{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:11:57Z","timestamp":1787019117250,"version":"build-2736575974"},"reference-count":39,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T00:00:00Z","timestamp":1627948800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 106-2314-B-038-013-MY3"],"award-info":[{"award-number":["MOST 106-2314-B-038-013-MY3"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Biological Research For Nursing"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Most Indonesians with hyperuricemia are less than 40 years old, which suggests an increasing gout risk in the country. Meanwhile, untreated hyperuricemia was also suggested to lead to hypertension. Yet, it is unclear whether blood pressure (BP) plays a mediating role between urate and gout.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>We investigated the mediating effect of BP between urate and gout risk in Indonesians using a partial least squares-structural equation model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method:<\/jats:title>\n                    <jats:p>A community-based retrospective case-control study was conducted between July 1 and August 31, 2019 in Indonesia. We randomly recruited 397 participants, including 86 patients with gout and 311 healthy controls from seven community health service centers. Multivariate logistic regression was employed to analyze the adjusted odds ratios of the association between risk factors, such as urate level and BP, and gout risk after controlling for other covariates. A path analysis was utilized to analyze the mediating effect of systolic BP between urate and gout. The STROBE reporting guideline for the observational study is adopted in our reporting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result:<\/jats:title>\n                    <jats:p>We found that a 1 mg\/dL increase of urate level significantly increased gout risk with an OR of 4.97 (95% CI: 3.48\u20137.09) and an AOR of 4.44 (95% CI: 3.07 \u20136.42) after adjusting for covariates. The association between urate and gout was also significantly mediated by systolic BP (\u03b2 = 0.05; 95% CI Bias Corrected [0.02\u20130.08], p &lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Urate was significantly associated with gout risk and was possibly mediated by increased systolic BP in Indonesians. Controlling systolic BP could be one of the strategies to decrease the risk of gout for individuals with hyperuricemia. Health education can be carried out by community health nurses to individuals on controlling their urate level and systolic BP to decrease the gout risk among Indonesian.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10998004211029044","type":"journal-article","created":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T05:00:56Z","timestamp":1627966856000},"page":"40-47","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Increased Systolic Blood Pressure Mediates the Relationship Between Urate and Gout Risk in Indonesia: A Novel Application of a Partial Least Squares-Structural Equation Model"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6460-838X","authenticated-orcid":false,"given":"Maria","family":"Dyah Kurniasari","sequence":"first","affiliation":[{"name":"School of Nursing, College of Nursing, Taipei Medical University, Republic of China"},{"name":"Faculty of Medicine and Health Sciences, Department of Nursing, Universitas Kristen Satya Wacana, Salatiga City, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0457-2845","authenticated-orcid":false,"given":"Ferry Fredy","family":"Karwur","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, Department of Nutrition, Universitas Kristen Satya Wacana, Salatiga City, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosiana Eva","family":"Rayanti","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, Department of Nursing, Universitas Kristen Satya Wacana, Salatiga City, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrian Dolfriandra","family":"Huruta","sequence":"additional","affiliation":[{"name":"Faculty of Economics and Business, Universitas Kristen Satya Wacana, Salatiga, Indonesia"},{"name":"PhD Program in Business, Chung Yuan Christian University, Zhongli District, Taoyuan, Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu Huei","family":"Lin","sequence":"additional","affiliation":[{"name":"Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuen Fu","family":"Weng","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Republic of China"},{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1137-9274","authenticated-orcid":false,"given":"Hsiu Ting","family":"Tsai","sequence":"additional","affiliation":[{"name":"School of Nursing, College of Nursing, Taipei Medical University, Republic of China"},{"name":"Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,8,3]]},"reference":[{"key":"bibr1-10998004211029044","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-017-0890-9"},{"key":"bibr2-10998004211029044","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2018.00160"},{"key":"bibr3-10998004211029044","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.88.3.588"},{"key":"bibr4-10998004211029044","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-019-1953-9"},{"key":"bibr5-10998004211029044","doi-asserted-by":"publisher","DOI":"10.1590\/1806-9282.63.07.600"},{"key":"bibr6-10998004211029044","doi-asserted-by":"publisher","DOI":"10.1038\/jhh.2013.4"},{"key":"bibr7-10998004211029044","volume-title":"Statistical power analysis for the behavioral sciences","author":"Cohen J.","year":"1988","edition":"2"},{"key":"bibr8-10998004211029044","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-017-3548-2"},{"key":"bibr9-10998004211029044","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph120809672"},{"key":"bibr10-10998004211029044","first-page":"1595","volume":"19","author":"Darmawan J.","year":"1992","journal-title":"The Journal of Rheumatology"},{"key":"bibr11-10998004211029044","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-018-1585-0"},{"key":"bibr12-10998004211029044","doi-asserted-by":"publisher","DOI":"10.3758\/BRM.41.4.1149"},{"key":"bibr13-10998004211029044","volume-title":"StatPearls","author":"George C.","year":"2021"},{"key":"bibr14-10998004211029044","volume-title":"A primer on partial least squares structural equation modeling (PLS-SEM)","author":"Hair J. 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