{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T18:08:19Z","timestamp":1789063699181,"version":"build-2803163510"},"reference-count":15,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"2022 National Key Research and Development Program of China","award":["2022YFC3600903"],"award-info":[{"award-number":["2022YFC3600903"]}]}],"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>\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      (\n                      <jats:italic>H. pylori<\/jats:italic>\n                      ) infection has been linked to several extragastric metabolic disorders. However, its cross-sectional association with hyperuricemia remains uncertain, partly because previous studies have often been limited by small sample sizes and incomplete adjustment for metabolic and renal factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This large-scale cross-sectional study used data from a health examination database. The main regression analyses included 67,826 participants with valid\n                      <jats:italic>H. pylori<\/jats:italic>\n                      status, serum uric acid measurements, hyperuricemia classification, age, sex, and BMI. Modified Poisson regression with a log link and HC0 robust sandwich variance was used to estimate prevalence ratios for hyperuricemia, while linear regression with HC3 heteroscedasticity-robust standard errors was used for continuous serum uric acid. Sex-stratified and robustness analyses were also performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the unadjusted model,\n                      <jats:italic>H. pylori<\/jats:italic>\n                      infection was associated with higher prevalence of hyperuricemia (PR\u2009=\u20091.27, 95% CI: 1.22\u20131.32,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). This association was progressively attenuated after sequential adjustment and was small in the extended clinical model (PR\u2009=\u20091.02, 95% CI: 0.98\u20131.06,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.269). For continuous serum uric acid,\n                      <jats:italic>H. pylori<\/jats:italic>\n                      positivity remained associated with a small increase after full adjustment (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20092.14 \u03bcmol\/L, 95% CI: 0.80\u20133.49,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). Functional-form sensitivity analyses yielded similarly small effect estimates for hyperuricemia, although statistical significance varied across model specifications. Sex-stratified and robustness analyses were generally consistent with these findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      In this large health examination population, any remaining association between H. pylori positivity and hyperuricemia after comprehensive adjustment was small and sensitive to model specification.\n                      <jats:italic>H. pylori<\/jats:italic>\n                      positivity was also associated with a statistically detectable but clinically modest difference in continuous serum uric acid levels. Given the cross-sectional design, these findings should not be interpreted causally.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0358039","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T17:33:40Z","timestamp":1789061620000},"page":"e0358039","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Helicobacter pylori infection, hyperuricemia, and serum uric acid levels: The role of metabolic, renal, and inflammatory factors in a large health examination population"],"prefix":"10.1371","volume":"21","author":[{"given":"Zhiyue","family":"Xu","sequence":"first","affiliation":[{"name":"Shanghai Health and Medical Center","place":["Wuxi, Jiangsu Province, China"],"department":["Department of 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Laboratory"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6115-0630","authenticated-orcid":true,"given":"Yong","family":"Fang","sequence":"additional","affiliation":[{"name":"Shanghai Health and Medical Center","place":["Wuxi, Jiangsu Province, China"],"department":["Department of Clinical Laboratory"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"issue":"1","key":"pone.0358039.ref001","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1038\/s41572-023-00431-8","article-title":"Helicobacter pylori infection","volume":"9","author":"P Malfertheiner","year":"2023","journal-title":"Nat Rev Dis Primers"},{"issue":"30","key":"pone.0358039.ref002","doi-asserted-by":"crossref","first-page":"2968","DOI":"10.4254\/wjh.v7.i30.2968","article-title":"Extragastric manifestations of Helicobacter pylori infection: Possible role of bacterium in liver and 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