Background Serum uric acid levels increase in postmenopausal women but decrease when hormone replacement therapy (HRT) is administered. However, no study has evaluated the effects of different types of HRT on serum uric acid levels.

Objectives We examined whether estrogen monotherapy, estrogen-progestogen combination therapy, and tibolone use affected serum uric acid levels in this population.

Methods We performed a retrospective case-control study of postmenopausal women. From 2005 to 2015, postmenopausal women measured serum uric acid levels more than twice were included. Patients were grouped according to HRT regimen: estrogen monotherapy, estrogen-progestogen combination therapy, or tibolone. The control group did not receive HRT. Differences in serum uric acid levels were examined in each group. Our analysis was adjusted to accommodate different follow-up intervals for individual patients. Multiple variables were adjusted using the Tukey-Kramer method. Age, body mass index, hypertension, diabetes mellitus, dyslipidemia, alcohol consumption, smoking status, and co-medications were also adjusted.

Results In the control group, the serum uric acid level increased to 0.86±0.27 mg/dL (least squares mean ± standard error). In comparison, after adjusting for multiple variables, the serum uric levels in the estrogen-progestogen combination therapy group were found to be significantly lower (-0.41±0.29 mg/dL, P<0.001). However, the serum uric acid levels in the estrogen monotherapy and tibolone groups did not differ significantly from the control group level.

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Conclusions Serum uric acid levels decreased in response to estrogen-progestogen combination therapy in postmenopausal women. We attribute our findings to the effects of progesterone, rather than estrogen.

References

1. Roddy E, Doherty M. Epidemiology of gout. Arthritis Res Ther. 2010;12:223.

2. Hak AE, Curhan GC, Grodstein F, Choi HK. Menopause, postmenopausal hormone use and risk of incident gout. Ann Rheum Dis. 2010;69:1305–9.

3. Hak AE, Choi HK. Menopause, postmenopausal hormone use and serum uric acid levels in US women–the Third National Health and Nutrition Examination Survey. Arthritis Res Ther. 2008;10:R116.

4. Bruderer SG, Bodmer M, Jick SS, Meier CR. Association of hormone therapy and incident gout: population-based case-control study. Menopause. 2015;22:1335–42.

References

Acknowledgements No grants or other support were received for this study.

Disclosure of Interest None declared