The Effect of Uric Acid Levels on Bone Metabolism in Postmenopausal Women
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Original Investigation
P: 12-18
April 2019

The Effect of Uric Acid Levels on Bone Metabolism in Postmenopausal Women

Turk J Osteoporos 2019;25(1):12-18
1. Hitit Üniversitesi, Erol Olçok Eğitim ve Araştırma Hastanesi, Tıbbi Biyokimya Laboratuvarı, Çorum, Türkiye
2. Okmeydanı Eğitim ve Araştırma Hastanesi, Tıbbi Biyokimya Laboratuvarı, İstanbul, Türkiye
3. Okmeydanı Eğitim ve Araştırma Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, İstanbul, Türkiye
No information available.
No information available
Received Date: 26.12.2018
Accepted Date: 09.02.2019
Publish Date: 25.04.2019
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ABSTRACT

Objective:

The decrease in estrogen levels leads to oxidative stress by accumulating reactive oxygen species in the cell and suppressing the antioxidant defense system. Thus, the activity of osteoclasts and bone resorption are stimulated. It is stated that uric acid may contribute to the bone mineral density (BMD) due to antioxidant specialty. In our study; we investigated the relationship among serum uric acid levels, BMD and other bone metabolic markers in women with the postmenopausal period.

Materials and Methods:

BMD and laboratory data (glucose, urea, creatinine, calcium, phosphorus, alkaline phosphatase, uric acid, parathyroid hormone, and 25-hydroxyvitamin D3 levels) of 141 postmenopausal women aged between 50 and 69 were evaluated.

The participants were divided into three groups according to the t-score. These were; the patients with t-score <-2.5 were osteoporosis patient group, t-score between -2.5 and -1.0 were osteopenia patient group, and t-score >-1 were normal BMD group. Biochemical tests were measured by photometric method and hormone tests were measured by electrochemiluminescence method.

Results:

Uric acid levels were significantly higher in the osteopenia group than the normal BMD group (p=0.023). There was no statistically significant difference in uric acid levels between the osteoporosis-steopenia and the osteoporosis-normal BMD groups. No correlation was found between uric acid levels and BMD in all groups. While there was a negative correlation in uric acid levels between the postmenopausal osteopenia and the normal BMD groups (r=-0.423, p=0.016), there was no a significant difference between the osteoporosis and the normal BMD groups (p>0.05).

Conclusion:

As a result of our study, it is difficult to mention a clear relationship between uric acid and lumbar BMD in postmenopausal women. We believe that further studies are needed for solving the uric acid riddle and explaining the effect on bone metabolism. In addition, uric acid levels in patients with postmenopausal osteopenia should be examined in detail.

