Higher uric acid serum levels are associated with sarcopenia among elderly in a community health center

Main Article Content

A. Deza Farista
Nur Rivianti
Erial Bahar
Mega Permata
Muhammad Reagan
Crisnah Indah
Ika Artini

Abstract

Background
As people age, skeletal muscle mass and strength decrease, leading to sarcopenia, diagnosed through calf circumference, muscle mass, strength, and physical performance. Uric acid (UA), with both pro-oxidant and antioxidant properties, is an indicator of oxidative stress and may contribute to sarcopenia. This study aimed to determine the correlation between serum uric acid levels and sarcopenia in elderly in a community health center.


Methods
A cross-sectional study was conducted involving 42 subjects aged ≥60 years, consisting of 37 female and 5 male participants. We applied Asian Working Group for Sarcopenia (AWGS) 2019 criteria to define sarcopenia. Muscle mass was measured using skeletal muscle index (SMI) based on bioimpedance analysis (BIA). Handgrip strength (HGS), physical performance, calf circumference, and blood test data were collected. A backward regression analysis was performed to investigate the relationship between UA and SMI, HGS, physical performance, and calf circumference after adjusting for gender, smoking history, upper arm circumference, and body mass index.

Results
After adjusting for potential confounding variables, uric acid remained significantly associated with muscle strength (β=0.326; p=0.023) and calf circumference (β=0.264; p=0.010), but not with muscle mass (β=0.046; p=0.727) or physical performance (β=–0.171; p=0.279).

Conclusion
There is a significant correlation between uric acid levels and muscle strength, physical performance, and calf circumference in sarcopenia among the elderly in the community health center. Higher uric acid serum levels might slow down the progression of sarcopenia.

Article Details

Section

Original Articles

How to Cite

Higher uric acid serum levels are associated with sarcopenia among elderly in a community health center. (2025). Universa Medicina, 44(3), 335-344. https://doi.org/10.18051/UnivMed.2025.v44.335-344

References

1. Kementerian Perencanaan Pembangunan Nasional/Badan Perencanaan Pembangunan Nasiona (Bappenas). [Ministry of National Development Planning]. Penduduk berkualitas menuju Indonesia emas: kebijakan kependudukan Indonesia 2020-2050. [Population of quality toward a golden Indonesia: Indonesian population policy for 2020-2050]. Jakarta: Kementerian Perencanaan Pembangunan Nasional/Badan Perencanaan Pembangunan Nasiona (Bappenas);2023. Indonesian.

2. Moga TD, Moga I , Sabau M, et al. Sarcopenia, a major clinical problem in old age, potential causes, clinical consequences and therapeutic possibilities, Balneo PRM Resh J 2022; 13: 492. https://doi.org/ 10.12680/balneo.2022.492.

3. Chen LK, Woo J, Assantachai P, et al. Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc 2020;21:300-7.e2. doi: 10.1016/j.jamda.2019.12.012.

4. Hidayat R, Riviati N. Sarcopenia from pathophysiology to clinical: literature review. Biomed J Indones 2021;7:1-10. doi: 10.32539/BJI.v7i1.11.

5. Barbiera A, Pelosi L, Sica G, Scicchitano BM. Nutrition and microRNAs: novel insights to fight sarcopenia. Antioxidants 2020;9:951. doi: 10.3390/antiox9100951.

6. Saito Y, Tanaka A, Node K, Kobayashi Y. Uric acid and cardiovascular disease: a clinical review. J Cardiol 2021;78:51-7. doi: 10.1016/j.jjcc.2020.12.013.

7. Guo SM, Liu YT, He SR, et al. Differential relationship of uric acid to mortality and clinical biomarkers of aging according to grip strength in older adults: a cohort study. Aging (Albany NY) 2021;13:10555. doi: 10.18632/aging.202820.

8. Liu X, Chen X, Hu F, et al. Higher uric acid serum levels are associated with sarcopenia in west China: a cross-sectional study. BMC Geriatr 2022;22:671. doi: 10.1186/s12877-022-02817-x.

9. Huang YC, Chen SL, Dong Y, Shi Y. Association between elevated serum uric acid levels and high estimated glomerular filtration rate with reduced risk of low muscle strength in older people: a retrospective cohort study. BMC Geriatr 2023;23:652. doi: 10.1186/s12877-023-04374-3.

10. Xu L, Jing Y, Zhao C, et al. Cross-sectional analysis of the association between serum uric acid levels and handgrip strength among Chinese adults over 45 years of age. Ann Transl Med 2020;8:1562. doi: 10.21037/atm-20-2813a.

