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Low serum uric acid may increase risk for low bone mineral density in young men with AS
Low levels of serum uric acid may be linked to low bone mineral density in young men with ankylosing spondylitis, according to findings among patients attending St. Mary’s Hospital in South Korea.
Researchers studied 150 men with ankylosing spondylitis (AS) who met the New York criteria for AS classification. Mean patient age was 32 years. Patients were excluded in the presence of reactive arthritis; psoriasis; inflammatory bowel disease; thyroid or related disorders; chronic liver or kidney disease; and the use of allopurinol, fenofibrate, beta blockers or diuretics.
Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry, and sacroiliitis was assessed through the grading images according to New York criteria by a reader blinded to patient details.
The mean serum concentration of serum uric acid (UA) was 5.5 mg/dL. Seventeen patients had hyperuricemia, and patients with AS and higher BMI tended to have higher levels of UA, according to the researchers.
The association between UA and BMD was assessed using multiple linear regression models and models adjusted for age, BMI, erythrocyte sedimentation rate (ESR) and serum calcium. Patients with higher levels of UA tended to have higher BMD in the lumbar spine, a difference that remained significant after adjusting for age, BMI and ESR. Patients with low levels of serum UA were more likely to have lower BMD than patients with higher levels of UA, and 39 (26%) of the patients had BMD below the expected range for age.
In univariate analysis, low BMD was associated with low UA concentration, high BMI, increased ESR and the absence of HLA-B27, according to the researchers.
No difference was seen between UA tertile groups with respect to the presence of HLA-B27 or history of arthritis, uveitis, enthesitis, radiographic progression or medication type. Patients with higher levels of UA tended to have higher concentrations of blood calcium, but no other laboratory associations were made. - by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.