Gout Found to Have a Significant Effect on Osteoporosis

Osteoporosis is a systemic skeletal disease that causes bones to become weak and brittle. Osteoporosis can progress to such a point where mild falls or stressors, such as bending over or coughing, can cause fractures. The risk factors for developing osteoporosis have been well documented in previous studies and include aging, female menopause, low body weight, gastrointestinal diseases, and hematologic disorders. Treatment for osteoporosis can involve prescribed bisphosphonates, increasing daily calcium intake, and participating in daily exercise.

The chronic inflammatory disease known as gout is characterized by elevated levels of uric acid in the blood (hyperuricemia). The uric acid crystalizes, deposits in the joints, and results in painful flares of swelling and discomfort in joints.

Uric acid can act as both an antioxidant and a preoxidant, inducing oxidative stress related to inflammation. The subsequently produced inflammatory cytokines have been shown to stimulate osteoclast bone resorption; however, there have been conflicting results in prior studies that have investigated the effects of gout on osteoporosis.

Medicine published a population-based study investigating this association between gout and osteoporosis using a national database comprised of 628,565 participants. The participants had a gout diagnosis and were prescribed medications for gout for at least 90 days. The gout cohort was age- and sex-matched with a control group with no history of gout or use of gout medication. Researchers analyzed baseline demographic and clinical characteristics between cohorts to evaluate the effect of gout on the risk of osteoporosis.

“Despite having conditions in which bone density is expected to be the highest,” the researchers wrote, “the results of this study showed that the incidence of osteoporosis increased up to four times in younger male patients in their 20s with gout compared to without gout.”

Overall, 25,357 individuals with gout and 19,030 controls developed osteoporosis over the course of the study period. Compared with the control group, participants in the gout group had an increased incidence rate of osteoporosis. Furthermore, a stratified analysis by age showed that patients with gout had higher rates of osteoporosis regardless of age, with the exception of those aged >80 years.

Researchers concluded that, “Although the effect is much smaller than that of age and female sex, which are the typical risk factors for osteoporosis, it is true that gout has a significant effect on osteoporosis compared with other common comorbidities, such as hypertension and diabetes constituting metabolic syndrome.”