Study Finds Increased Risk of Osteoporosis in Patients With Gout

Gout is a form of inflammatory arthritis caused by the deposition of monosodium urate crystals in and around the joints and is characterized by severe gout flares that can last several days or week. The incidence of gout increases with age and carries strong associations with several comorbidities such as hypertension, stroke, obesity, type 2 diabetes, and chronic kidney disease. More recently, there has been special attention paid to the potential associations between gout and osteoporosis.

Osteoporosis, primarily affecting the elderly population, is characterized by lowered bone density and enhanced bone fragility. This bone fragility leaves patients at a significantly increased risk for fractures. Previous studies have hypothesized that monosodium urate crystal-related inflammation may cause worse outcomes on bones by stimulating complex inflammatory signaling pathways and pro-inflammatory molecules.

A retrospective study with a longitudinal 13-year follow-up was conducted to further investigate this association and determine whether such a link exists between gout and risk of developing osteoporosis. “We explored the possible link between gout and incident osteoporosis/osteoporotic fractures based on long-term follow-up nationwide data,” the authors of the study wrote in Nutrients.

A total of 16,305 patients with gout and 65,220 controls comprised the study population. Through propensity matching, gout patients were matched at a 1:4 ratio on the basis of sex, age, and income. The researchers then utilized a Cox proportional hazard model to identify the relevance between gout and incident osteoporosis and/or fractures.

Osteoporosis developed in 761 individuals with gout, and the incidence rate of the development of osteoporosis in individuals with gout was 8.0/1,000 person-years. Comparatively, 2,805 controls developed osteoporosis, and the incidence rate was 7.3/1,000 person-years. After adjusting for confounding variables, individuals with gout had an 11% higher development of osteoporosis compared with controls. Additionally, subgroup analyses demonstrated a particular increase in the incident in osteoporosis in gout sufferers who were male or aged <60 years.

“Our results may cautiously inform the modestly increased likelihood of incident osteoporosis in a subset of patients with gout during a long-term follow-up,” the authors stated. “Therefore, patients with gout may require screening for the early detection and appropriate treatment of osteoporosis as an avenue to manage gout.”