{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:03:09Z","timestamp":1790100189874,"version":"4.0.1"},"reference-count":55,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Zhejiang Provincial Medical and Health Science and Technology Project","award":["2023KY777"],"award-info":[{"award-number":["2023KY777"]}]}],"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>Driven by rapid lifestyle transitions, hyperuricemia (HUA) has evolved into a formidable public health challenge. While insulin resistance (IR) and visceral adiposity are core pathophysiological factors associated with HUA, their relative dominance under discordant metabolic phenotypes remains unclear. We aimed to evaluate the joint and discordant associations of the triglyceride-glucose (TyG) index (surrogate for IR) and lipid accumulation product (LAP) (surrogate for visceral adiposity) with HUA risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 60,516 participants (35,593 males, 24,923 females) from a large medical checkup cohort (January to December 2025). Participants were cross-classified into four metabolic phenotypes based on TyG and LAP medians: Double-low (N\u2009=\u200926,023), Double-high (N\u2009=\u200925,998), Isolated High LAP (N\u2009=\u20094,236), and Isolated High TyG (N\u2009=\u20094,259). Multivariable logistic regression and restricted cubic splines were utilized to assess risk stratifications and non-linear dose-response relationships. Additionally, additive interactions and subgroup analyses were conducted to evaluate synergistic effects and population heterogeneity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>LAP and TyG exhibited independent and additive associations with HUA, exhibiting no significant multiplicative interaction (P for interaction\u2009=\u20090.965) but a significant synergistic effect on the additive scale (Attributable Proportion: 15.1%). Among discordant phenotypes, Isolated High LAP demonstrated a striking dominance over Isolated High TyG in its association with HUA risk. Spline curves revealed that without concurrent high LAP, extreme TyG elevations failed to sustain a high HUA risk, exhibiting a paradoxical decline. Subgroup analysis unmasked crucial demographic heterogeneities: this TyG attenuation was particularly pronounced in males and individuals with a BMI\u2009\u2265\u200924 kg\/m\u00b2. Conversely, the high LAP phenotype conferred the most pronounced relative risk in females (OR: 2.45), effectively abrogating their inherent estrogenic urate-excretory protection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Visceral adiposity, represented by LAP, emerges as the principal metabolic correlate of HUA. Without the concurrent structural and metabolic burden of visceral fat, IR alone is insufficient to maintain extreme serum uric acid elevations. These findings suggest the clinical importance of prioritizing visceral fat reduction and agents with dual metabolic-uricosuric benefits over isolated glycemic control in HUA management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0357105","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T17:22:41Z","timestamp":1790097761000},"page":"e0357105","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Independent and joint associations of visceral adiposity and insulin resistance with hyperuricemia: A large-scale cross-sectional study"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1805-503X","authenticated-orcid":true,"given":"Lusha","family":"Li","sequence":"first","affiliation":[{"name":"Zhejiang University","place":["Hangzhou, Zhejiang, China"],"department":["Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingkai","family":"Yan","sequence":"additional","affiliation":[{"name":"Zhejiang University","place":["Hangzhou, Zhejiang, China"],"department":["Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xixuan","family":"Cai","sequence":"additional","affiliation":[{"name":"Zhejiang University","place":["Hangzhou, Zhejiang, China"],"department":["Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianjiang","family":"Pan","sequence":"additional","affiliation":[{"name":"Zhejiang University","place":["Hangzhou, Zhejiang, China"],"department":["Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8895-3775","authenticated-orcid":true,"given":"Liying","family":"Chen","sequence":"additional","affiliation":[{"name":"Zhejiang University","place":["Hangzhou, Zhejiang, China"],"department":["Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"issue":"10","key":"pone.0357105.ref001","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.5551\/jat.63907","article-title":"Risk