References

1
Varacallo MA, Fox EJ. Osteoporosis and Its Complications. The Medical clinics of North America. 2014;98:817-31.
2
Lean JM, Davies JT, Fuller K, Jagger CJ, Kirstein B, Partington GA ve ark. A crucial role for thiol antioxidants in estrogen-deficiency bone loss. J Clin Inves 2003; 112: 915-23.
3
Cervellati C, Bonaccorsi G, Cremonini E, Bergamini CM, Patella A, Castaldini C, et al. Bone mass density selectively correlates with serum markers of oxidative damage in post-menopausal women. Clin Chem Lab Med 2013;51:333-8.
4
Mainini G, Rotondi M, Di Nola K, Pezzella MT, Iervolino SA, Seguino E, et al. Oral supplementation with antioxidant agents containing alpha lipoic acid: effects on postmeno¬pausal bone mass. Clin Exp Obstet Gynecol 2012;39:489-93.
5
Maggio D, Barabani M, Pierandrei M, Polidori MC, Catani M, Mecocci P, et al. Marked decrease in plasma antioxidants in aged osteoporotic women: results of a cross-sectional study. J Clin Endocrinol Metab 2003;88:1523-7.
6
Johnson RJ, Kang DH, Feig D, Kivlighn S, Kanellis J, Watanabe S, et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension 2003;41:1183-90.
7
Dehghan A, van Hoek M, Sijbrands EJ, Hofman A, Witteman JC. High serum uric acid as a novel risk factor for type 2 diabetes. Diabetes Care 2008;31:361-2.
8
Verdecchia P, Schillaci G, Reboldi G, Santeusanio F, Porcellati C, Brunetti P. Relation between serum uric acid and risk of cardiovascular disease in essential hypertension. The PIUMA study. Hypertension 2000;36:1072-8.
9
Taghizadeh N, Vonk JM, Boezen HM. Serum uric acid levels and cancer mortality risk among males in a large general population-based cohort study. Cancer Causes Control 2014;25:1075-80.
10
Andreadou E, Nikolaou C, Gournaras F, Rentzos M, Boufidou F, Tsoutsou A, et al. Serum uric acid levels in patients with Parkinson’s disease: their relationship to treatment and disease duration. Clin Neurol Neurosurg 2009;111:724-8.
11
Beyazit F., Pek E. Effects of vitamin B12, folate, uric acid, and serum biomarkers of inflammation on bone mineral density in postmenopausal women. Menopause Rev 2018;17:69-76.
12
Lane NE, Parimi N, Lui LY, Wise BL, Yao W, Lay YA, et al; Osteoporotic Fractures in Men Study Group. Association of serum uric acid and incident nonspine fractures in elderly men: the Osteoporotic Fractures in Men (MrOS) study. J Bone Miner Res 2014;29:1701-7.
13
Ishii S, Miyao M, Mizuno Y, Tanaka-Ishikawa M, Akishita M, Ouchi Y. between serum uric acid and lumbar spine bone mineral density in peri- and postmenopausal Japanese women. Osteoporos Int 2014;25:1099-105.
14
Zhang D, Bobulescu IA, Maalouf NM, Adams-Huet B, Poindexter J, Park S, et al. Relationship between serum uric Acid and bone mineral density in the general population and in rats with experimental hyperuricemia. J Bone Miner Res 2015;30:992-9.
15
Makovey J, Macara M, Chen JS, Hayward CS, March L, Seibel MJ, et al. Serum uric acid plays a protective role for bone loss in peri- and postmenopausal women: a longitudinal study. Bone 2013;52:400-6.
16
Topçuoglu A, Uzun H, Aydin S, Kahraman N, Vehid S, Zeybek G, et al. The effect of hormone replacement therapy on oxidized low density lipoprotein levels and paraoxonase activity in postmenopausal women. Tohoku J Exp Med 2005;205: 9-86.
17
WHO. Guidelines for Preclinical Evaluation and Clinical Trials in Osteoporosis 1998. Report of WHO Study Group.
18
Ahn SH, Lee SH, Kim BJ, LimKH, Bae SJ, Kim EH, et al. Higher serum uric acid is associated with higher bone mass, lower bone turnover, and lower prevalence of vertebral fracture in healthy postmenopausal women. Osteoporos Int 2013;24:2961-70.
19
Lin X, Zhao C, Qin A, Hong D, Liu W, Huang K, et al. Association between serum uric acid and bone health in general population: a large and multicentre study. Oncotarget 2015;6:35395-403.
20
