Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Front Endocrinol (Lausanne). 2023 Mar 28;14:1108475. doi: 10.3389/fendo.2023.1108475. eCollection 2023.
Obesity is an increasingly severe global public health issue. This study aims to estimate the cross-sectional association between bone mineral density (BMD) and hyperuricemia (HU) in obesity.
A total of 275 obese subjects (126 men and 149 women) participated in this cross-sectional study. Obesity was diagnosed as body mass index (BMI) ≥28 kg/m, whereas HU was defined as the blood uric acid level of 416 μmol/L in men and 360 μmol/L in women. The BMD of the lumbar spine and right hip was measured by dual-energy X-ray absorptiometry (DXA). The multivariable logistic regressions were employed to examine the relationship between BMD and HU in obesity, with the adjustment of gender, age, fasting blood glucose, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, creatinine, blood urea nitrogen, high-sensitivity C-reactive protein (hs-CRP), cigarette smoking, and alcohol drinking status.
The overall prevalence of HU was 66.9% in this obese population. The mean age and BMI of this population were 27.9 ± 9.9 years and 35.2 ± 5.2 kg/m, respectively. The multivariable-adjusted OR (the highest lowest BMD quartile) demonstrated a negative relationship between BMD and HU in total (OR = 0.415, 95%CI: 0.182-0.946; p = 0.036), L1 (OR = 0.305, 95%CI: 0.127-0.730; p = 0.008), L2 (OR = 0.405, 95%CI: 0.177-0.925; p = 0.032), and L3 (OR = 0.368, 95%CI: 0.159-0.851; p = 0.020) lumbar vertebrae. In the subgroup analysis for the male population, the BMD was also negatively associated with HU in total (OR = 0.077, 95%CI: 0.014-0.427; p = 0.003), L1 (OR = 0.019, 95%CI: 0.002-0.206; p = 0.001), L2 (OR = 0.161, 95%CI: 0.034-0.767; p = 0.022), L3 (OR = 0.186, 95%CI: 0.041-0.858; p = 0.031), and L4 (OR = 0.231, 95%CI: 0.056-0.948; p = 0.042) lumbar vertebrae. However, such findings did not exist in women. In addition, there was no significant relationship between hip BMD and HU in obesity.
Our results showed that the lumbar BMD was negatively associated with HU in obesity. However, such findings only existed in men, rather than women. In addition, no significant relationship between hip BMD and HU existed in obesity. Due to the limited sample size and nature of the cross-sectional design, further large prospective studies are still needed to clarify the issues.
肥胖是一个日益严重的全球公共卫生问题。本研究旨在评估肥胖人群中骨密度（BMD）与高尿酸血症（HU）之间的横断面关联。
共有 275 名肥胖受试者（126 名男性和 149 名女性）参与了这项横断面研究。肥胖的诊断标准为 BMI≥28kg/m2，而 HU 定义为男性血尿酸水平为 416μmol/L，女性为 360μmol/L。腰椎和右侧髋部的 BMD 通过双能 X 射线吸收法（DXA）进行测量。多变量逻辑回归用于检查肥胖人群中 BMD 与 HU 之间的关系，调整了性别、年龄、空腹血糖、空腹胰岛素、胰岛素抵抗评估的稳态模型（HOMA-IR）、胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白、肌酐、血尿素氮、高敏 C 反应蛋白（hs-CRP）、吸烟和饮酒状况。
在肥胖人群中，HU 的总患病率为 66.9%。该人群的平均年龄和 BMI 分别为 27.9±9.9 岁和 35.2±5.2kg/m2。多变量调整后的 OR（最高与最低 BMD 四分位）显示 BMD 与 HU 之间呈负相关（OR=0.415，95%CI：0.182-0.946；p=0.036），在整个腰椎（OR=0.305，95%CI：0.127-0.730；p=0.008）、L1（OR=0.305，95%CI：0.127-0.730；p=0.008）、L2（OR=0.405，95%CI：0.177-0.925；p=0.032）和 L3（OR=0.368，95%CI：0.159-0.851；p=0.020）。在男性亚组分析中，BMD 与 HU 也呈负相关（OR=0.077，95%CI：0.014-0.427；p=0.003），在整个腰椎（OR=0.019，95%CI：0.002-0.206；p=0.001）、L1（OR=0.161，95%CI：0.034-0.767；p=0.022）、L2（OR=0.186，95%CI：0.041-0.858；p=0.031）、L3（OR=0.186，95%CI：0.041-0.858；p=0.031）和 L4（OR=0.231，95%CI：0.056-0.948；p=0.042）腰椎。然而，这些发现在女性中并不存在。此外，肥胖人群中髋部 BMD 与 HU 之间没有显著关系。
我们的结果表明，腰椎 BMD 与肥胖人群中的 HU 呈负相关。然而，这些发现仅存在于男性，而不是女性。此外，肥胖人群中髋部 BMD 与 HU 之间没有显著关系。由于样本量有限且横断面设计的性质，仍需要进一步的大型前瞻性研究来阐明这些问题。
