Wang Yanmao, Zhou Runhua, Zhong Wanrun, Hu Chengfang, Lu Shengdi, Chai Yimin
Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Yishan Rd 600, Shanghai, 200233, People's Republic of China.
Int Orthop. 2018 Sep;42(9):2041-2047. doi: 10.1007/s00264-018-4033-5. Epub 2018 Jun 28.
Previous studies have shown that serum uric acid levels and inflammation are associated with bone mineral density. Gout, a disease characterized by hyperuricemia and inflammation, contributes to the risk of osteoporotic fractures. However, this association is controversial. Therefore, this study investigated whether gout in older people (age > 55 years) is associated with osteoporotic fracture risk.
This population-based, cross-sectional study included 2674 participants (147 cases of gout and 388 fractures). Standardized and self-administered questionnaires were employed and physical examinations, blood tests, and bone mineral density examinations were performed; multivariate-adjusted logistic regression models were used to evaluate associations between gout and osteoporotic fracture risk.
The data were adjusted for age; smoking status; alcohol status; physical activity; body mass index; waist circumference; hypertension; cardiovascular events; diabetes mellitus; rheumatoid arthritis; serum levels of total cholesterol (TC), triglycerides, and high- and low-density lipids; and T-scores. We found a significant association between gout and osteoporotic fracture risk in women (odds ratio [OR], 2.00; 95% confidence interval [CI], 1.12-3.56; P = 0.019), but no such association in men (OR, 1.30; 95% CI, 0.58-2.88; P = 0.525). Further stratified analyses showed a significant association between gout and osteoporotic fracture risk in women without rheumatic arthritis and in those with high TC levels or with osteoporosis (all, P < 0.05).
In older Chinese adults, gout is significantly associated with the risk of osteoporotic fractures in women, especially those without rheumatic arthritis and in those with high TC levels or with osteoporosis.
既往研究表明，血清尿酸水平和炎症与骨密度相关。痛风是一种以高尿酸血症和炎症为特征的疾病，会增加骨质疏松性骨折的风险。然而，这种关联存在争议。因此，本研究调查了老年人（年龄>55岁）痛风是否与骨质疏松性骨折风险相关。
这项基于人群的横断面研究纳入了2674名参与者（147例痛风患者和388例骨折患者）。采用标准化的自填式问卷，并进行体格检查、血液检查和骨密度检查；使用多变量调整逻辑回归模型评估痛风与骨质疏松性骨折风险之间的关联。
数据根据年龄、吸烟状况、饮酒状况、身体活动、体重指数、腰围、高血压、心血管事件、糖尿病、类风湿关节炎、血清总胆固醇（TC）、甘油三酯以及高密度和低密度脂蛋白水平和T值进行了调整。我们发现痛风与女性骨质疏松性骨折风险之间存在显著关联（比值比[OR]，2.00；95%置信区间[CI]，1.12 - 3.56；P = 0.019），但男性中未发现这种关联（OR，1.30；95% CI，0.58 - 2.88；P = 0.525）。进一步的分层分析显示，痛风与无风湿性关节炎的女性以及TC水平高或患有骨质疏松症的女性的骨质疏松性骨折风险之间存在显著关联（均P < 0.05）。
在年龄较大的中国成年人中，痛风与女性骨质疏松性骨折风险显著相关，尤其是那些没有风湿性关节炎以及TC水平高或患有骨质疏松症的女性。
