Department of Evidence-based Medicine, Xuanwu Hospital, Capital Medical University, Xicheng district.
Department of Clinical Medicine, Peking Union Medical College, Dongcheng district.
Medicine (Baltimore). 2021 Apr 30;100(17):e25733. doi: 10.1097/MD.0000000000025733.
The relationship between serum uric acid (UA) and bone mineral density (BMD) has been proposed by several researchers. However, there has been no consensus regarding the relationships among serum UA, diabetes, and BMD. The aim of this study is to investigate the association between UA, BMD, and at least osteopenia in type 2 diabetes patients.This research was a longitudinal study performed at Xiao-Tang-Shan Hospital in Beijing. Type 2 diabetes diagnosis was consistent with the WHO standard classification. Participants with osteopenia or osteoporosis documented by dual-energy X-ray absorptiometry were defined as having "at least osteopenia." A generalized additive model and multivariable logistic regressions were performed to explore the relationship between serum UA and at least osteopenia. Receiver operating characteristic analysis was conducted. Propensity score matching was used to verify the correctness of the cutoff point.In total, 3476 type 2 diabetes patients free of any osteopenia-related diseases were recruited in 2012 and followed up to 2018. The general proportions of patients with at least osteopenia in 2018 was 16.46% (572/3476). Serum UA was negatively associated with BMD stratified by sex, age group, and BMI level. Setting the first quartile as the reference, the risk of at least osteopenia in the fourth quartile was significant among all patients (odds ratio [OR]: 0.75; 95% confidence interval [CI]: 0.57, 0.98) and specifically in females (OR: 0.79; 95% CI: 0.43, 0.97), patients aged over 50 years (OR: 0.79; 95% CI: 0.60, 0.97) and patients with a BMI greater than 25 (OR: 0.74; 95% CI: 0.47, 0.97). The optimal cutoff point for the serum UA level to distinguish at least osteopenia in diabetic patients was 395 μmol/L.Serum UA concentration is negatively associated with the occurrence of at least osteopenia in Chinese patients with type 2 diabetes.
尿酸（UA）与骨矿物质密度（BMD）之间的关系已被多位研究人员提出。然而，关于血清 UA、糖尿病与 BMD 之间的关系，目前尚未达成共识。本研究旨在探讨 2 型糖尿病患者中 UA、BMD 与至少骨质疏松症之间的关联。
本研究是在北京小汤山医院进行的一项纵向研究。2 型糖尿病的诊断符合世界卫生组织（WHO）的标准分类。通过双能 X 射线吸收仪诊断为骨质疏松症或骨量减少的患者被定义为“至少存在骨质疏松症”。采用广义加性模型和多变量逻辑回归分析探讨血清 UA 与至少骨质疏松症之间的关系。并进行受试者工作特征（ROC）曲线分析。采用倾向性评分匹配验证切点的正确性。
共纳入 2012 年无任何骨质疏松症相关疾病的 3476 例 2 型糖尿病患者，并随访至 2018 年。2018 年至少存在骨质疏松症的患者比例为 16.46%（572/3476）。血清 UA 与性别、年龄组和 BMI 水平分层的 BMD 呈负相关。以第一四分位数为参考，所有患者的第四四分位数发生至少骨质疏松症的风险显著升高（比值比[OR]：0.75；95%置信区间[CI]：0.57，0.98），尤其是女性（OR：0.79；95%CI：0.43，0.97）、年龄超过 50 岁的患者（OR：0.79；95%CI：0.60，0.97）和 BMI 大于 25 的患者（OR：0.74；95%CI：0.47，0.97）。区分糖尿病患者至少存在骨质疏松症的血清 UA 水平的最佳切点为 395μmol/L。
血清 UA 浓度与中国 2 型糖尿病患者发生至少骨质疏松症呈负相关。
