{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T18:05:26Z","timestamp":1791223526930,"version":"4.1.0"},"reference-count":22,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hyperuricemia is a metabolic disorder linked to gout, kidney disease, and cardiovascular complications. Understanding its prevalence and risk factors across demographic groups is crucial for effective prevention and management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the prevalence of hyperuricemia among U.S. adults by sex, age, and racial\/ethnic groups, and identify common and sex-specific risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from 34,144 U.S. adults aged \u226520 years, obtained from the National Health and Nutrition Examination Survey (NHANES) 2007\u20132018, were analyzed. Hyperuricemia was defined as serum uric acid levels &gt;7.0 mg\/dL in males and &gt;6.0 mg\/dL in females. Prevalence estimates were calculated, and multivariate logistic regression models identified risk factors, adjusting for confounders such as body mass index (BMI), alcohol consumption, hypertension, renal function, and other variables. A sensitivity analysis excluding participants with a history of gout was conducted to evaluate the robustness of identified associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall prevalence of hyperuricemia was significantly higher in males (21.1%) compared to females (17.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). Females surpassed males in both prevalence and absolute numbers after age 50\u201359; by age\u2009\u2265\u200980, the number of female cases was more than twice that of males. Non-Hispanic Black adults had the highest prevalence (23.9% in males, 23.4% in females). Key risk factors for both sexes included obesity (OR = 3.91 in males; OR = 4.76 in females), hypertension (OR = 1.65 in males; OR = 2.09 in females), and impaired renal function (eGFR\u2009&lt;\u200930 mL\/min\/1.73 m\u00b2: OR = 3.72 in males; OR = 15.37 in females). Alcohol consumption was positively associated with hyperuricemia in males (OR = 1.25), but not significantly so in females. Diabetes showed opposite associations: protective in males (OR = 0.72) but a risk factor in females (OR = 1.22). Medication use exhibited expected directional effects: diuretic use was associated with significantly increased risk of hyperuricemia (OR = 2.67 in males; OR = 2.55 in females), while urate-lowering therapy was associated with reduced risk (OR = 0.57 in males; OR = 0.55 in females).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Hyperuricemia remains highly prevalent in the U.S., with notable disparities by sex, age, and race\/ethnicity. Older women bear a particularly high burden, partly due to obesity, renal dysfunction, and diuretic use. Incorporating medication use into analyses strengthens the evidence for sex-specific risk profiles. These findings highlight the importance of considering targeted screening and prevention strategies in specific high-risk groups, such as older women and patients receiving diuretics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0337714","type":"journal-article","created":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T18:22:27Z","timestamp":1772043747000},"page":"e0337714","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":9,"title":["Sex, age, and racial\/ethnic disparities in hyperuricemia prevalence and risk factors among U.S. adults: An analysis of NHANES 2007\u20132018 data"],"prefix":"10.1371","volume":"21","author":[{"given":"Yadan","family":"Zou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruohan","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanfeng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongxing","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8047-9984","authenticated-orcid":true,"given":"Sheng-Guang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"issue":"11","key":"pone.0337714.ref001","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.3390\/healthcare12111072","article-title":"Knowledge, Attitudes, and Practices about Hyperuricemia and Gout in Community Health Workers and Patients with Diabetes","volume":"12","author":"S Sun","year":"2024","journal-title":"Healthcare (Basel)"},{"issue":"5","key":"pone.0337714.ref002","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1016\/j.numecd.2023.11.019","article-title":"Tophi and carotid atherosclerosis in gout patients: Role of insulin resistance","volume":"34","author":"K Si","year":"2024","journal-title":"Nutr Metab Cardiovasc Dis"},{"issue":"1","key":"pone.0337714.ref003","article-title":"Diagnosis and management of gout: are the British Society for Rheumatology and National Institute for Health and Care Excellence guidelines both needed?","volume":"8","author":"E Roddy","year":"2024","journal-title":"Rheumatol Adv Pract"},{"issue":"5","key":"pone.0337714.ref004","first-page":"120","article-title":"Comorbidity in gout and hyperuricemia: prevalence, causes, prospects of urate lowering therapy","volume":"91","author":"MS Eliseev","year":"2019","journal-title":"Ter Arkh"},{"issue":"6","key":"pone.0337714.ref005","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1002\/art.40807","article-title":"Contemporary Prevalence of Gout and Hyperuricemia in the United States and Decadal Trends: The National Health and Nutrition Examination Survey, 2007-2016","volume":"71","author":"M Chen-Xu","year":"2019","journal-title":"Arthritis Rheumatol"},{"issue":"2","key":"pone.0337714.ref006","first-page":"301","article-title":"Trends in hyperuricemia and gout prevalence: Nutrition and Health Survey in Taiwan from 1993-1996 to 2005-2008","volume":"20","author":"S-Y Chuang","year":"2011","journal-title":"Asia Pac J Clin Nutr"},{"key":"pone.0337714.ref007","unstructured":"Miao Z, Li C, Chen Y, Zhao S, Wang Y, Wang Z, et al. 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