{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T01:36:53Z","timestamp":1789263413352,"version":"build-2803163510"},"reference-count":51,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82373534"],"award-info":[{"award-number":["82373534"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp; Research"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to identify metabolic signatures reflecting air pollution and further explore their associations with gout risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrieved 207,908 gout\u2010free participants from a large cohort study. Annual average concentrations of fine particulate matter (PM\n                      <jats:sub>2.5<\/jats:sub>\n                      ), inhalable particulate matter (PM\n                      <jats:sub>10<\/jats:sub>\n                      ), nitrogen dioxide (NO\n                      <jats:sub>2<\/jats:sub>\n                      ), and nitrogen oxides (NO\n                      <jats:sub>x<\/jats:sub>\n                      ) were estimated using bilinear interpolation based on the residential address. Elastic net regression was used to identify air pollutant\u2013related metabolites and construct metabolic signatures. Cox regression models were performed to evaluate the association between air pollutants, related metabolic signatures, and the risk of gout. Mediation analyses were performed to explore how metabolites mediate the relationships linking air pollutants to gout.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During a median follow\u2010up of 12.56 years, 2,474 incident gout cases were identified. We identified metabolite biomarkers reflecting air pollutants, including 87 metabolites for PM\n                      <jats:sub>2.5<\/jats:sub>\n                      , 76 for PM\n                      <jats:sub>10<\/jats:sub>\n                      , 68 for NO\n                      <jats:sub>2<\/jats:sub>\n                      , and 71 for NO\n                      <jats:sub>x<\/jats:sub>\n                      . Air pollution\u2013related metabolic signatures were associated with elevated gout risk, with hazard ratios of 1.10 (95% confidence interval [CI] 1.05\u20131.14) for PM\n                      <jats:sub>2.5<\/jats:sub>\n                      , 1.12 (95% CI 1.08\u20131.17) for PM\n                      <jats:sub>10<\/jats:sub>\n                      , 1.09 (95% CI 1.04\u20131.13) for NO\n                      <jats:sub>2<\/jats:sub>\n                      , and 1.11 (95% CI 1.06\u20131.15) for NO\n                      <jats:sub>x<\/jats:sub>\n                      . Consistently, per\u2010interquartile range\u00a0increase in PM\n                      <jats:sub>2.5<\/jats:sub>\n                      , PM\n                      <jats:sub>10<\/jats:sub>\n                      , NO\n                      <jats:sub>2<\/jats:sub>\n                      , and NO\n                      <jats:sub>x<\/jats:sub>\n                      was associated with 17%, 15%, 6%, and 6% increased gout risk, respectively. Additionally, metabolic signatures mediated the air pollutants\u2013gout associations, with the mediation proportions varying from 2.36% for PM\n                      <jats:sub>2.5<\/jats:sub>\n                      to 4.30% for NO\n                      <jats:sub>x<\/jats:sub>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study indicated that air pollutants and metabolic signatures were associated with elevated gout risk, with metabolomic signatures playing a mediating role in the air pollutants\u2013gout relationship.<\/jats:p>\n                  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