factors for hyperuricemia or gout in men and women: the circulatory risk in communities study (CIRCS)","volume":"30","author":"S Teramura","year":"2023","journal-title":"J Atheroscler Thromb"},{"issue":"1","key":"pone.0357105.ref002","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1186\/s12902-022-01118-z","article-title":"Changes in the prevalence of hyperuricemia in clients of health examination in Eastern China, 2009 to 2019","volume":"22","author":"D She","year":"2022","journal-title":"BMC Endocr Disord"},{"issue":"1","key":"pone.0357105.ref003","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1038\/s41392-024-01916-y","article-title":"Hyperuricemia and its related diseases: mechanisms and advances in therapy","volume":"9","author":"L Du","year":"2024","journal-title":"Signal Transduct Target Ther"},{"issue":"22","key":"pone.0357105.ref004","doi-asserted-by":"crossref","first-page":"12394","DOI":"10.3390\/ijms222212394","article-title":"Uric acid in inflammation and the pathogenesis of atherosclerosis","volume":"22","author":"Y Kimura","year":"2021","journal-title":"Int J Mol Sci"},{"issue":"183","key":"pone.0357105.ref005","first-page":"749","article-title":"Cardiovascular- kidney-metabolic syndrome - an integrative review","volume":"36","author":"KS Kittelson","year":"2024","journal-title":"Discov Med"},{"issue":"17","key":"pone.0357105.ref006","doi-asserted-by":"crossref","first-page":"9221","DOI":"10.3390\/ijms22179221","article-title":"Molecular biological and clinical understanding of the pathophysiology and treatments of hyperuricemia and its association with metabolic syndrome, cardiovascular diseases and chronic kidney disease","volume":"22","author":"H Yanai","year":"2021","journal-title":"Int J Mol Sci"},{"key":"pone.0357105.ref007","doi-asserted-by":"crossref","first-page":"1597112","DOI":"10.3389\/fcvm.2025.1597112","article-title":"Research status of triglyceride glucose-body mass index (TyG-BMI index)","volume":"12","author":"K Song","year":"2025","journal-title":"Front Cardiovasc Med"},{"issue":"1","key":"pone.0357105.ref008","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1186\/s12967-019-2074-1","article-title":"Visceral adipose accumulation increased the risk of hyperuricemia among middle-aged and elderly adults: a population-based study","volume":"17","author":"X Huang","year":"2019","journal-title":"J Transl Med"},{"key":"pone.0357105.ref009","doi-asserted-by":"crossref","first-page":"102843","DOI":"10.1016\/j.pmedr.2024.102843","article-title":"The association between visceral adipose accumulation and hyperuricemia risk among Chinese elder individuals: a nationwide prospective cohort study","volume":"45","author":"Y Han","year":"2024","journal-title":"Prev Med Rep"},{"issue":"10","key":"pone.0357105.ref010","doi-asserted-by":"crossref","first-page":"2348","DOI":"10.1016\/j.numecd.2022.06.022","article-title":"Cross-sectional and longitudinal associations between lipid accumulation product and hyperuricemia","volume":"32","author":"W Zhou","year":"2022","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"pone.0357105.ref011","doi-asserted-by":"crossref","first-page":"1553957","DOI":"10.3389\/fcvm.2025.1553957","article-title":"Nonlinear association between triglyceride-glucose index and risk of hyperuricemia in early-stage cardiovascular-kidney-metabolic syndrome: a cross-sectional study of United States population","volume":"12","author":"X Chen","year":"2025","journal-title":"Front Cardiovasc Med"},{"issue":"3","key":"pone.0357105.ref012","doi-asserted-by":"crossref","DOI":"10.1152\/ajprenal.00012.2017","article-title":"Insulin stimulates uric acid reabsorption via regulating urate transporter 1 and ATP-binding cassette subfamily G member 2","volume":"313","author":"D Toyoki","year":"2017","journal-title":"Am J Physiol Renal Physiol"},{"issue":"12","key":"pone.0357105.ref013","first-page":"752352","article-title":"Genetic and Physiological Effects of Insulin on Human Urate Homeostasis","author":"AK Mandal","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"1","key":"pone.0357105.ref014","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1186\/s12944-024-02412-6","article-title":"The role of the triglyceride-glucose index as a biomarker of cardio-metabolic syndromes","volume":"23","author":"V Gounden","year":"2024","journal-title":"Lipids Health Dis"},{"key":"pone.0357105.ref015","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1186\/s13098-018-0376-8","article-title":"Metabolic clustering of risk factors: