title: Serum uric acid in relation to endogenous reproductive hormones during the menstrual cycle: findings from the BioCycle study.
abstract: OBJECTIVE
  Do uric acid levels across the menstrual cycle show associations with endogenous estradiol (E2) and reproductive hormone concentrations in regularly menstruating women?
  
  
  CONCLUSIONS
  Mean uric acid concentrations were highest during the follicular phase, and were inversely associated with E2 and progesterone, and positively associated with FSH.
  
  
  BACKGROUND
  E2 may decrease serum levels of uric acid in post-menopausal women; however, the interplay between endogenous reproductive hormones and uric acid levels among regularly menstruating women has not been elucidated.
  
  
  METHODS
  The BioCycle study was a prospective cohort study conducted at the University at Buffalo research centre from 2005 to 2007, which followed healthy women for one (n = 9) or 2 (n = 250) menstrual cycle(s).
  
  
  METHODS
  Participants were healthy women aged 18-44 years. Hormones and uric acid were measured in serum eight times each cycle for up to two cycles. Marginal structural models with inverse probability of exposure weights were used to evaluate the associations between endogenous hormones and uric acid concentrations.
  
  
  RESULTS
  Uric acid levels were observed to vary across the menstrual cycle, with the lowest levels observed during the luteal phase. Every log-unit increase in E2 was associated with a decrease in uric acid of 1.1% (β = -0.011; 95% confidence interval (CI): -0.019, -0.004; persistent-effects model), and for every log-unit increase in progesterone, uric acid decreased by ≈ 0.8% (β = -0.008; 95% CI: -0.012, -0.004; persistent-effects model). FSH was positively associated with uric acid concentrations, such that each log-unit increase was associated with a 1.6% increase in uric acid (β = 0.016; 95% CI: 0.005, 0.026; persistent-effects model). Progesterone and FSH were also associated with uric acid levels in acute-effects models. Of 509 cycles, 42 were anovulatory (8.3%). Higher uric acid levels were associated with increased odds of anovulation (odds ratio 2.39, 95% CI: 1.25, 4.56).
  
  
  CONCLUSIONS
  The change in uric acid levels among this cohort of healthy women was modest, and analysis was limited to two menstrual cycles. The women in this study were healthy and regularly menstruating, and as such there were few women with high uric acid levels and anovulatory cycles.
  
  
  CONCLUSIONS
  These findings demonstrate the importance of taking menstrual cycle phase into account when measuring uric acid in premenopausal women, and confirm the hypothesized beneficial lowering effects of endogenous E2 on uric acid levels. These findings suggest that there could be an underlying association affecting both sporadic anovulation and high uric acid levels among young, regularly menstruating women. Further studies are needed to confirm these findings and elucidate the connection between uric acid and reproductive and later cardiovascular health.
authors.affiliation: Epidemiology Branch, Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS, 6100 Executive Blvd 7B03, Rockville, MD 20852, USA.
authors.forename: Sunni L
authors.initials: SL
authors.lastname: Mumford
authors.forename: Sonya S
authors.initials: SS
authors.lastname: Dasharathy
authors.forename: Anna Z
authors.initials: AZ
authors.lastname: Pollack
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Perkins
authors.forename: Donald R
authors.initials: DR
authors.lastname: Mattison
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Cole
authors.forename: Jean
authors.initials: J
authors.lastname: Wactawski-Wende
authors.forename: Enrique F
authors.initials: EF
authors.lastname: Schisterman
mesh_terms: D000293:Adolescent; D000328:Adult; D000858:Anovulation / Q000097:blood; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D008597:Menstrual Cycle / Q000097:blood*; D011374:Progesterone / Q000097:blood*; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid; D011374:Progesterone; D004958:Estradiol; D005640:Follicle Stimulating Hormone
keywords: anovulation; estradiol; menstrual cycle; premenopausal women; uric acid
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