Serum Uric Acid Levels and Bone Mineral Density in Peri- and Postmenopausal Korean Women: A Cross-sectional Study on 3,566 Cases

Uric acid (UA) may influence bone health through its antioxidant and pro-oxidant properties. While previous studies have investigated the relationship between serum UA levels and bone mineral density (BMD), their findings have been conflicting. This study aimed to examine the impact of serum UA levels on BMD in peri- and postmenopausal Korean women. We evaluated 3,566 women aged 50-80 years who voluntarily underwent laboratory tests and BMD measurements as part of a general health examination between March 2014 and March 2020. Participants were stratified into quartiles according to their serum UA levels. Univariate and multivariate analyses were performed to assess the association between serum UA levels and BMD. The mean age of the participants was 56.9±5.8 years. BMD at the lumbar spine and hip was significantly higher in women with elevated serum UA levels, showing a continuous increase across the quartiles. Furthermore, after adjusting for covariates, the mean total lumbar spine BMD increased from 0.892 g/cm² (95% CI: 0.884-0.900) in the lowest UA quartile to 0.918 g/cm² (95% CI: 0.909-0.927) in the highest quartile (P<0.001). Similarly, the adjusted total hip BMD was higher in the highest UA quartile at 0.847 g/cm² (95% CI: 0.840-0.854) compared with 0.828 g/cm² (95% CI: 0.821-0.834) in the lowest quartile (P=0.001). Our results suggest that elevated serum UA levels are associated with higher BMD in peri- and postmenopausal Korean women, indicating a potential protective role in bone metabolism.