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Gout and Risk of Fracture in Women: A Prospective Cohort Study
Author(s) -
Paik Julie M.,
Kim Seoyoung C.,
Feskanich Diane,
Choi Hyon K.,
Solomon Daniel H.,
Curhan Gary C.
Publication year - 2017
Publication title -
arthritis and rheumatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.106
H-Index - 314
eISSN - 2326-5205
pISSN - 2326-5191
DOI - 10.1002/art.39852
Subject(s) - medicine , gout , prospective cohort study , hip fracture , hyperuricemia , relative risk , cohort study , wrist , proportional hazards model , confounding , physical therapy , osteoporosis , surgery , confidence interval , uric acid
Objective Uric acid may be linked to bone health through its antioxidant or prooxidant effects, thereby affecting bone resorption and formation, or through its dual inhibition of vitamin D activation and parathyroid hormone production. Results of prior studies on the relationship between uric acid and bone mineral density have been conflicting. This prospective study was undertaken to examine the relationship between gout, a disease characterized by hyperuricemia and inflammation, and risk of hip or wrist fracture in women. Methods We conducted a prospective observational study of gout and risk of incident wrist and hip fracture in women participating in the Nurses’ Health Study (n = 103,799 at baseline, with 14 years of follow‐up for the wrist fracture analysis and 22 years of follow‐up for the hip fracture analysis). Gout history and incident cases of wrist and hip fracture were assessed by biennial questionnaire. Cox proportional hazards models were used to simultaneously adjust for potential confounders. Results In this cohort, there were 3,769 incident wrist fractures (1990–2004) and 2,147 incident hip fractures (1990–2012), with 107 wrist fractures and 117 hip fractures occurring in participants with gout. In those women with a history of gout compared with women without gout, the multivariable‐adjusted relative risk of wrist fracture was 1.12 (95% confidence interval [95% CI] 0.92–1.36) and the multivariable‐adjusted relative risk of hip fracture was 1.38 (95% CI 1.14–1.68). Conclusion In women, a history of gout is associated with a modestly increased risk of hip fracture, but not significantly associated with a risk of wrist fracture.