BACKGROUND
Serum uric acid is known to be a positive association with bone mineral density, but few studies have been large enough to investigate which range of serum uric acid levels is protective against osteoporosis/osteopenia. This study showed specific ranges of serum uric acid levels are beneficial for bone health.
OBJECTIVE
To explore the relationship between serum uric acid and bone mineral density in people aged 18 or older.
METHODS
A cross-sectional study was conducted to examine the association between SUA and BMD from five cycles of NHANES (2005-2010, 2013-2014, and 2017-2020). Binary logistic regression models and restricted cubic spline models were used to evaluate the association between SUA and osteoporosis/osteopenia.
RESULTS
19881 participants aged ≥ 18 years were included. Higher SUA levels were significantly associated with a lower incidence of osteoporosis/osteopenia after adjustment for potential confounders and after subgroup analysis. The results of restricted cubic spline regression analysis demonstrated that there was a U-shape non-linear relationship between SUA and osteoporosis/osteopenia in all people (P Nonlinear =0.0114), male subgroup (P Nonlinear=0.0040), female subgroup (P Nonlinear =0.0235) and aged≥60 years subgroup (P Nonlinear =0.0001). Meanwhile, a transverse S-shaped relationship was observed in the obese people subgroup (P Nonlinear =0.0486). The cutoff SUA level was higher in males (456 μmol/L) than that in females (376 μmol/L) at the lowest risk of osteoporosis/osteopenia, and cutoff SUA levels in both groups were higher than that in normal SUA levels. The optimal SUA level in the elderly population is 408 μmol/L, and the optimal SUA level in the obese population is 440 μmol/L.
CONCLUSIONS
A complicated relationship between SUA and BMD in different populations was observed. Maintaining SUA within a moderate range may be beneficial to bone health.