Serum Uric Acid and Biomarkers of Lumbar Spine Bone Mineral Density

  • Yulong YangEmail author
  • Shinya IshiiEmail author
Reference work entry
Part of the Biomarkers in Disease: Methods, Discoveries and Applications book series (BDMDA)


Uric acid is the final product of purine metabolism in humans and higher primates, and its serum level has markedly increased during their evolution. Uric acid is known to be a potent antioxidant, and an increased level of uric acid has been considered advantageous, since it may compensate the inability to synthesize vitamin C, another prominent antioxidative substance, to maintain the total amount of antioxidants in the body. The advantage of a high serum uric acid level through its antioxidant property is observed in its protective effect against various neurological disorders including Alzheimer’s disease, Huntington’s disease, and stroke. On the other hand, uric acid has been implicated in the development of a number of diseases. For example, accumulation of uric acid crystals in joints is the primary pathophysiological cause of gout. In addition, uric acid may contribute to the development of cardiovascular diseases. It has been proposed that uric acid exerts a prooxidant property in certain conditions, and its prooxidant activity is involved in the development of oxidative stress-related diseases. The paradoxical behavior of uric acid is not fully understood, but whether uric acid acts as a prooxidant or an antioxidant may be partially determined by its concentration in the blood and its form.

Recent accumulated studies have provided evidence that oxidative stress is the primary underlying mechanism of age-related bone loss. Oxidative stress enhances osteoclast activity and increases bone resorption. Various antioxidant substances such as vitamin C and carotenoids are favorably associated with bone health. These observations led to the hypothesis that uric acid possesses bone-protective potential, considering its potent antioxidative property. Indeed, recent epidemiological studies suggest that a high uric acid level is associated with higher bone mineral density and decreased risk of bone fractures in various populations, especially in older men and women. Clinical studies of bone turnover markers and experimental studies have lent support to the beneficial effect of uric acid on bone health. These pieces of evidence point toward the clinical utility of serum uric acid as a biomarker of osteoporosis or fracture risk. Further research is needed to prove this contention.


Uric acid Oxidative stress Antioxidant Cardiovascular disease Bone mineral density Osteoporosis Bone fracture 

List of Abbreviations


Bone mineral density


Cardiovascular disease


Dual-energy X-ray absorptiometry


Estimated glomerular filtration rate


Parathyroid hormone


Quantitative ultrasound


Reactive oxygen species


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Copyright information

© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  1. 1.Internal Medicine Resident, Mount Sinai Beth IsraelNew YorkUSA
  2. 2.Department of Geriatric MedicineGraduate School of Medicine, The University of TokyoTokyoJapan

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