THE ROLE OF URIC ACID AND GOUT IN THE DEVELOPMENT OF OSTEOPOROSIS
Author(s)
Helen A. Crentsil, PharmD1, Chantelle Rampersad, MS1, Youssef Roman, Pharm D, PhD2, Alexandra Perez Rivera, MS, PharmD1;
1Nova Southeastern University - College of Pharmacy, Fort Lauderdale, FL, USA, 2Idaho State University - L. S. Skaggs College of Pharmacy, Pocatello, ID, USA
1Nova Southeastern University - College of Pharmacy, Fort Lauderdale, FL, USA, 2Idaho State University - L. S. Skaggs College of Pharmacy, Pocatello, ID, USA
OBJECTIVES: Osteoporosis and gout/hyperuricemia are common, often co-occur in older adults, and share inflammatory/metabolic pathways that may affect bone health. We assessed whether osteoporosis prevalence differs by gout or hyperuricemia status and whether urate-lowering therapy (ULT) use is associated with differences in bone-related and inflammatory biomarkers.
METHODS: We conducted an observational analysis of the 2013-2014 and 2017-2018 cycles of the National Health and Nutrition Examination Survey (NHANES), a nationally representative, cross-sectional survey of non-institutionalized U.S. adults. Participants aged ≥20 years were included. Self-reported clinician-diagnosed gout and osteoporosis were identified from questionnaire data. Serum uric acid and bone/systemic inflammation biomarkers were obtained from NHANES laboratory files, and ULT use was identified from prescription medication files. Biomarkers were categorized as normal vs abnormal for selected analyses. Chi-square tests assessed associations between osteoporosis, gout, serum uric acid category, and biomarker status. Independent t-tests compared mean biomarker levels by ULT use. Statistical significance was set at p < 0.05.
RESULTS: The prevalence of self-reported osteoporosis did not differ between individuals with gout and those without gout (10.9% vs 10.2%, p=0.787). Osteoporosis prevalence was also comparable between participants with hyperuricemia and those with normal uric acid levels (10.7% vs 10.1%, p=0.564). Compared with non-ULT users, ULT users had higher mean vitamin D (p=0.001), alkaline phosphatase (ALP) (p=0.026), and C-reactive protein (CRP) (p=0.045), and lower phosphorus (p=0.043). There were no significant differences in calcium or systemic immune-inflammation index (SII) levels by ULT status.
CONCLUSIONS: In this nationally representative cross-sectional analysis, osteoporosis prevalence was not associated with gout or uric acid category. However, ULT use was associated with differences in vitamin D, ALP, phosphorus, and CRP. These findings support further research to determine whether biomarker differences among ULT users have implications for bone health risk assessment and monitoring in real-world practice.
METHODS: We conducted an observational analysis of the 2013-2014 and 2017-2018 cycles of the National Health and Nutrition Examination Survey (NHANES), a nationally representative, cross-sectional survey of non-institutionalized U.S. adults. Participants aged ≥20 years were included. Self-reported clinician-diagnosed gout and osteoporosis were identified from questionnaire data. Serum uric acid and bone/systemic inflammation biomarkers were obtained from NHANES laboratory files, and ULT use was identified from prescription medication files. Biomarkers were categorized as normal vs abnormal for selected analyses. Chi-square tests assessed associations between osteoporosis, gout, serum uric acid category, and biomarker status. Independent t-tests compared mean biomarker levels by ULT use. Statistical significance was set at p < 0.05.
RESULTS: The prevalence of self-reported osteoporosis did not differ between individuals with gout and those without gout (10.9% vs 10.2%, p=0.787). Osteoporosis prevalence was also comparable between participants with hyperuricemia and those with normal uric acid levels (10.7% vs 10.1%, p=0.564). Compared with non-ULT users, ULT users had higher mean vitamin D (p=0.001), alkaline phosphatase (ALP) (p=0.026), and C-reactive protein (CRP) (p=0.045), and lower phosphorus (p=0.043). There were no significant differences in calcium or systemic immune-inflammation index (SII) levels by ULT status.
CONCLUSIONS: In this nationally representative cross-sectional analysis, osteoporosis prevalence was not associated with gout or uric acid category. However, ULT use was associated with differences in vitamin D, ALP, phosphorus, and CRP. These findings support further research to determine whether biomarker differences among ULT users have implications for bone health risk assessment and monitoring in real-world practice.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO130
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)