痛風、規律運動與骨質疏鬆症的交互作用：以群體為基礎之研究

痛風、運動與骨質疏鬆症之間的關聯性至今仍未完全釐清，尤其在東亞人群中相關研究相對有限。本研究為一項橫斷面研究，使用2008年至2019年之台灣生物資料庫資料，共納入10,192名年齡介於30至70歲、無癌症病史之參與者，旨在探討這些因子間的交互作用對骨質疏鬆症預防的意義。骨質疏鬆症的評估採用雙能量X光吸收儀（DXA）進行，痛風診斷與運動習慣資料則透過標準化問卷調查獲得，規律運動定義為每週至少三次、每次持續30分鐘以上的體能活動。研究結果顯示，在10,192名參與者中，3,655人（35.86%）被診斷為骨質疏鬆症。痛風與骨質疏鬆症風險降低顯著相關（OR = 0.654，95% CI = 0.495–0.864），規律運動亦顯著降低骨質疏鬆症風險（OR = 0.760，95% CI = 0.684–0.844）。痛風與運動之間存在顯著交互作用（交互作用P值= 0.0002）。進一步分析發現，有規律運動的痛風患者骨質疏鬆症風險降低達68%（OR = 0.323，95% CI = 0.218–0.479），無痛風的規律運動者風險降低幅度為21%（OR = 0.788，95% CI = 0.708–0.876）。ABCG2 rs2231142基因變異與骨質疏鬆症風險無顯著相關性。本研究結論顯示，在台灣人群中，規律運動與痛風患者罹患骨質疏鬆症的風險顯著降低有關，相較於遺傳傾向，非遺傳因素特別是身體活動在骨質疏鬆症預防上更為關鍵，倡導規律運動應作為針對痛風等高風險族群預防骨質疏鬆症的重要公共衛生策略。

The association between gout, exercise, and osteoporosis remains incompletely understood, particularly in East Asian populations where relevant studies are limited. This cross-sectional study utilized data from the Taiwan Biobank (2008–2019), including 10,192 participants aged 30–70 years without a history of cancer, to investigate the interactions among these factors and their implications for osteoporosis prevention. Osteoporosis was assessed using Dual-energy X-ray Absorptiometry (DXA), while gout diagnosis and exercise habits were obtained through standardized questionnaires. Regular exercise was defined as engaging in physical activity at least three times per week, with each session lasting 30 minutes or more. Among the 10,192 participants, 3,655 (35.86%) were diagnosed with osteoporosis. The results revealed a significant association between gout and reduced osteoporosis risk (odds ratio [OR] = 0.654, 95% confidence interval [CI] = 0.495–0.864). Regular exercise was also significantly associated with lower osteoporosis risk (OR = 0.760, 95% CI = 0.684–0.844). A significant interaction was observed between gout and exercise (interaction P-value = 0.0002). Further analysis showed that gout patients with regular exercise exhibited a 68% reduction in osteoporosis risk (OR = 0.323, 95% CI = 0.218–0.479), while regular exercisers without gout had a 21% risk reduction (OR = 0.788, 95% CI = 0.708–0.876). No significant association was found between the ABCG2 rs2231142 gene variant and osteoporosis risk. In conclusion, regular exercise is significantly associated with reduced osteoporosis risk in Taiwanese individuals with gout. Non-genetic factors, particularly physical activity, appear to play a more critical role than genetic predisposition in osteoporosis prevention. Promoting regular exercise should be considered a key public health strategy for preventing osteoporosis, especially in high-risk groups such as those with gout.