JCR: Journal of Clinical Rheumatology最新文献

{"title":"Interpretable Machine Learning for Predicting Anterior Uveitis in Axial Spondyloarthritis.","authors":"Hui Li, Qin Guo, Tiantian Zhang, Shufen Zhou, Chengshan Guo","doi":"10.1097/RHU.0000000000002225","DOIUrl":"10.1097/RHU.0000000000002225","url":null,"abstract":"<p><strong>Background: </strong>Axial spondyloarthritis (axSpA) is a chronic inflammatory disease primarily affecting the spine and sacroiliac joints, with anterior uveitis (AU) as a common extra-articular manifestation. Predicting AU onset in axSpA patients is challenging, as traditional statistical methods often fail to capture the disease's complexity.</p><p><strong>Methods: </strong>This study aimed to develop an interpretable machine learning (ML) model to predict AU onset in axSpA patients through a historical cohort analysis of 1508 patients from a tertiary medical center. Clinical data involving 54 variables were preprocessed through imputation, factorization, oversampling, outlier capping, and standardization. Recursive feature elimination identified 12 key predictors. Subsequently, 10 ML algorithms were assessed using performance metrics and visualization techniques.</p><p><strong>Results: </strong>The gradient boosting machine model incorporating 12 key factors showed high accuracy in predicting AU risk. Shapley additive explanations analysis revealed that hip involvement, nonsteroidal anti-inflammatory drug use, and smoking were the most influential predictors. The model's interpretability provided clear insights into the contribution of each feature to AU risk, supporting early diagnosis and personalized treatment.</p><p><strong>Conclusion: </strong>The gradient boosting machine model predicts AU risk in axSpA patients, helping identify high-risk cases for early intervention and personalized treatment to prevent complications such as vision loss.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e42-e48"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy and Safety of Different Regimens of Current JAK Inhibitors in Psoriatic Arthritis: A Network Meta-analysis.","authors":"Huiying Wan, Xiyuan Zhou, Jia Su, Tian Xia, Dingding Zhang","doi":"10.1097/RHU.0000000000002232","DOIUrl":"10.1097/RHU.0000000000002232","url":null,"abstract":"<p><strong>Background: </strong>Janus kinase (JAK) inhibitors have been approved for treating psoriatic arthritis (PsA); however, the comparative efficacy of different JAK inhibitors remains unclear. This study aimed to investigate the comparative efficacy and safety of different JAK inhibitors in treating PsA.</p><p><strong>Methods: </strong>This network meta-analysis was conducted in strict accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Network Meta-Analyses and Cochrane methods.</p><p><strong>Results: </strong>Five studies involving 2757 patients were included. Pairwise meta-analysis revealed that JAK inhibitors significantly increased the American College of Rheumatology 20 score and Psoriasis Area and Severity Index 75 responses, which were confirmed by the network meta-analysis. The network meta-analysis further suggested that filgotinib 200 mg once daily (OD) (odds ratio [OR] = 3.17, 95% credible interval [CrI] = 1.07-9.88) and upadacitinib 30 mg OD (OR = 2.34, 95% CrI = 1.13-4.78) had higher American College of Rheumatology 20 score responses compared with tofacitinib 5 mg twice a day. However, upadacitinib 30 mg OD was associated with a higher risk of adverse events (placebo: OR = 1.80, 95% CrI = 1.14-2.87) and serious adverse events compared with filgotinib 200 mg OD (OR = 0.05, 95% CrI = 0.00-0.82). Upadacitinib 15 mg OD, the currently recommended therapy, is comparable in both efficacy and safety to other treatment regimens.</p><p><strong>Conclusions: </strong>Filgotinib 200 mg OD is the safest and most effective JAK inhibitor for PsA, followed by upadacitinib 30 mg OD. However, upadacitinib 30 mg OD carries the highest risk of adverse events. Upadacitinib 15 mg OD, the currently recommended therapy, is not superior in efficacy and safety compared with other treatment options. More high-quality studies are needed to confirm these findings due to the limited number of included studies.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"199-204"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Axial Spondyloarthritis Detection: Two-Year Follow-up of the Sp-EYE Study on Acute Anterior Uveitis and Chronic Back Pain Screening.","authors":"Pasoon Hellamand, Marleen G H van de Sande, Rianne E van Bentum, Frank D Verbraak, Jos W R Twisk, Irene van der Horst Bruinsma","doi":"10.1097/RHU.0000000000002202","DOIUrl":"10.1097/RHU.0000000000002202","url":null,"abstract":"<p><strong>Objective: </strong>In the previous Spondyloarthritis EYE study, we confirmed the potential of a screening strategy for early axial spondyloarthritis (axSpA) detection using acute anterior uveitis (AAU) and chronic back pain (CBP) as referral criteria. This follow-up study assessed changes in diagnostic categories (definite, suspected, and no axSpA) over 2 years and identified baseline factors predicting axSpA diagnosis at 24 months.