title: Higher serum uric acid as a protective factor against incident osteoporotic fractures in Korean men: a longitudinal study using the National Claim Registry.
abstract: In this large longitudinal study of 16,078 Korean men aged 50 years or older, we observed that baseline elevation of serum uric acid level significantly associated with a lower risk of incident fractures at osteoporosis-related sites during an average follow-up period of 3 years.
  
  
  BACKGROUND
  Male osteoporosis and related fractures are becoming recognized as important public health concerns. Oxidative stress has detrimental effects on bone metabolism, and serum uric acid (UA) is known to be a strong endogenous antioxidant. In the present study, we performed a large longitudinal study with an average follow-up period of 3 years to clarify the role of UA on the risk of incident osteoporotic fractures (OFs).
  
  
  METHODS
  A total of 16,078 Korean men aged 50 years or older who had undergone comprehensive routine health examinations were enrolled. Incident fractures at osteoporosis-related sites (e.g., hip, spine, distal radius, and proximal humerus) that occurred after the baseline examinations were identified from the nationwide claims database of the Health Insurance Review and Assessment Service of Korea by using selected International Classification of Diseases, 10th revision codes.
  
  
  RESULTS
  In total, 158 (1.0 %) men developed incident OFs. The event rate was 33.1 per 10,000 person-years. Subjects without incident OFs had 6.0 % higher serum UA levels than subjects with OFs (P = 0.001). Multivariable-adjusted Cox proportional hazard analyses adjusted for age, body mass index, glomerular filtration rate, lifestyle factors, medical and drug histories, and the presence of baseline radiological vertebral fractures revealed that the hazard ratio per standard deviation increase of baseline UA levels for the development of incident OFs was 0.829 (95 % CI = 0.695-0.989, P = 0.038).
  
  
  CONCLUSIONS
  These data provide the epidemiological evidence that serum UA may act as a protective factor against the development of incident OFs in Korean men.
authors.affiliation: Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap2-Dong, Songpa-Gu, Seoul, 138-736, Korea.
authors.forename: B-J
authors.initials: BJ
authors.lastname: Kim
authors.forename: S
authors.initials: S
authors.lastname: Baek
authors.forename: S H
authors.initials: SH
authors.lastname: Ahn
authors.forename: S H
authors.initials: SH
authors.lastname: Kim
authors.forename: M-W
authors.initials: MW
authors.lastname: Jo
authors.forename: S J
authors.initials: SJ
authors.lastname: Bae
authors.forename: H-K
authors.initials: HK
authors.lastname: Kim
authors.forename: J
authors.initials: J
authors.lastname: Choe
authors.forename: G-M
authors.initials: GM
authors.lastname: Park
authors.forename: Y-H
authors.initials: YH
authors.lastname: Kim
authors.forename: S H
authors.initials: SH
authors.lastname: Lee
authors.forename: G S
authors.initials: GS
authors.lastname: Kim
authors.forename: J-M
authors.initials: JM
authors.lastname: Koh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D065840:Protective Factors; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D014527:Uric Acid