Association between serum uric acid levels and lumbar spine Z-scores in adults aged <50 years: A cross-sectional study

Higher serum uric acid levels are associated with increased spinal bone mineral density in adults under 50, mediated partly by creatinine (∼49 % of the effect), with stronger effects in women and those with better renal function and lower adiposity. These findings reposition uric acid as a potential early protector against bone loss, paving the way for sex- and metabolism-tailored interventions to prevent osteoporosis in younger populations.