{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:19:00Z","timestamp":1788787140556,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,10,5]],"date-time":"2016-10-05T00:00:00Z","timestamp":1475625600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Serum uric acid (<jats:styled-content style=\"fixed-case\">SUA<\/jats:styled-content>) accounts for about 50% of extracellular antioxidant activity, suggesting that hyperuricemia may have a protective role in diseases characterized by high levels of oxidative stress, such as osteoporosis. We aimed to meta\u2010analyse data regarding bone mineral density (<jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content>), osteoporosis and fractures in people with higher <jats:styled-content style=\"fixed-case\">SUA<\/jats:styled-content> vs. lower <jats:styled-content style=\"fixed-case\">SUA<\/jats:styled-content> concentrations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Two investigators conducted a literature search using PubMed and Scopus, without language restrictions. Standardized mean differences (<jats:styled-content style=\"fixed-case\">SMD<\/jats:styled-content>s) and 95% confidence intervals (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>s) were used for <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content>; risk ratios (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>s) and adjusted odds ratios (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>s) for cross\u2010sectional data. Most possible adjusted hazard ratios (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>s) were used to assess the association between baseline <jats:styled-content style=\"fixed-case\">SUA<\/jats:styled-content> and incident fractures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1405 initial hits, 19 studies were eligible including a total of 55 859 participants. Subjects with higher <jats:styled-content style=\"fixed-case\">SUA<\/jats:styled-content> levels had significantly higher <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content> values for the spine (six studies; <jats:styled-content style=\"fixed-case\">SMD<\/jats:styled-content> = 0\u00b729; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0\u00b722\u20130\u00b735; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 47%), total hip (seven studies; <jats:styled-content style=\"fixed-case\">SMD<\/jats:styled-content> = 0\u00b729; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0\u00b724\u20130\u00b734; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 33%) and femoral neck (six studies; <jats:styled-content style=\"fixed-case\">SMD<\/jats:styled-content> = 0\u00b725; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0\u00b716\u20130\u00b734; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 71%). Simple correlation analyses substantially confirmed these findings. An increase of one standard deviation in <jats:styled-content style=\"fixed-case\">SUA<\/jats:styled-content> levels reduced the number of new fractures at follow\u2010up (three studies; <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> = 0\u00b783; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0\u00b774\u20130\u00b792; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 0%). No significant differences between men and women emerged, although data about women were limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hyperuricemia was found independently associated with <jats:styled-content style=\"fixed-case\">BMD<\/jats:styled-content> and fractures, supporting a protective role for uric acid in bone metabolism disorders.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.12677","type":"journal-article","created":{"date-parts":[[2016,9,16]],"date-time":"2016-09-16T14:13:01Z","timestamp":1474035181000},"page":"920-930","source":"Crossref","is-referenced-by-count":63,"title":["Hyperuricemia protects against low bone mineral density, osteoporosis and fractures: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"46","author":[{"given":"Nicola","family":"Veronese","sequence":"first","affiliation":[{"name":"Geriatrics Section Department of Medicine University of Padova Padova Italy"},{"name":"Institute for Clinical 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