AUTHOR=Ibrahim Wisam Nabeel , Younes Nadin , Shi Zumin , Abu-Madi Marawan Abdelhamid 

TITLE=Serum Uric Acid Level Is Positively Associated With Higher Bone Mineral Density at Multiple Skeletal Sites Among Healthy Qataris

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2021.653685

DOI=10.3389/fendo.2021.653685

ISSN=1664-2392

ABSTRACT=ABSTRACT 
Background: Oxidative stress has been implicated as a fundamental mechanism in the decline of bone mass. Although serum uric acid (SUA) has potent antioxidant properties, the findings of many epidemiological and experimental studies couldn’t draw a clear conclusive description of the relation between SUA and bone health. Further, data on Qatari subjects to the above observation is scant. Thus, in this study, we aim to investigate the association between SUA and Bone mineral density (BMD) at different skeletal sites among healthy Qataris. 
Methodology: a cross-sectional retrospective analysis including total-body and site-specific bone mineral density scores and other serological markers of 2981 healthy Qatari citizens from the Qatar biobank database. The study participants were divided into four quartiles based on the level of SUA, and the BMD was measured using dual-energy X-ray absorptiometry (DXA). Baseline correlation and multiple regression analyses were applied to investigate the association between SUA and BMD and the influence of multiple confounding factors. 
Results: High levels of SUA were significantly associated with the increased bone mineral density of the total body and at site-specific skeletal locations (p-value < 0.001). further adjustment in age and gender confirmed the dose-response relation between SUA and BMD of total body and other skeletal sites (p-value < 0.01). Further adjustment with gender, age, body mass index (BMI), smoking, vitamin D, alkaline phosphatase, and estimated glomerular filtration rate (eGFR) levels had attenuated the association that remained significant for individuals with high SUA levels (p-value ≤ 0.01). The adjusted subgroup analyses stratified by age, gender, BMI,  and smoking confirmed the overall significant association between SUA and total body BMD; however, the association was not evident in non-obese, females,  young adults, and smokers. No interaction was found among the confounding factors. 
Conclusion: Higher SUA levels may play a role in protecting healthy Qatari citizens from deterioration in bone density and may prevent occurrences of pathological fractures. However, such observation demands further investigations to outline the underlying mechanism in the suggested interplay.