{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T10:42:32Z","timestamp":1771065752060,"version":"3.50.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T00:00:00Z","timestamp":1738886400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>To explore the controversial relationship between uric acid (UA) levels and bone mineral density (BMD) in patients with type 2 diabetes mellitus (T2DM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>The PubMed, Embase, and Cochrane Library databases were searched using keywords and related words. Study quality was evaluated using the Newcastle-Ottawa Scale. Studies retrieved in the literature search were systematically screened to extract information and data based on predefined inclusion and exclusion criteria. RevMan version 5.3 and Stata Release 13.0 were used for statistical analysis. Results are expressed as mean difference (MD) and corresponding 95% confidence interval (CI). Heterogeneity was evaluated using the I<jats:sup>2<\/jats:sup> and Q tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This meta-analysis included 10 studies comprising 5,717 patients with T2DM. Study quality ranged from moderate to high. Results of comparative analyses were as follows: normal BMD versus (vs.) osteoporosis (OP) in females, MD \u221213.83 \u03bcmol\/L (95% CI \u221241.69 to 14.03); I<jats:sup>2<\/jats:sup> = 7%; P=0.30); normal BMD vs. osteopenia in females, MD \u221212.41 \u03bcmol\/L (95% CI \u221237.81 to 12.99; I<jats:sup>2<\/jats:sup> = 0%; P=0.92); normal BMD vs. abnormal BMD (osteopenia\/OP), MD \u221223.82 \u03bcmol\/L (95% CI \u221233.50 to \u221214.13; I<jats:sup>2<\/jats:sup> = 0%; P=0.44); and osteopenia vs. OP, MD \u221222.35 \u03bcmol\/L (95% CI \u221229.55 to \u221215.15; I<jats:sup>2<\/jats:sup> = 5%; P=0.39). No publication bias was observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared with normal BMD, abnormal BMD (osteopenia\/OP) was associated with lower UA levels. Compared with osteopenia, OP also showed lower UA.<\/jats:p><jats:p>Systematic review registration:<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1415550","type":"journal-article","created":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T05:10:58Z","timestamp":1738905058000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Correlation between uric acid levels and bone mineral density in patients with type 2 diabetes mellitus: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Hang","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cuijuan","family":"Qi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunjia","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luping","family":"Ren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuchun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,2,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24043772","article-title":"Oxidative stress and inflammation in osteoporosis: molecular mechanisms involved and the relationship with microRNAs","volume":"24","author":"Iantomasi","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B2","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1038\/s41413-022-00205-0","article-title":"The role of sphingosine-1-phosphate in bone remodeling and osteoporosis","volume":"1","author":"Grewe","year":"2022","journal-title":"Bone Res"},{"key":"B3","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1007\/s00198-021-06051-w","article-title":"Fractures in untreated patients with osteoporosis in Germany: an InGef healthcare insurance database analysis","volume":"1","author":"B\u00f6cker","year":"2022","journal-title":"Osteoporosis Int"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3390\/antiox12020373","article-title":"Oxidative stress and natural antioxidants in osteoporosis: novel preventive and therapeutic approaches","volume":"12","author":"Marcucci","year":"2023","journal-title":"Antioxidants (Basel)"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1080\/15257770802138558","article-title":"Uric acid: the oxidant-antioxidant paradox","volume":"27","author":"Sautin","year":"2008","journal-title":"Nucleos Nucleot Nucl"},{"key":"B6","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1186\/s12891-022-05636-8","article-title":"Creatinine-to-cystatin C ratio as a marker of sarcopenia for identifying osteoporosis in male patients with type 2 diabetes mellitus","volume":"23","author":"Dai","year":"2022","journal-title":"BMC Musculoskelet Disord"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S401397","article-title":"Levels with bone mineral densities and risk of osteoporosis and osteopenia in men and menopausal women with type 2 diabetes mellitus","volume":"16","author":"Lu","year":"2023","journal-title":"Diabetes Metab Syndr Obes"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1055\/a-1702-5168","article-title":"A risk assessment tool for identifying osteoporosis in older women with type 2 diabetes mellitus","volume":"130","author":"Pan","year":"2022","journal-title":"Exp Clin Endocr