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The associations between uric acid with BMDs and risk of the 10-year probability of fractures in Chinese patients with T2DM stratified by age and gender

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Abstract

Purpose

Accumulating evidence suggests that serum uric acid (SUA) plays a beneficial role in bone health in the general population through antioxidant mechanisms. However, there is controversy over the association between SUA and bone in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the association of serum UA with BMDs and future fracture risks and its potential influencing factors in those patients.

Method

This was a cross-sectional study of 485 patients. BMDs at femoral neck (FN), Troch and the lumbar spine (LS) were measured by DXA. The 10-year probability of fracture risk was assessed using the fracture risk assessment tool (FRAX). SUA level and other biochemical indexes were measured.

Results

There were lower SUA concentrations in patients with osteoporosis/osteopenia compared with those in the normal group, which only existed in non-elderly men and elderly women with T2DM. After adjustment for potential confounders, SUA was positively associated with BMD and negatively with 10-year probability of fracture risk only in non-elderly men and elderly women with T2DM. Multiple stepwise regression analysis showed that SUA was an independent determinant of BMD and 10-year probability of fracture risk, which also occurred in the above patients.

Conclusion

These results implied that relatively high SUA is a protective factor for bone in T2DM patients, but the osteoprotective effect of SUA was mediated by age and gender, and persisted only in non-elderly men and elderly women. Large intervention studies are needed to further confirm the outcomes and provide possible explanations.

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Data availability

The data used to support the findings of this study are available from the authors upon request.

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Author contributions

J.X. and Y.-M.Z. contributed to study design, interpretation of data for the work, literature search; N.X. contributed to the data collection, analysis and writing of the manuscript. Y.W., Y.C., Y.-N.G., R.-X.L. contributed to the data collection, J.X. and Y.-M.Z. contributed equally as co-corresponding authors of this paper.

Funding

This work was support by the Taishan Scholar Construction Project Special Funding (Grant number.TS201712092), Shandong Provincial Natural Science Foundation (Grant number. ZR2020MH111), National Natural Science Foundation of China (Grant number. 82100937), and Shandong Provincial Natural Science Foundation (Grant number. ZR2021QH132).

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Authors and Affiliations

  1. Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, **an, 250021, Shandong, China

    Na Xu, Yan Wang, Yu Chen, Yu-ning Guo & ** Xu

  2. Shandong Clinical Research Center of Diabetes and Metabolic Diseases, **an, 250021, Shandong, China

    Na Xu, Yan Wang, Yu Chen, Yu-ning Guo, Ren-xuan Li & ** Xu

  3. Shandong Institute of Endocrine and Metabolic Diseases, **an, 250021, Shandong, China

    Na Xu, Yan Wang, Yu Chen, Yu-ning Guo, Ren-xuan Li & ** Xu

  4. Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, **an, 250021, Shandong, China

    Na Xu, Yan Wang, Yu Chen, Yu-ning Guo, Ren-xuan Li & ** Xu

  5. Department of Endocrinology, Shandong Provincial Hospital, **an, 250021, Shandong, China

    Ren-xuan Li

  6. Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, **an, 250021, Shandong, China

    Yan-man Zhou

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  1. Na Xu
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  2. Yan Wang
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  3. Yu Chen
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  7. ** Xu
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Corresponding authors

Correspondence to Yan-man Zhou or ** Xu.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Institutional Review Board of Shandong Provincial Hospital affiliated with Shandong First Medical University (SWYX: NO.2022-451).

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Xu, N., Wang, Y., Chen, Y. et al. The associations between uric acid with BMDs and risk of the 10-year probability of fractures in Chinese patients with T2DM stratified by age and gender. Endocrine 80, 520–528 (2023). https://doi.org/10.1007/s12020-023-03353-3

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