Recent advances in research on the association between paediatric hyperuricaemia and bone health

With changes in lifestyle and dietary patterns, paediatric hyperuricaemia has become an increasingly recognised metabolic condition worldwide. Its potential implications for skeletal health have attracted growing attention at the intersection of paediatric endocrinology, metabolism, and bone biology. This narrative review synthesises current evidence regarding the potential relationship between hyperuricaemia and skeletal health in children and adolescents. We discuss the epidemiology and clinical characteristics of paediatric hyperuricaemia, potential mechanisms linking urate dysregulation to bone metabolism, and available evidence concerning bone mineral density, bone microstructure, linear growth, and fracture risk. Because direct paediatric evidence remains limited, findings from adult populations, experimental models, and rare inherited metabolic disorders are considered primarily as indirect or hypothesis-generating evidence rather than as definitive proof of causality. We also discuss approaches to skeletal assessment, lifestyle management, and urate-lowering therapy, whilst highlighting major gaps in the current evidence base and priorities for future research.