{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T10:34:36Z","timestamp":1786444476493,"version":"build-2736575974"},"reference-count":42,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Special Fund from Medicinal Basic Research Innovation Center of Chronic Kidney Disease","award":["CKD\/SXMU-2024-01"],"award-info":[{"award-number":["CKD\/SXMU-2024-01"]}]},{"name":"Shanxi Province Higher Education \u201cBillion Project\u201d Science and Technology Guidance Project","award":["BYJL024"],"award-info":[{"award-number":["BYJL024"]}]},{"name":"The funding of Shanxi Key Laboratory of Metabolic-Immune Homeostasis and Drug Innovation","award":["202504010931023"],"award-info":[{"award-number":["202504010931023"]}]},{"name":"Shanxi Provincial Health Commission 2026 Strengthening Basic Disciplines Plan for Science and Technology Advancing Medical Innovation Program","award":["2026QJGC010"],"award-info":[{"award-number":["2026QJGC010"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Endocrinology"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      High body mass index (BMI \u2a7e25\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) is a critical driver of the global gout epidemic. We aimed to characterize the evolving burden of gout attributable to high BMI and establish the potential causal links between varying obesity grades and gout risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We aimed to characterize the evolving burden of gout attributable to high BMI and establish the potential causal links between varying obesity grades and gout risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>An observational global epidemiological analysis and a bidirectional two-sample Mendelian randomization (MR) study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Utilizing Global Burden of Disease (GBD) 2021 data, we analyzed disability-adjusted life years (DALYs) and age-standardized DALY rates across 204 countries. Trends were assessed via Joinpoint regression, decomposition, and inequality analyses. Future trajectories were projected using Bayesian age-period-cohort models. Bidirectional MR evaluated the causal impact of Class 1\u20133 obesity on gout, adjusting for multiple comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>From 1990 to 2021, global DALYs for high BMI-related gout increased 2.26-fold, with a 56.9% rise in age-standardized DALY rates. While High-socio-demographic index (SDI) regions face the highest absolute burden, the fastest growth occurred in low-middle SDI regions, indicating a geographic shift. A significant \u201cage-shift\u201d was observed, with the burden increasingly affecting younger males. Epidemiological changes were the primary drivers. MR analysis provided evidence supporting a potential causal relationship between Class 1 and 3 obesity and gout (all odds ratios\u2009&gt;\u20091), with no evidence of reverse causality. Projections suggest that the global age-standardized DALY rates will reach 7.1 per 100,000 by 2040.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The global burden of high BMI-related gout is escalating, driven by epidemiological transitions and rising risks in younger men. Genetic evidence supports weight management as a fundamental preventive pillar. Targeted interventions, particularly in rapidly urbanizing regions, are urgently needed to curb this health threat.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration:<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20420188261465525","type":"journal-article","created":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T05:27:01Z","timestamp":1784784421000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Global burden of gout attributable to high BMI (1990\u20132021) and causal link with obesity: a GBD and Mendelian randomization study"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6171-271X","authenticated-orcid":false,"given":"Baofeng","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Endocrinology, First Hospital of Shanxi Medical University, Taiyuan, China"},{"name":"First Clinical Medical College, Shanxi Medical University, Taiyuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Shanxi Medical University, Taiyuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zekai","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Shanxi Medical University, Taiyuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunhuan","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, First Hospital of Shanxi Medical University, Taiyuan, China"},{"name":"First Clinical Medical College, Shanxi Medical University, Taiyuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Shanxi Medical University, Taiyuan 030001, China"},{"name":"Shanxi Key Laboratory of Metabolic-Immune Homeostasis and Drug Innovation, Shanxi Medical University, Taiyuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2826-5804","authenticated-orcid":false,"given":"Yunfeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, First Hospital of Shanxi Medical University, Taiyuan 030001, China"},{"name":"First Clinical Medical College, Shanxi Medical University, Taiyuan, China"},{"name":"Shanxi Key Laboratory of Metabolic-Immune Homeostasis and Drug Innovation, Shanxi Medical University, Taiyuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/obr.70093"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)02750-2"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01446-6"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/nature21363"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2025.103711"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.7326\/ANNALS-24-03951"},{"key":"e_1_3_4_8_2","article-title":"Global, regional, and national burden of gout, 1990\u20132020, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021","volume":"6","author":"GBD 2021 Gout Collaborators","year":"2024","unstructured":"GBD 2021 Gout Collaborators. 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