{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:03:28Z","timestamp":1787018608310,"version":"build-2736575974"},"reference-count":24,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Science Progress"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This cross-sectional study investigates the association between the serum uric acid-to-creatinine (UA\/Cr) ratio and gallstone risk using NHANES 2017\u20132020 data, while exploring modifying effects of demographic and metabolic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 5450 adult participants were included after excluding individuals with missing gallstone diagnoses or incomplete UA\/Cr data. UA\/Cr was calculated as uric acid (mg\/dL)\/creatinine (mg\/dL). Gallstone diagnosis relied on self-reported questionnaires. Weighted logistic regression models (unadjusted, partially adjusted, fully adjusted) assessed associations, with covariates including demographic (age, sex, race\/ethnicity, education), lifestyle (smoking, alcohol use), and metabolic factors (BMI, hypertension, total bilirubin, diabetes). A restricted cubic spline analysis was further employed to visualize potential nonlinear relationships. Additionally, subgroup analyses were conducted to evaluate the association between the UA\/Cr and gallstone risk across various subgroups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Gallstone prevalence was 9.85% (537\/5450), with higher UA\/Cr in affected individuals (7.29 vs. 6.16,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.034). Fully adjusted models demonstrated a 17% increased gallstone risk per UA\/Cr unit (Odds ratio (OR)\u2009=\u20091.17, 95% confidence interval: 1.09\u20131.38,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.021). The highest UA\/Cr quartile (\u22657.234) showed a 41% elevated risk (OR\u2009=\u20091.41,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.017). Restricted cubic spline analysis revealed a non-linear dose\u2013response relationship (inflection point: UA\/Cr\u2009=\u20096.4). Subgroup analyses identified stronger associations in females (OR = 1.23,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.012), obese individuals (OR\u2009=\u20091.24,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.016), and divorced participants (OR\u2009=\u20091.21,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.009).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Elevated UA\/Cr ratio was independently associated with an increased risk of gallstone disease in this nationally representative sample. Future prospective and mechanistic studies are warranted to clarify the temporal relationship and the underlying pathways linking purine metabolism to biliary pathology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00368504251353326","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T10:25:58Z","timestamp":1750847158000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["The association between serum uric acid to creatinine ratio and gallstones: National Health and Nutrition Examination Survey 2017\u20132020"],"prefix":"10.1177","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6453-4334","authenticated-orcid":false,"given":"Shuping","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Nephrology, Lishui District People's Hospital, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilong","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Nanjing Yimin Hospital, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Lishui District People's Hospital, Nanjing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2024.04.015"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-022-05947-8"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/1751-2980.12857"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.2024.2377952"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-023-01273-3"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/met.2022.0013"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-024-01295-3"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjd.2021.11.010"},{"key":"e_1_3_2_11_2","article-title":"The correlation between NAFLD and serum uric acid to serum creatinine ratio","volume":"18","author":"Choi J","year":"2023","unstructured":"Choi J, Joe H, Oh JE, et al. The correlation between NAFLD and serum uric acid to serum creatinine ratio. 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Renal tubular damage depresses renal uric acid excretion in primary biliary cirrhosis. Hepatology 1984; 4: 1265\u20131266. PMID:6500516.","journal-title":"Hepatology"},{"key":"e_1_3_2_24_2","first-page":"1193","article-title":"Predictive value of serum uric acid on new-onset cholelithiasis (a report of 97 469 cases)","volume":"17","author":"Wei YC","year":"2018","unstructured":"Wei YC, Tao M, Liang MY, et al. Predictive value of serum uric acid on new-onset cholelithiasis (a report of 97 469 cases). 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