Dong XW, Tian HY, He J, Wang C, Qiu R, Chen YM. Elevated Serum Uric Acid Is Associated with Greater Bone Mineral Density and Skeletal Muscle Mass in Middle-Aged and Older Adults. PLoS One 2016;11:e0154692.
21
Han W, Bai X, Wang N, Han L, Sun X, Chen X. Association between lumbar bone mineral density and serum uric acid in postmenopausal women: a cross-sectional study of healthy Chinese population. Arch Osteoporos 2017;12:50.
22
Chen L, Peng Y, Fang F, Chen J, Pan L, You L. Correlation of serum uric acid with bone mineral density and fragility fracture in patients with primary osteoporosis: a single-center retrospective study of 253 cases. Int J Clin Exp Med 2015;8:6291-4.
23
Sritara C, Ongphiphadhanakul B, Chailurkit L, Yamwong S, Ratanachaiwong W, Sritara P. Serum uric acid levels in relation to bone-related phenotypes in men and women. J Clin Densitom 2013;16:336-40.
24
Dalbeth N, Topless R, Flynn T, CadzowM, Bolland MJ, Merriman TR. Mendelian randomization analysis to examine for a causal effect of urate on bone mineral density. J Bone Miner Res 2015;30:985-91.
25
Xiong A, Yao Q, He J, Fu W, Yu J, Zhang Z. No causal effectof serum urate on bone-related outcomes among a population of postmenopausal women and elderly men of Chinese Han ethnicity—a Mendelian randomization study. Osteoporos Int 2016;27:1031-9.
26
Bhupathiraju SN, Alekel DL, Stewart JW, Hanson LN, Shedd KM, Reddy MB, et al. Relationship of circulating total homocysteine and Creactive protein to trabecular bone in postmenopausal women. J Clin Densitom 2007;10:395-403.
27
Bowman GL, Shannon J, Frei B, Kaye JA, Quinn JF. Uric acid as a CNS antioxidant. J Alzheimers Dis 2010;19:1331-6.
28
Peng H, Li H, Li C, Chao X, Zhang Q, Zhang Y. Association between vitamin D insufficiency and elevated serum uric acid among middle-aged and elderly Chinese Han women. PLoS One 2013;8:e61159.
29
Hordon LD, Peacock M. Vitamin D metabolism in women with femoral neck fracture. Bone Miner 1987;2:413-26.
30
Yahyaoui R, Esteva I, Haro-Mora JJ, Almaraz MC, Morcillo S, Rojo-Martínez G, et al. Effect of longterm administration of cross-sex hormone therapy on serum and urinary uric acid in transsexual persons. J Clin Endocrinol Metab 2008;93:2230-3.
31
Sugiura M, Nakamura M, Ogawa K, Ikoma Y, Ando F, Shimokata H, et al. Dietary patterns of antioxidant vitamin and carotenoid intake associated with bone mineral density: findings from post-menopausal Japanese female subjects. Osteoporos Int 2011;22:143-52.
32
Codoñer-Franch P, Tavárez-Alonso S, Simó-Jordá R, Laporta-Martín P, Carratalá-Calvo A, Alonso-Iglesias E. Vitamin D status is linked to biomarkers of oxidative stress, inflammation, and endothelial activation in obese children. J Pediatr 2012;161:848-54.
33
Nabipour I, Sambrook PN, Blyth FM, Janu MR, Waite LM, Naganathan V, et al. Serum Uric Acid Is Associated With Bone Health in Older Men: A Cross-Sectional Population-Based Study. J Bone Miner Res 2011;26:955-64.
34
Massa J, O’Reilly E, Munger KL, Delorenze GN, Ascherio A. Serum uric acid and risk of multiple sclerosis. J Neurol 2009;256:1643-8.
35
Sugiura M, Nakamura M, Ogawa K, Ikoma Y, Ando F, Yano M. Bone mineral density in post-menopausal female subjects is associated with serum antioxidant carotenoids. Osteoporos Int 2008;19:211-9.
36
Chen W, Roncal-Jimenez C, Lanaspa M, Gerard S, Chonchol M, Johnson RJ, et al. Uric acid suppresses 1 alpha hydroxylase in vitro and in vivo. Metabolism 2014;63:150-60.
37
Lippi G, Montagnana M, Franchini M, Favaloro EJ, Targher G. The paradoxical relationship between serum uric acid and cardiovascular disease. Clin Chim Acta 2008;392:1-7.
38
Bagnati M, Perugini C, Cau C, Bordone R, Albano E, Bellomo G. When and why a water-soluble antioxidant becomes prooxidant during copper-induced low-density lipoprotein oxidation: a study using uric acid. Biochem J 1999;340:143-52.