Association between serum uric acid and bone mineral density in males from NHANES 2011-2020

Abstract

Currently, the relationship between serum uric acid (SUA) and bone mineral density (BMD) in men remains controversial. This study aims to investigate the relationship between SUA and lumbar spine BMD in American men using data from the National Health and Nutrition Examination Survey (NHANES). A total of 6254 male subjects aged 12-80 years (mean age 35.52 ± 14.84 years) in the NHANES from 2011 to 2020 were analyzed. SUA was measured by DxC using the timed endpoint method, and lumbar spine BMD was measured by dual-energy X-ray absorptiometry (DXA). Multivariate linear regression models were used to explore the relationship between SUA and BMD by adjusting for age, race/Hispanic origin, drinking behavior, smoking behavior, physical activity, body mass index (BMI), poverty-to-income ratio (PIR), total protein, serum calcium, cholesterol, serum phosphorus, and blood urea nitrogen. After correcting for the above confounders, it was found that SUA was positively associated with lumbar spine BMD in the range of SUA < 5 mg/dL (β = 0.006 95% CI 0.003-0.009, P < 0.001), and BMD of individuals in the highest quartile of SUA was 0.020 g/cm² higher than those in the lowest quartile of SUA (β = 0.020 95% CI 0.008-0.032, P = 0.003). This study showed that SUA was positively correlated with lumbar spine BMD in American men within a certain range. This gives clinicians some insight into how to monitor SUA levels to predict BMD levels during adolescence when bone is urgently needed for growth and development and during old age when bone loss is rapid.

Figure 1

Flowchart of participants selection. BMD, bone mineral density. SUA, serum uric acid.

Figure 2

Relationship between serum uric acid and lumbar spine bone mineral density. (a) Each black dot represents a sample. (b) The solid line indicates a smooth curve fit between the variables. The blue band indicates the 95% confidence interval of the fit. Adjusted for age, Race/Hispanic origin, drinking behavior, smoking behavior, physical activity, BMI, PIR, total protein, serum calcium, cholesterol, serum phosphorus and blood urea nitrogen.

Figure 3

(A) The association between serum uric acid and lumbar spine bone mineral density (stratified by age). Adjusted for race/Hispanic origin, drinking behavior, smoking behavior, physical activity, BMI, PIR, total protein, serum calcium, cholesterol, serum phosphorus, blood urea nitrogen. (B) The association between serum uric acid and lumbar spine bone mineral density (stratified by race/Hispanic origin). Adjusted for age, drinking behavior, smoking behavior, physical activity, BMI, PIR, total protein, serum calcium, cholesterol, serum phosphorus, blood urea nitrogen.