Diab"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.930410","article-title":"Relationship of bone status with serum uric acid and bilirubin in men with type 2 diabetes: a cross-sectional study","volume":"27","author":"Wu","year":"2021","journal-title":"Med Sci Monit"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-023-03353-3","article-title":"The associations between uric acid with BMDs and risk of the 10-year probability of fractures in Chinese patients with T2DM stratified by age and gender","volume":"80","author":"Xu","year":"2023","journal-title":"ENDOCRINE"},{"key":"B11","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/j.cca.2018.07.033","article-title":"Association of serum uric acid with bone mineral density and clinical fractures in Chinese type 2 diabetes mellitus patients: A cross-sectional study","volume":"486","author":"Yan","year":"2018","journal-title":"Clin Chim Acta"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3390\/biom13040616","article-title":"Correlation between blood lipid level and osteoporosis in older adults with type 2 diabetes mellitus\u2014a retrospective study based on inpatients in Beijing, China","volume":"13","author":"Zhao","year":"2023","journal-title":"Biomolecules"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/3982831","article-title":"Association between uric acid and bone mineral density in postmenopausal women with type 2 diabetes mellitus in China: A cross-sectional inpatient study","volume":"2020","author":"Zhao","year":"2020","journal-title":"J Diabetes Res"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S384266","article-title":"Associations of obesity indices with bone mineral densities and risk of osteoporosis stratified across diabetic vascular disease in T2DM patients","volume":"15","author":"Zheng","year":"2022","journal-title":"Diabetes Metab Syndr Obes"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-017-3930-6","article-title":"Bone mass loss is associated with systolic blood pressure in postmenopausal women with type 2 diabetes in Tibet: a retrospective cross-sectional study","volume":"28","author":"Zhou","year":"2017","journal-title":"Osteoporosis Int"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.20.00989","article-title":"Oxidative stress and osteoporosis","volume":"15","author":"Kimball","year":"2021","journal-title":"J Bone Joint Surg Am"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare9121681","article-title":"Association between serum uric acid levels and bone mineral density in postmenopausal women: a cross-sectional and longitudinal study","volume":"9","author":"Kang","year":"2021","journal-title":"Healthcare (Basel)"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1002\/jbt.21707","article-title":"Uric acid promotes osteogenic differentiation and inhibits adipogenic differentiation of human bone mesenchymal stem cells","volume":"29","author":"Li","year":"2015","journal-title":"J Biochem Mol Toxic"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1038\/nm.3074","article-title":"WNT signaling in bone homeostasis and disease: From human mutations to treatments","volume":"19","author":"Baron","year":"2013","journal-title":"Nat Med"},{"key":"B20","doi-asserted-by":"publisher","first-page":"379","DOI":"10.2741\/4214","article-title":"Wnt and the Wnt signaling pathway in bone development and disease","volume":"19","author":"Wang","year":"2014","journal-title":"Front Biosci (Landmark Ed)"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.2174\/1871530318666181102115106","article-title":"Review of the literature examining the association of serum uric acid with osteoporosis and mechanistic insights into Its effect on bone metabolism","volume":"19","author":"Kaushal","year":"2019","journal-title":"Endocr Metab Immune"},{"key":"B22","first-page":"48","article-title":"Bone mass measurement and factors associated with risk of fracture in a group of peri- and postmenoupausal women","volume":"20","author":"Rasheed","year":"2008","journal-title":"J Ayub Med Coll Abbottabad"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.2430","article-title":"Relationship between serum uric acid and bone mineral density in the general population and in rats with experimental hyperuricemia","volume":"30","author":"Zhang","year":"2015","journal-title":"J Bone Miner Res"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2022.02.006","article-title":"Assessment and treatment of osteoporosis and fractures in type 2 diabetes","volume":"33","author":"Sheu","year":"2022","journal-title":"Trends Endocrin Met"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1415550\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T05:11:02Z","timestamp":1738905062000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1415550\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,7]]},"references-count":24,"alternative-id":["10.3389\/fendo.2025.1415550"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1415550","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,7]]},"article-number":"1415550"}}