11. Huang C, Niu K, Kobayashi Y, et al. An inverted J-shaped association of serum uric acid with muscle strength among Japanese adult men: a cross-sectional study. BMC Musculoskelet Disord 2013;14:258. doi: 10.1186/1471-2474-14-258.

12. Molino-Lova R, Sofi F, Pasquini G, et al. Higher uric acid serum levels are associated with better muscle function in the oldest old: results from the Mugello Study. Eur J Intern Med 2017;41:39-43. doi: 10.1016/j.ejim.2017.03.014.

13. Xiao X, Yi C, Peng Y, et al. The association between serum uric acid and appendicular skeletal muscle mass and the effect of their interaction on mortality in patients on peritoneal dialysis. Kidney Blood Press Res 2020;45:969-81. doi: 10.1159/000510746.

14. Seki R, Kimura T, Inoue K. Serum uric acid level has stronger correlations with metabolic syndrome-related markers in women than in men in a Japanese health check-up population. Open J Epidemiol 2020;10:399-418. doi: 10.4236/ojepi.2020.104032.

15. Dong Y, Wang Z, Wang S, et al. Gender-specific and U-shaped relationship between serum uric acid and all-cause mortality among Chinese older adults: a national population-based longitudinal study. Int J Public Health 2023;68:1605957. doi: 10.3389/ijph.2023.1605934.

16. He J, Hu F, Wang Y, Mei Y. Potential protective effects of increased serum uric acid concentration in sarcopenia: a meta-analysis and systematic review. Medicine (Baltimore) 2024;103:e37376. doi: 10.1097/MD.0000000000037376.

17. Jang YS, Nerobkova N, Yun I, et al. Association between smoking behavior and serum uric acid among adults: findings from a national cross-sectional study. PLoS One 2023;18:e0285471. doi: 10.1371/journal.pone.0285080.

18. Moon J, Lee H, Kong M, et al. Association between electronic cigarette use and levels of high-sensitivity C-reactive protein and uric acid. Asia Pac J Public Health 2020;32:35-41. doi: 10.1177/101053951989977

19. Fanning N, Merriman TR, Dalbeth N, Stamp LK. An association of smoking with serum urate and gout: a health paradox. Semin Arthritis Rheum 2018;47:825-842. doi: 10.1016/j.semarthrit.2017.11.004.

20. Floriano JP, Nahas PC, de Branco FMS, et al. Serum uric acid is positively associated with muscle mass and strength, but not with functional capacity, in kidney transplant patients. Nutrients 2020;12:2390. doi: 10.3390/nu12082390.

21. Lin J, Hu M, Gu X, et al. Effects of cigarette smoking associated with sarcopenia in persons 60 years and older: a cross-sectional study in Zhejiang province. BMC Geriatr 2024;24:51. doi: 10.1186/s12877-024-04993-4.

22. Akazawa N, Kishi M, Hino T, et al. Higher body mass index in hospitalized older patients is related to higher muscle quality. J Nutr Health Aging 2022;26:495-500. doi: 10.1007/s12603-022-1785-9.

23. Nahas PC, Rossato LT, de Branco FMS, et al. Serum uric acid is positively associated with muscle strength in older men and women: findings from NHANES 1999–2002. Clin Nutr 2021;40:4386-93. doi: 10.1016/j.clnu.2020.12.043.

24. Lee J, Hong YS, Park SH, Kang KY. High serum uric acid level is associated with greater handgrip strength in the aged population. Arthritis Res Ther 2019;21:73. doi: 10.1186/s13075-019-1858-2.

25. Kawamoto R, Ninomiya D, Kasai Y, et al. Serum uric acid is positively associated with handgrip strength among Japanese community-dwelling elderly women. PLoS One 2016;11:e0151044. doi: 10.1371/journal.pone.0151044.

26. Prasetyawan RD, Hidayati N. The correlation between intensity of physical activity and uric acid level in gout arthritis patients in the Sobo public health care Banyuwangi. Sobo Health Center Banyumas 2016;23:1-10.

27. Rahbek C, Kamper R, Haddock B, Andersen H, Jørgensen N, Suetta C. The relationship between low-grade inflammation and muscle mass, strength, and physical performance in a geriatric out-patient population. J Geriatr Med Gerontol 2021;7:1-9. doi: 10.23937/2469-5858/1510119.

28. Zhou S, Wu L, Si H, Shen B. Longitudinal association between uric acid and incident sarcopenia. Nutrients 2023;15:1698. doi: 10.3390/nu15143097.

29. Du L, Zong Y, Li H, et al. Hyperuricemia and its related diseases: mechanisms and advances in therapy. Sig Transduct Target Ther 2024;9: 212. doi: 10.1038/s41392-024-01916-y.