Serum urate levels and the risk of hip fractures: Data from the Cardiovascular Health Study

Tapan Mehta, Petra Bůžková, Mark J. Sarnak, Michel Chonchol, Jane A. Cauley, Erin Wallace, Howard A. Fink, John Robbins, Diana Jalal

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Purpose Uric acid inhibits vitamin D activation experimentally and higher serum urate levels are associated with higher parathyroid hormone levels in humans suggesting a link between uric acid and bone health. We hypothesized that hyperuricemia may increase the risk of fractures in older adults. Methods 1963 men and 2729 women 65 years of age who participated in the Cardiovascular Health Study and had baseline serum urate levels were included in the study. The primary outcome was incident hip fracture, assessed prospectively through June, 2008 by inpatient and outpatient records. The analysis was stratified by sex a priori. Results There was a U-shaped relationship between serum urate levels and hip fractures in men. Men in the lowest and the highest urate quartiles (< 4.88 and 6.88 mg/dL respectively) had a significantly higher rate of fractures in unadjusted analysis. However, upon multivariate adjustment, only the HR for hip fracture in highest quartile versus the reference remained significant (HR 1.9; 95% C.I. 1.1, 3.1; p value 0.02). High serum urate levels were not associated with hip fractures in women. Conclusion In this large prospective cohort of community-dwelling older adults, increased serum urate levels were associated with an increased risk of hip fractures in men. Further studies are needed to confirm these findings and to understand the mechanisms that underlie them.

Original languageEnglish (US)
Pages (from-to)438-446
Number of pages9
JournalMetabolism: clinical and experimental
Issue number3
StatePublished - Mar 1 2015

Bibliographical note

Funding Information:
This analysis was conducted on data collected as part of the Cardiovascular Health Study of the National Heart Lung and Blood Institute of the National Institutes. It was supported by contracts HHSN268201200036C , HHSN268200800007C , N01 HC55222 , N01HC85079 , N01HC85080 , N01HC85081 , N01HC85082 , N01HC85083 , N01HC85086 , and grant HL080295 from the National Heart, Lung, and Blood Institute (NHLBI) , with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS) . Additional support was provided by AG023629 from the National Institute on Aging (NIA) . A full list of principal CHS investigators and institutions can be found at This work was also supported by Dr. Jalal’s grant: 1K23DK088833 .

Publisher Copyright:
© 2015 Elsevier Inc.


  • Bone Health
  • Fractures
  • Urate


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