evaluation of Triglyceride-glucose index (TyG index) for evaluation of insulin resistance","volume":"10","author":"SH Khan","year":"2018","journal-title":"Diabetol Metab Syndr"},{"issue":"1","key":"pone.0357105.ref016","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s12937-023-00904-2","article-title":"The association between hyperuricemia and insulin resistance surrogates, dietary- and lifestyle insulin resistance indices in an Iranian population: MASHAD cohort study","volume":"23","author":"N Seifi","year":"2024","journal-title":"Nutr J"},{"key":"pone.0357105.ref017","doi-asserted-by":"crossref","first-page":"861760","DOI":"10.3389\/fendo.2022.861760","article-title":"Triglyceride glucose index is more closely related to hyperuricemia than obesity indices in the medical checkup population in Xinjiang, China","volume":"13","author":"M Kahaer","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"pone.0357105.ref018","doi-asserted-by":"crossref","first-page":"3751","DOI":"10.2147\/DMSO.S430235","article-title":"Correlation between abdominal fat distribution and serum uric acid in patients recently diagnosed with type 2 diabetes","volume":"16","author":"H-P Wang","year":"2023","journal-title":"Diabetes Metab Syndr Obes"},{"key":"pone.0357105.ref019","doi-asserted-by":"crossref","first-page":"835154","DOI":"10.3389\/fendo.2022.835154","article-title":"Adipose tissue insulin resistance is positively associated with serum uric acid levels and hyperuricemia in Northern Chinese adults","volume":"13","author":"H Sun","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"key":"pone.0357105.ref020","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/1471-2261-5-26","article-title":"The \u201clipid accumulation product\u201d performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison","volume":"5","author":"HS Kahn","year":"2005","journal-title":"BMC Cardiovasc Disord"},{"issue":"5","key":"pone.0357105.ref021","doi-asserted-by":"crossref","DOI":"10.1161\/HYP.0000000000000087","article-title":"Measurement of blood pressure in humans: a scientific statement from the American Heart Association","volume":"73","author":"P Muntner","year":"2019","journal-title":"Hypertension"},{"key":"pone.0357105.ref022","article-title":"Obesity: preventing and managing the global epidemic. Report of a WHO consultation","volume":"894","year":"2000","journal-title":"World Health Organ Tech Rep Ser"},{"key":"pone.0357105.ref023","doi-asserted-by":"crossref","first-page":"3783","DOI":"10.2147\/DMSO.S481233","article-title":"Association of serum uric acid with indices of insulin resistance: proposal of a new model with reference to gender differences","volume":"17","author":"R Liu","year":"2024","journal-title":"Diabetes Metab Syndr Obes"},{"issue":"48","key":"pone.0357105.ref024","doi-asserted-by":"crossref","first-page":"112972","DOI":"10.3748\/wjg.v31.i48.112972","article-title":"Serum uric acid-to-high-density lipoprotein cholesterol ratio and cardiovascular risk in Asian patients with metabolic dysfunction-associated steatotic liver disease","volume":"31","author":"Y Wang","year":"2025","journal-title":"World J Gastroenterol"},{"issue":"22","key":"pone.0357105.ref025","doi-asserted-by":"crossref","first-page":"4798","DOI":"10.3390\/nu15224798","article-title":"Association between asymptomatic hyperuricemia with adiposity indices: a cross-sectional study in a Spanish population","volume":"15","author":"C S\u00e1nchez-Bacaicoa","year":"2023","journal-title":"Nutrients"},{"issue":"18","key":"pone.0357105.ref026","doi-asserted-by":"crossref","first-page":"2404","DOI":"10.1001\/jama.283.18.2404","article-title":"Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971-1992. National Health and Nutrition Examination Survey","volume":"283","author":"J Fang","year":"2000","journal-title":"JAMA"},{"issue":"1","key":"pone.0357105.ref027","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1186\/s12944-021-01561-2","article-title":"The usefulness of obesity and lipid-related indices to predict the presence of Non-alcoholic fatty liver disease","volume":"20","author":"G Sheng","year":"2021","journal-title":"Lipids Health Dis"},{"issue":"7","key":"pone.0357105.ref028","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1515\/jpem-2019-0579","article-title":"The correct formula to calculate triglyceride-glucose index (TyG)","volume":"33","author":"J Alizargar","year":"2020","journal-title":"J Pediatr Endocrinol Metab"},{"issue":"1","key":"pone.0357105.ref029","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s12944-023-01802-6","article-title":"Lipid