Investigation of the relationship between vitamin d and osteoporosis in patients individuals with gout

Low serum levels of 25-hydroxy vitamin D (Vit. D) and hyperuricemia (HU) may cause bone-related diseases such as osteoporosis. The relationship between Vit. D and osteoporosis among Iraqi patients with HU have not been reported so far, although HU and Vit. D deficiency is common. In this study, it is aimed to investigate the relationship between Vit. D with elevated serum uric acid (SUA) among patients in Salahaddin Province, Iraq. The data were collected from 120 participants attending laboratories in Tikrit Teaching Hospital in Iraq from October 2022 to February 2023. 60 hyperuricemic patients with SUA levels above the upper limit of the reference values as patients group and 60 individuals (volunteers) with average SUA values as controls were enrolled in the study. Traditional biomarkers such as fasting plasma calcium (Ca+2), C Reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were measured and compared between the two groups. The studied parameters and parameter levels were analyzed according to gender. The mean age of the studied patients was 61.50± 9.2 years, while in the control group, it was 52.2 ± 6.4 years. The SUA levels of patients and control groups were 7.51 ± 0.93 mg/dl and 4.40 ± 0.98 mg/dL, respectively. Vit. D level is a mean of 20.39 ± 13.26 ng/mL in patients with elevated SUA and 36.22 ± 7.26 ng/mL (at normal levels) in the control, and therefore Vit. D deficiency was prevalent in patients with high SUA. Moreover, the HU patients had a lower level of Ca+2 with a mean of 8.49 ± 0.73 mg/dl and higher levels of CRP with a mean of 18.06 ± 9.44 mg/dl and ESR levels with a mean of 35.50 ± 13.98 mm/hr than those with normal SUA levels (Ca+2; 9.11 ± 0.384mg/dl, CRP; 2.36 ± 1.716mg/dl, and ESR; 9 ± 4mm/hr., respectively). Vit. D level was significant positively associated with Ca+2 (r= 0.434, p=0.001), and non-significantly inversely correlated with SUA (r=-0.042, p=0.753), CRP(r=-0.155, p=0.238), and ESR(r=-0.123, p=0.349). These data show that Vit. D and Ca+2 deficiencies are important risk factors for osteoporosis, and both are essential for bone health. Moreover, Vit. D and Ca+2 are very important for patients suffering from hyperuricemia. Osteoporosis can occur in both men and women, and there are differences significantly. However, female patients with low vitamin D and Ca2+ and high CRP values as well as high ESR values have a higher risk than male patients with HU or gout. The results of our current study confirm that female sex, older age, amount of SUA, elevated ESR and CRP, decreased Vit. D and Ca+2 levels are all correlated variables for assessing osteoporosis risk. These findings confirm the need for Vit. D and Ca+2 supplementation. To fully understand the mechanisms and clarify the association between Vit. D deficiency and hyperuricemia, it is also necessary to investigate how Vit. D supplementation affects uric acid and therefore whether this supplementation treatment can prevent osteoporosis.