Serum Uric Acid Levels Linked to Reduced Hip Osteoporosis Risk in Postmenopausal Women With RA

Higher serum uric acid (UA) levels may be associated with a reduced risk for hip osteoporosis in postmenopausal women with rheumatoid arthritis (RA), according to study results published in Medicine.

Higher serum UA levels have been shown to have a positive correlation with bone mineral density (BMD) in the general population. In this retrospective cross-sectional study, the investigators sought to determine the association between serum UA and osteoporosis risk in postmenopausal women with RA.

Data were collected from 447 postmenopausal patients with RA and 200 age-matched healthy control participants. Bone mineral density measurements of the lumbar spine, hip, and neck were analyzed using dual-energy x-ray absorptiometry, along with clinical data, including age, height, weight, and body mass index, and laboratory data including serum UA levels, serum creatinine, and estimated glomerular filtration rate.

Study findings revealed that serum UA levels in postmenopausal women with RA vs healthy control participants were significantly lower (median serum UA, 4 [3.3-4.8] vs 4.1 [3.6-4.8] mg/dL; P=.012). Compared with control participants, patients with RA had significantly lower total hip, femoral neck, and lumbar spine BMD. In addition, the incidence of osteoporosis was significantly higher in patients with RA compared with control participants (lumbar spine, 25.5% vs 7%; P <.001; hip, 15.9% vs 1.5%; P <.001; and either site, 32.5% vs 8%; P <.001, respectively). After adjusting for confounding factors, the results showed a positive association between serum UA levels and BMD in the femoral neck (β=0.0104; P=.01) and total hip (β=0.0102; P=.017).

Overall, higher serum UA levels were associated with lower risk for osteoporosis in postmenopausal women with RA.

Study limitations included the researchers’ inability to determine the existence of a causal relationship between serum UA levels and osteoporosis, and the narrow scope of data including only postmenopausal women with RA.

Researchers concluded, “… UA may exert a protective effect on bone health in RA, especially at the hip joint, probably through its antioxidative effect against oxidative stress-induced bone loss. Our data may provide a novel insight into the role of UA in the bone metabolism of patients with RA.”


Lee H-N, Kim A, Kim Y, Kim G-T, Sohn DH, Lee S-G. Higher serum uric acid levels are associated with reduced risk of hip osteoporosis in postmenopausal women with rheumatoid arthritis [published online June 12, 2020]. Medicine. doi:10.1097/MD.0000000000020633