accumulation product (LAP) index for the diagnosis of nonalcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis","volume":"22","author":"M Ebrahimi","year":"2023","journal-title":"Lipids Health Dis"},{"issue":"4","key":"pone.0357105.ref030","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1089\/met.2008.0034","article-title":"The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects","volume":"6","author":"LE Simental-Mend\u00eda","year":"2008","journal-title":"Metab Syndr Relat Disord"},{"issue":"6","key":"pone.0357105.ref031","doi-asserted-by":"crossref","first-page":"558","DOI":"10.4097\/kja.19087","article-title":"Multicollinearity and misleading statistical results","volume":"72","author":"JH Kim","year":"2019","journal-title":"Korean J Anesthesiol"},{"issue":"7","key":"pone.0357105.ref032","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1002\/oby.23779","article-title":"Age- and sex-specific changes in visceral fat mass throughout the life-span","volume":"31","author":"RB Baarts","year":"2023","journal-title":"Obesity (Silver Spring)"},{"issue":"1","key":"pone.0357105.ref033","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s12986-021-00583-y","article-title":"Estradiol regulates intestinal ABCG2 to promote urate excretion via the PI3K\/Akt pathway","volume":"18","author":"L Liu","year":"2021","journal-title":"Nutr Metab (Lond)"},{"issue":"1","key":"pone.0357105.ref034","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1038\/s41598-024-84617-4","article-title":"The effects and predictive values of novel anthropometric parameters on uric acid levels and hyperuricemia in adults","volume":"15","author":"L Hongwei","year":"2025","journal-title":"Sci Rep"},{"issue":"3","key":"pone.0357105.ref035","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1007\/s10067-024-06884-w","article-title":"Association between anthropometric indices and hyperuricemia: a nationwide study in China","volume":"43","author":"D Chen","year":"2024","journal-title":"Clin Rheumatol"},{"issue":"9","key":"pone.0357105.ref036","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/S2213-8587(19)30084-1","article-title":"Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement","volume":"7","author":"IJ Neeland","year":"2019","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"8","key":"pone.0357105.ref037","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1007\/s00592-025-02447-w","article-title":"Age-specific and sex-specific associations of visceral adipose tissue with metabolic health status and cardiovascular disease risk","volume":"62","author":"W Zhang","year":"2025","journal-title":"Acta Diabetol"},{"issue":"1","key":"pone.0357105.ref038","doi-asserted-by":"crossref","DOI":"10.1210\/clinem\/dgaf282","article-title":"Relationship between insulin sensitivity and hyperinsulinemia in early insulin resistance is sex-dependent","volume":"111","author":"SJ Blackwood","year":"2025","journal-title":"J Clin Endocrinol Metab"},{"issue":"10","key":"pone.0357105.ref039","doi-asserted-by":"crossref","DOI":"10.1172\/JCI186633","article-title":"Gene-environment interaction modifies the association between hyperinsulinemia and serum urate levels through SLC22A12","volume":"135","author":"W Fujii","year":"2025","journal-title":"J Clin Invest"},{"issue":"5","key":"pone.0357105.ref040","doi-asserted-by":"crossref","DOI":"10.1093\/lifemeta\/loae018","article-title":"Fatty acid oxidation-induced HIF-1\u03b1 activation facilitates hepatic urate synthesis through upregulating NT5C2 and XDH","volume":"3","author":"N Liang","year":"2024","journal-title":"Life Metab"},{"key":"pone.0357105.ref041","doi-asserted-by":"crossref","first-page":"749328","DOI":"10.3389\/fnut.2021.749328","article-title":"Fructose induces visceral adipose tissue inflammation and insulin resistance even without development of obesity in adult female but not in male rats","volume":"8","author":"S Kova\u010devi\u0107","year":"2021","journal-title":"Front Nutr"},{"issue":"7","key":"pone.0357105.ref042","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1507\/endocrj.EJ23-0160","article-title":"Cardiovascular significance of adipose-derived adiponectin and liver-derived xanthine oxidoreductase in metabolic syndrome","volume":"70","author":"Y Fujishima","year":"2023","journal-title":"Endocr J"},{"key":"pone.0357105.ref043","doi-asserted-by":"crossref","first-page":"4553","DOI":"10.2147\/DMSO.S472686","article-title":"Elevated blood glucose can promote uric acid excretion: a cross-sectional study involving urinary glucose and urinary uric acid in