Serum Uric Acid and Bone Health in Middle-Aged and Elderly Hypertensive Patients: A Potential U-Shaped Association and Implications for Future Fracture Risk

Background: The influence of serum uric acid (SUA) on bone metabolism, as suggested by previous studies, remains a contentious issue. SUA plays a complex role in bone health and hypertension, making it challenging to discern its impact on the skeletal status of middle-aged and elderly hypertensive p...

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Main Authors: Shuaiwei Song, Xintian Cai, Junli Hu, Qing Zhu, Di Shen, Huimin Ma, Yingying Zhang, Rui Ma, Pan Zhou, Wenbo Yang, Jing Hong, Nanfang Li
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Metabolites
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Online Access:https://www.mdpi.com/2218-1989/15/1/15
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author Shuaiwei Song
Xintian Cai
Junli Hu
Qing Zhu
Di Shen
Huimin Ma
Yingying Zhang
Rui Ma
Pan Zhou
Wenbo Yang
Jing Hong
Nanfang Li
author_facet Shuaiwei Song
Xintian Cai
Junli Hu
Qing Zhu
Di Shen
Huimin Ma
Yingying Zhang
Rui Ma
Pan Zhou
Wenbo Yang
Jing Hong
Nanfang Li
author_sort Shuaiwei Song
collection DOAJ
description Background: The influence of serum uric acid (SUA) on bone metabolism, as suggested by previous studies, remains a contentious issue. SUA plays a complex role in bone health and hypertension, making it challenging to discern its impact on the skeletal status of middle-aged and elderly hypertensive patients. This study aims to elucidate the effects of SUA on bone health, with a particular focus on its association with osteoporosis and the risk of fractures. Methods: Multiple linear regression analyzed SUA levels against bone mineral density (BMD) and future fracture risk. Additionally, multivariate logistic regression was used to examine the association between SUA and osteoporosis. Dose–response relationship analysis was conducted using generalized smooth curve fitting (GSCF) and restricted cubic spline (RCS) methods. Results: With the exception of the total femur region, SUA and BMD showed a positive connection. GSCF analysis revealed an inverted U-shaped relationship between SUA and BMD, alongside a U-shaped trend with FRAX scores. Moreover, RCS analysis indicated a U-shaped relationship between osteoporosis risk and SUA levels, with higher risks identified in the first and third tertiles compared to the second tertile. Conclusions: In individuals with middle-aged and older hypertension, SUA is substantially linked to bone health. The identification of an inverted U-shaped relationship with BMD and U-shaped relationships with FRAX scores and osteoporosis risk highlights the nuanced influence of SUA. These findings suggest that both low and high SUA levels may adversely affect bone health, emphasizing the need for further research.
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spelling doaj-art-ece1ef2fd4324657a96660b6aabf25f02025-01-24T13:41:10ZengMDPI AGMetabolites2218-19892025-01-011511510.3390/metabo15010015Serum Uric Acid and Bone Health in Middle-Aged and Elderly Hypertensive Patients: A Potential U-Shaped Association and Implications for Future Fracture RiskShuaiwei Song0Xintian Cai1Junli Hu2Qing Zhu3Di Shen4Huimin Ma5Yingying Zhang6Rui Ma7Pan Zhou8Wenbo Yang9Jing Hong10Nanfang Li11Hypertension Center, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, ChinaHypertension Center, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, ChinaHypertension Center, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, ChinaHypertension Center, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, ChinaHypertension Center, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, ChinaHypertension Center, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, ChinaHypertension Center, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, ChinaHypertension Center, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, ChinaHypertension Center, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, ChinaHypertension Center, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, ChinaHypertension Center, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, ChinaHypertension Center, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, ChinaBackground: The influence of serum uric acid (SUA) on bone metabolism, as suggested by previous studies, remains a contentious issue. SUA plays a complex role in bone health and hypertension, making it challenging to discern its impact on the skeletal status of middle-aged and elderly hypertensive patients. This study aims to elucidate the effects of SUA on bone health, with a particular focus on its association with osteoporosis and the risk of fractures. Methods: Multiple linear regression analyzed SUA levels against bone mineral density (BMD) and future fracture risk. Additionally, multivariate logistic regression was used to examine the association between SUA and osteoporosis. Dose–response relationship analysis was conducted using generalized smooth curve fitting (GSCF) and restricted cubic spline (RCS) methods. Results: With the exception of the total femur region, SUA and BMD showed a positive connection. GSCF analysis revealed an inverted U-shaped relationship between SUA and BMD, alongside a U-shaped trend with FRAX scores. Moreover, RCS analysis indicated a U-shaped relationship between osteoporosis risk and SUA levels, with higher risks identified in the first and third tertiles compared to the second tertile. Conclusions: In individuals with middle-aged and older hypertension, SUA is substantially linked to bone health. The identification of an inverted U-shaped relationship with BMD and U-shaped relationships with FRAX scores and osteoporosis risk highlights the nuanced influence of SUA. These findings suggest that both low and high SUA levels may adversely affect bone health, emphasizing the need for further research.https://www.mdpi.com/2218-1989/15/1/15serum uric acidhypertensionbone mineral densityFRAX scoreosteoporosis
spellingShingle Shuaiwei Song
Xintian Cai
Junli Hu
Qing Zhu
Di Shen
Huimin Ma
Yingying Zhang
Rui Ma
Pan Zhou
Wenbo Yang
Jing Hong
Nanfang Li
Serum Uric Acid and Bone Health in Middle-Aged and Elderly Hypertensive Patients: A Potential U-Shaped Association and Implications for Future Fracture Risk
Metabolites
serum uric acid
hypertension
bone mineral density
FRAX score
osteoporosis
title Serum Uric Acid and Bone Health in Middle-Aged and Elderly Hypertensive Patients: A Potential U-Shaped Association and Implications for Future Fracture Risk
title_full Serum Uric Acid and Bone Health in Middle-Aged and Elderly Hypertensive Patients: A Potential U-Shaped Association and Implications for Future Fracture Risk
title_fullStr Serum Uric Acid and Bone Health in Middle-Aged and Elderly Hypertensive Patients: A Potential U-Shaped Association and Implications for Future Fracture Risk
title_full_unstemmed Serum Uric Acid and Bone Health in Middle-Aged and Elderly Hypertensive Patients: A Potential U-Shaped Association and Implications for Future Fracture Risk
title_short Serum Uric Acid and Bone Health in Middle-Aged and Elderly Hypertensive Patients: A Potential U-Shaped Association and Implications for Future Fracture Risk
title_sort serum uric acid and bone health in middle aged and elderly hypertensive patients a potential u shaped association and implications for future fracture risk
topic serum uric acid
hypertension
bone mineral density
FRAX score
osteoporosis
url https://www.mdpi.com/2218-1989/15/1/15
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