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. 2022 Nov 11;101(45):e31524.
doi: 10.1097/MD.0000000000031524.

Gout as a risk factor for osteoporosis: A Korean population-based study

Ji Hyoun Kim  1   2 , So Rae Kim  2 , Gilwon Kang  3 , In Ah Choi  1   2
Affiliations

Gout as a risk factor for osteoporosis: A Korean population-based study

Ji Hyoun Kim et al. Medicine (Baltimore). .

Abstract

Uric acid acts as both an antioxidant and a pre-oxidant that induces oxidative stress; thus, it plays a paradoxical role in inflammation. However, the effect of gout, a hallmark of hyperuricemia, on osteoporosis remains unclear. Therefore, this study aimed to investigate the association between gout and osteoporosis. This retrospective cohort study used data from the Korean National Health Insurance Service Database. In total, 628,565 participants who were diagnosed with gout and prescribed medications for gout for at least 90 days were selected. The control cohort included patients with no history of gout or use of gout medication. Age and sex 1:1 propensity score matching and Cox proportional hazards models were used to investigate risk factors for osteoporosis. In total, 305,810 patients with gout met the inclusion criteria. Compared with the control group, both men and women with gout showed an increased incidence rate ratio of osteoporosis. In the stratified analysis by age, patients with gout showed an increased incidence rate ratio for osteoporosis in all age groups, except for those over 80 years of age (P < .001). Gout showed an increased hazard ratio of 1.48 (95% CI: 1.45-1.51, P < .001). The female sex has also been identified as a risk factor for osteoporosis. Patients in their 70s had the highest HR. Gout is significantly associated with the risk of osteoporosis. In particular, the results of this study showed that the incidence of osteoporosis increased up to four times in male patients in their 20s with gout compared to without gout.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Flowchart of the selection of the study population from the National Health Insurance Service database. In total, 305,810 patients with gout and 305,810 control participants were compared via propensity score matching.
Figure 2.
Figure 2.
Cumulative incidence of osteoporosis in patients with gout and controls, stratified by age. (A) < 65 years, (B) ≥ 65 years. CI = confidence intervals, HR = hazard ratio.
Figure 3.
Figure 3.
Cumulative incidence of osteoporosis in patients with gout and controls stratified by sex. (A) female group, (B) male group. CI = confidence intervals, HR = hazard ratio.
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