In this population-based prospective cohort study, approximately 41,000 women and nearly 33,000 men ≥ 50 years participating in a medical prevention program 1985-2005 in western Austria were followed up for the occurrence of osteoporotic hip fractures during 2003-2013. ICD-10 based discharge diagnoses for hip fracture included S72.0, S72.1, and S72.2 available from all regional hospitals. GGT-related hip fracture risk was ascertained at each participant´s first and last examination during the prevention program. In a subset of 5445 participants, alcohol consumption could be included as a covariate. RESULTS In men, hip fracture risk rose significantly by 75% and 86% for every tenfold increase of GGT measured at the first and last examination, respectively, and in women, hip fracture risk rose by 22% from the last examination. Elevated GGT (≥ 36 U/l in women, ≥ 56 U/l in men) at the first examination was associated with increased hip fracture risk only in men (HR 1.51, 95% CI 1.25-1.82), and at the last examination in both women (HR 1.14, 95% CI 1.02-1.28) and men (HR 1.61, 95% CI 1.33-1.95). Alcohol consumption had no significant influence on GGT-mediated hip fracture risk in women and men. CONCLUSIONS Our findings identified an association of elevated GGT and hip fracture in women and men ≥ 50 years and suggest GGT as a candidate serum marker of long-term hip fracture risk in an elderly population.
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Affiliation(s)
- W Brozek
- Agency for Preventive and Social Medicine, Bregenz, Austria.
| | - H Ulmer
- Agency for Preventive and Social Medicine, Bregenz, Austria
- Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria
| | - A Pompella
- Department of Translational Research and New Technologies in Medicine and Surgery, Università Di Pisa, Pisa, Italy
| | - G Nagel
- Agency for Preventive and Social Medicine, Bregenz, Austria
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - A Leiherer
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
- Private University of the Principality of Liechtenstein, Triesen, Liechtenstein
- Medical Central Laboratories, Feldkirch, Austria
| | - O Preyer
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - H Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - E Zitt
- Agency for Preventive and Social Medicine, Bregenz, Austria
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
- Department of Internal Medicine 3 (Nephrology and Dialysis), Feldkirch Academic Teaching Hospital, Feldkirch, Austria
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Lai SW, Kuo YH, Liao KF. Serum uric acid and the risk of incident hip fractures in women and men. Maturitas 2021; 154:55. [PMID: 34332821 DOI: 10.1016/j.maturitas.2021.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Shih-Wei Lai
- Department of Public Health, College of Public Health, and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
| | - Yu-Hung Kuo
- Department of Research, Taichung Tzu Chi Hospital, Taichung, Taiwan
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien, Taiwan; Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi Hospital, Taichung, Taiwan.
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Brozek W, Preyer O, Concin H, Nagel G, Ulmer H, Zitt E. Response to comments on the paper "serum uric acid is associated with incident hip fractures in women and men". Maturitas 2021; 154:56-57. [PMID: 34344569 DOI: 10.1016/j.maturitas.2021.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 07/16/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Wolfgang Brozek
- Agency for Preventive and Social Medicine, Bregenz, Austria.
| | - Oliver Preyer
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Hans Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Gabriele Nagel
- Agency for Preventive and Social Medicine, Bregenz, Austria; Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Hanno Ulmer
- Agency for Preventive and Social Medicine, Bregenz, Austria; Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria
| | - Emanuel Zitt
- Agency for Preventive and Social Medicine, Bregenz, Austria; Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Academic Teaching Hospital Feldkirch, Feldkirch, Austria; Department of Nephrology and Dialysis, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
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