title: The Influence of Serum Uric Acid on Bone Mineral Density, Hip Geometry, and Fracture Risk: The Rotterdam Study.
abstract: BACKGROUND
  The role of uric acid (UA) in skeletal metabolism remains to be unraveled.
  
  
  OBJECTIVE
  We prospectively investigated the association between UA, bone mineral density at the femoral neck (FN-BMD), hip bone geometry parameters, and incident fracture risk and examined whether the associations were modified by age and vitamin C intake.
  
  
  METHODS
  Data of 5074 participants of The Rotterdam Study, a prospective population-based cohort.
  
  
  METHODS
  Serum UA was assessed at baseline.
  
  
  METHODS
  FN-BMD was measured at baseline, and at second, third, and fourth visits of the Rotterdam Study. Hip bone geometry parameters were measured at baseline and at the second and third visits.
  
  
  RESULTS
  Serum UA levels (per SD increase) were positively associated with FN-BMD (β = 0.007 g/cm(2); 95% confidence interval [CI] = 0.002-0.01), thicker cortices (β = 0.002 cm; 95% CI = 0.0003-0.002), lower bone width (β = -0.013 cm; 95% CI = -0.23 to -0.003), and lower cortical buckling ratio (β = -0.19; 95% CI = -0.33 to -0.06). The effects of UA on FN-BMD and cortical buckling ratio tended to become stronger over time. Hazard ratios and 95% CIs per SD increase of baseline UA levels for the development of any type of incident fractures, nonvertebral fractures, and osteoporotic fractures were 0.932 (0.86-0.995), 0.924 (0.856-0.998), and 0.905 (0.849-0.982), respectively. These associations were more prominent in older individuals (age, >65 y) and in participants with high intakes of vitamin C (> median).
  
  
  CONCLUSIONS
  Higher levels of serum UA are associated with higher BMD (at the expense of thicker cortices and narrower bone diameters) and may be a protective factor in bone metabolism. However, interactions with age and vitamin C may be present.
authors.affiliation: Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands.
authors.forename: Taulant
authors.initials: T
authors.lastname: Muka
authors.affiliation: Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands.
authors.forename: Ester A L
authors.initials: EA
authors.lastname: de Jonge
authors.affiliation: Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands.
authors.forename: Jessica C
authors.initials: JC
authors.lastname: Kiefte-de Jong
authors.affiliation: Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands.
authors.forename: André G
authors.initials: AG
authors.lastname: Uitterlinden
authors.affiliation: Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands.
authors.forename: Abbas
authors.initials: A
authors.lastname: Dehghan
authors.affiliation: Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands.
authors.forename: M Carola
authors.initials: MC
authors.lastname: Zillikens
authors.affiliation: Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: Departments of Epidemiology (T.M., E.A.L.d.J., J.C.K.-d.J., A.G.U., A.H., A.D., O.H.F., F.R.) and Internal Medicine (E.A.L.d.J., A.G.U., M.C.Z., F.R.), Erasmus Medical Center, Rotterdam CA 3000, The Netherlands; Netherlands Consortium for Healthy Ageing (A.G.U., A.H., A.D., M.C.Z., O.H.F., F.R.), Netherlands Genomics Initiative, The Hague 2593 CE, The Netherlands; and Leiden University College (J.C.K.-d.J.), The Hague 3595 DG, The Netherlands.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rivadeneira
mesh_terms: D000368:Aged; D015519:Bone Density; D015331:Cohort Studies; D005260:Female; D005272:Femur Neck / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006620:Hip Fractures / Q000097:blood* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D058866:Osteoporotic Fractures / Q000097:blood / Q000453:epidemiology; D010384:Pelvic Bones / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D011859:Radiography; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
chemical_list: D014527:Uric Acid