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Gout associated with higher hip fracture risk

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Women with a history of gout are more at risk of hip fracture, a new study has shown.

An analysis of data from the Nurses´ Health Study found a modestly increased risk of hip fracture, but no increased risk of wrist fracture, among participants with gout.

Gout is a type of arthritis which is caused by a build-up of uric acid in the blood. This leads to small crystals forming in and around the joints, causing them to become inflamed and painful.

Dr Julie M. Paik and colleagues from Harvard Medical School in Boston said that uric acid may be linked to bone health through its anti-oxidant or pro-oxidant effects, thereby affecting bone resorption and formation, or through inhibition of vitamin D activation and higher parathyroid hormone level.

Previous research on the relation between uric acid and bone mineral density has demonstrated conflicting results. Until now, there were no prospective studies examining the relation between gout and hip or wrist fracture risk in women.

The new study, published in the journal Arthritis & Rheumatology, included 103,799 women. Participants responded to biennial questionnaires that requested information about their lifestyle, diet, medications and diagnoses, including gout history and wrist and hip fracture.

During 22 years of follow-up there were 2,147 incident hip fractures, with 117 hip fractures in women with a history of gout. The analysis for wrist fractures covered 14 years of follow-up and found there were 3,769 incident wrist fractures, and 107 among participants with gout.

The multivariable-adjusted relative risk of hip fracture in women with a history of gout compared with women without gout was 1.38. In comparison, the multivariable-adjusted relative risk of wrist fracture in women with a history of gout compared with women without gout was 1.12.

Reporting on the findings, MedPageToday said the observation that risks were increased only for hip and not for wrist fracture indicates that the risk for fractures can differ according to the site.

If this is confirmed in other studies, it would be useful to examine the potential effects of urate-lowering treatment on fracture risk, the researchers suggested.

http://onlinelibrary.wiley.com/doi/10.1002/art.39852/abstract

http://www.medpagetoday.com/rheumatology/generalrheumatology/60164