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REVIEW article

Front. Endocrinol.
Sec. Bone Research
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1515176

The Impact of Uric acid on Musculoskeletal Diseases: Clinical Associations and Underlying Mechanisms

Provisionally accepted
Jing Zhang Jing Zhang 1Na Sun Na Sun 2Wanhao Zhang Wanhao Zhang 1Wenjie Yue Wenjie Yue 1Xiaochen Qu Xiaochen Qu 1Zhonghai Li Zhonghai Li 1Gang Xu Gang Xu 1*
  • 1 First Affiliated Hospital, Dalian Medical University, Dalian, China
  • 2 Dalian No.3 People's Hospital, Dalian, Liaoning Province, China

The final, formatted version of the article will be published soon.

    Serum urate (SU) levels are significantly elevated in conditions such as gout, type 2 diabetes (T2D), obesity, and other metabolic syndromes. Recently, due to the high prevalence of hyperuricemia (HUA), numerous clinical connections between SU and musculoskeletal disorders like sarcopenia, osteoarthritis (OA), rheumatoid arthritis (RA), intervertebral disc degeneration (IDD), and osteoporosis (OP) have been identified. This review discusses the mechanisms linking SU to musculoskeletal disorders, as well as the clinical associations of SU with conditions such as sarcopenia, T2D with sarcopenia, McArdle disease, heart failure, gout, OA, IDD, OP and exercise-induced acute kidney injury (EIAKI), offering valuable insights for improved prevention and treatment strategies. Mechanisms linking SU to musculoskeletal disorders include oxidative stress, MSU (monosodium urate) crystal deposition, inflammation, and other factors. In adults, both age and SU levels should be considered for preventing sarcopenia, while gender and SU may directly impact muscle mass in children and adolescents.HUA and gout may be risk factors for OA progression, although some reports suggest otherwise.A U-shaped relationship between SU and IDD has been reported, particularly in Chinese men, indicating lower or higher SU level may be risk factors for IDD. Maintaining SU levels within a certain range may help prevent OP and fractures. Future research, including epidemiological studies and new pathogenesis findings, will further clarify the relationship between musculoskeletal diseases and SU.

    Keywords: Uric Acid, Musculoskeletal Diseases, Sarcopenia, Osteoarthritis, Intervertebral Disc Degeneration, Gout, Osteoporosis Abbreviations: ADMA, asymmetric dimethylarginine, ADP, adenosine diphosphate

    Received: 22 Oct 2024; Accepted: 15 Jan 2025.

    Copyright: © 2025 Zhang, Sun, Zhang, Yue, Qu, Li and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Gang Xu, First Affiliated Hospital, Dalian Medical University, Dalian, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.