China","volume":"17","author":"Y Zhou","year":"2024","journal-title":"Diabetes Metab Syndr Obes"},{"issue":"3","key":"pone.0357105.ref044","doi-asserted-by":"crossref","first-page":"296","DOI":"10.23876\/j.krcp.24.321","article-title":"Role of urate transporters in the kidneys and intestine in uric acid homeostasis","volume":"45","author":"SH Kim","year":"2026","journal-title":"Kidney Res Clin Pract"},{"issue":"1","key":"pone.0357105.ref045","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5049\/EBP.2021.19.1.1","article-title":"Urate transporters in the kidney: what clinicians need to know","volume":"19","author":"S Chung","year":"2021","journal-title":"Electrolyte Blood Press"},{"issue":"9","key":"pone.0357105.ref046","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1007\/s40618-021-01513-8","article-title":"High urinary excretion rate of glucose attenuates serum uric acid level in type 2 diabetes with normal renal function","volume":"44","author":"Y Qin","year":"2021","journal-title":"J Endocrinol Invest"},{"issue":"5","key":"pone.0357105.ref047","doi-asserted-by":"crossref","first-page":"450","DOI":"10.3390\/cells13050450","article-title":"A possible therapeutic application of the selective inhibitor of urate transporter 1, dotinurad, for metabolic syndrome, chronic kidney disease, and cardiovascular disease","volume":"13","author":"H Yanai","year":"2024","journal-title":"Cells"},{"issue":"4","key":"pone.0357105.ref048","doi-asserted-by":"crossref","DOI":"10.1111\/cob.12523","article-title":"Cardiometabolic risk factors in adults with normal weight obesity: a systematic review and meta-analysis","volume":"12","author":"II Rakhmat","year":"2022","journal-title":"Clin Obes"},{"issue":"19","key":"pone.0357105.ref049","doi-asserted-by":"crossref","first-page":"3992","DOI":"10.3390\/nu14193992","article-title":"Association of visceral fat area and hyperuricemia in non-obese US adults: a cross-sectional study","volume":"14","author":"Z Li","year":"2022","journal-title":"Nutrients"},{"issue":"3","key":"pone.0357105.ref050","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1089\/met.2024.0198","article-title":"Lipid accumulation product outperforms BMI and waist circumference in metabolic disorders","volume":"23","author":"D Elsayed","year":"2025","journal-title":"Metab Syndr Relat Disord"},{"key":"pone.0357105.ref051","doi-asserted-by":"crossref","first-page":"1565997","DOI":"10.3389\/fmed.2025.1565997","article-title":"Association between lipid accumulation product and non-alcoholic fatty liver disease with normal weight: a population-based study","volume":"12","author":"L Shen","year":"2025","journal-title":"Front Med (Lausanne)"},{"issue":"5","key":"pone.0357105.ref052","doi-asserted-by":"crossref","first-page":"663","DOI":"10.2215\/CJN.11480821","article-title":"SGLT2 inhibition and uric acid excretion in patients with type 2 diabetes and normal kidney function","volume":"17","author":"DLS Suijk","year":"2022","journal-title":"Clin J Am Soc Nephrol"},{"issue":"3","key":"pone.0357105.ref053","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1002\/cpt.2651","article-title":"Protecting the kidney: the unexpected logic of inhibiting a glucose transporter","volume":"112","author":"V Vallon","year":"2022","journal-title":"Clin Pharmacol Ther"},{"issue":"11","key":"pone.0357105.ref054","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1161\/CIRCULATIONAHA.123.065517","article-title":"Metabolic communication by SGLT2 inhibition","volume":"149","author":"AM Billing","year":"2024","journal-title":"Circulation"},{"issue":"5","key":"pone.0357105.ref055","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1007\/s11096-025-01950-y","article-title":"Effects of sodium-glucose cotransporter-2 inhibitors on serum urate levels and gout in patients with and without type 2 diabetes: a systematic review and network meta-analysis","volume":"47","author":"Q Hu","year":"2025","journal-title":"Int J Clin Pharm"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0357105","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T17:22:51Z","timestamp":1790097771000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0357105"}},"subtitle":[],"editor":[{"given":"Marwan Salih","family":"Al-Nimer","sequence":"first","affiliation":[{"name":"University of Diyala College of Medicine","place":["IRAQ"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":55,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,22]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0357105","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]}}}