{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T05:19:00Z","timestamp":1788153540519,"version":"build-2803163510"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Whether urate-lowering therapy (ULT) affects cardiometabolic outcomes in individuals without established metabolic disease remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This retrospective cohort study used TriNetX data (2015\u20132023) to include adults with newly diagnosed hyperuricemia (UA &amp;gt;7 mg\/dL) and no baseline diabetes, cardiovascular disease, or metabolic disorders. Patients initiating ULT were propensity score-matched (1:1) to untreated controls (2,906 pairs). The primary outcome was a composite cardiometabolic endpoint.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a median follow-up of 3.03 years, ULT initiation was associated with increased risk of the composite cardiometabolic outcome (HR 1.18, 95% CI 1.07\u20131.30) and of all-cause mortality (HR 1.52, 95% CI 1.27\u20131.82). The increased risk was evident among men, individuals without prior gout, users of xanthine oxidase inhibitors, and those who achieved target serum urate (&amp;lt;5 mg\/dL) within 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In individuals without major cardiometabolic disease, initiating ULT was associated with increased cardiometabolic risk. Serum urate may have context-dependent physiological roles in early metabolic states, warranting further research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1934688","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:29:45Z","timestamp":1788150585000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early urate-lowering therapy and cardiometabolic risk in adults without documented major cardiometabolic disease: a real-world cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"An-Ping","family":"Huo","sequence":"first","affiliation":[{"name":"Institute of Medicine, Chung Shan Medical University","place":["Taichung, Taiwan"]},{"name":"School of Medicine, Chung Shan Medical University","place":["Taichung, Taiwan"]},{"name":"Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Chung Shan Medical University Hospital","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiow-Ing","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Chung Shan Medical University","place":["Taichung, Taiwan"]},{"name":"Center for Health Data Science, Department of Medical Research, Chung Shan Medical University Hospital","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pui-Ying","family":"Leong","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Chung Shan Medical University","place":["Taichung, Taiwan"]},{"name":"School of Medicine, Chung Shan Medical University","place":["Taichung, Taiwan"]},{"name":"Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Chung Shan Medical University Hospital","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Cheng-Chung","family":"Wei","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Chung Shan Medical University","place":["Taichung, Taiwan"]},{"name":"School of Medicine, Chung Shan Medical University","place":["Taichung, Taiwan"]},{"name":"Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Chung Shan Medical University Hospital","place":["Taichung, Taiwan"]},{"name":"Department of Nursing, Chung Shan Medical University","place":["Taichung, Taiwan"]},{"name":"Graduate Institute of Integrated Medicine, China Medical University","place":["Taichung, Taiwan"]},{"name":"Office of Research and Development, Asia University","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsai-Ching","family":"Hsu","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Chung Shan Medical University","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.ejim.2020.07.006","article-title":"Hyperuricaemia and gout in cardiovascular, metabolic and kidney disease","volume":"80","author":"Borghi","year":"2020","journal-title":"Eur J Intern Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.2337\/db10-0916","article-title":"Hyperuricemia as a mediator of the proinflammatory endocrine imbalance in the adipose tissue in a murine model of the metabolic syndrome","volume":"60","author":"Baldwin","year":"2011","journal-title":"Diabetes"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21124479","article-title":"Fructose and uric acid: Major mediators of cardiovascular disease risk starting at pediatric age","volume":"21","author":"Russo","year":"2020","journal-title":"Int J Mol Sci"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/hjh.0000000000003807","article-title":"Asymptomatic hyperuricemia: to treat or not a threat? 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