Association of serum uric acid with bone mineral density and clinical fractures in Chinese type 2 diabetes mellitus patients: A cross-sectional study

Background: We evaluate the associations of serum uric acid (UA) with bone mineral density (BMD) and prevalence of clinical fractures in type 2 diabetes mellitus (T2DM) patients. Methods: 1562 T2DM patients undergoing BMD measurement and clinical fractures assessment were enrolled andserum UA concentrations were measured. Results: T2DM patients with osteoporosis had lower serum UA concentrations compared with those with normal BMD values and osteopenia. Serum UA concentration was significantly correlated with BMD values at the lumbar spine, femoral neck, and total hip in postmenopausal women, and serum UA concentration was positively associated with BMD values at the lumbar spine in men. Moreover, patients with clinical fractures had lower serum UA than those without. Multiple logistic regression analysis showed that serum UA concentrations were significantly and inversely associated with the presence of clinical fractures after adjustment for age, BMI, diabetes duration, fasting blood glucose (FBG), Glycated hemoglobin A1c (HbA1c), alkaline phosphatase (ALP), creatinine (Cr), neutrophil to lymphocyte ratio (NLR), diabetic vascular complications [men: OR = 0.996, 95% CI = 0.993-1.000, P = 0.039; women: OR = 0.996,95% CI = 0.994-0.998, P = 0.001]. The results were not statistically significant when models were further adjusted for BMD values at each site. Conclusions: Lower serum UA concentrations may be associatedwith lower BMD values and higher prevalence of clinical fractures independent of potential confounders except for BMD values at each site. These findings need to be confirmed by further prospective studies.