</p><p><strong>Methods: </strong>Patients with AAU and CBP were categorized into 3 groups: definite axSpA, suspected of axSpA, and no axSpA, based on clinical and radiographic data within 6 months after baseline. Suspected cases were monitored for 24 months, with the possibility of reclassification. A competing risk analysis was used to estimate the probability of transitioning from \"suspected of axSpA\" to \"definite axSpA\" or \"no axSpA,\" and logistic regression analysis was employed to determine if baseline factors could predict definite axSpA at 24 months.</p><p><strong>Results: </strong>Among 81 patients, 26 were classified as no axSpA, 36 as suspected of axSpA, and 19 as definite axSpA. At 24 months, suspected patients had an 18% probability to transition to definite axSpA (4 cases) and a 60% to no axSpA (15 cases). Significant predictors of axSpA diagnosis included the following: HLA-B27 positivity, good response to nonsteroidal anti-inflammatory drugs, inflammatory back pain, increasing C-reactive protein levels, buttock pain, and higher Bath Ankylosing Spondylitis Metrology Index scores.</p><p><strong>Conclusions: </strong>Our screening strategy identified approximately one third of previously undiagnosed axSpA cases among patients with AAU and CBP, mostly at baseline, with few additional cases at follow-up. The predictors revealed in this study could aid physicians in estimating axSpA disease probability.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e49-e57"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving the ACR's Reproductive Health Guidelines Into Practice: A Quantitative and Qualitative Assessment of a Novel Reproductive Rheumatology ECHO.","authors":"Megan E B Clowse, Jerome J Federspiel, Sarahn Wheeler, Catherine A Sims, Teresa Swezey, Amy Corneli, Kevin McKenna, Meyra Çoban, Jamilah Taylor, Lisa Criscione-Schreiber, Amanda G Snyderman, JoAnn Zell","doi":"10.1097/RHU.0000000000002222","DOIUrl":"10.1097/RHU.0000000000002222","url":null,"abstract":"<p><strong>Background: </strong>Project ECHO (Extension for Community Healthcare Outcomes) links experts with community providers through video teleconferences that include both didactics and case discussions. We piloted the first ECHO with a specific focus on reproductive rheumatology intended to increase rheumatologists' knowledge and self-efficacy in providing reproductive health care.</p><p><strong>Methods: </strong>The Project ECHO guides informed ReproRheum ECHO curriculum development, provider recruitment, logistics, and assessment. Assessments included interviews and pre/post surveys to assess knowledge, self-efficacy, and identify program strengths and weaknesses.</p><p><strong>Results: </strong>Eight rheumatology providers (5 physicians, 2 nurse practitioners, 1 rheumatology fellow) and 4 experts (2 reproductive rheumatologists, 2 maternal-fetal medicine physicians) participated in six 1-hour ReproRheum ECHO sessions from January to March 2023. All but one provider attended all sessions, demonstrating feasibility. Knowledge of the rate of birth defects after exposure to both azathioprine and mycophenolate significantly increased in participating physicians. Provider self-efficacy also increased significantly (6.8 ± 1.2 pre-ECHO to 8.1 ± 0.5 post-ECHO, p = 0.03). All participants \"agreed\" or \"strongly agreed\" that they had increased confidence in their ability to answer colleagues' questions and guide patients' choices in contraception and medication in pregnancy. In interviews, providers reported satisfaction with and appreciation of both didactic and case discussions, the multidisciplinary approach, and connecting with other providers. They reported improved comfort and increased frequency of discussing reproductive health in practice.</p><p><strong>Conclusions: </strong>The pilot ReproRheum ECHO was feasible and improved knowledge and self-efficacy among rheumatologists in reproductive health. This model is a promising approach to improving reproductive health care for women with rheumatic disease.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e66-e72"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Experience with TNF Inhibition and Longitudinal Image Monitoring in Osseous Sarcoidosis.","authors":"Seth J VanDerVeer, Erica M Hill","doi":"10.1097/RHU.0000000000002190","DOIUrl":"10.1097/RHU.0000000000002190","url":null,"abstract":"<p><strong>Background: </strong>In this case series, we present longitudinal imaging surveillance of 6 cases of osseous sarcoidosis, each of which was effectively treated with tumor necrosis factor (TNF) inhibition.</p><p><strong>Methods: </strong>We identified 6 patients from Brooke Army Medical Center with osseous sarcoidosis, who were treated with TNF inhibition and followed with longitudinal imaging studies. Cases of osseous sarcoidosis were defined as having pathologic evidence of noncaseating granulomas on bone biopsy and evidence of osseous lesions on imaging attributable to sarcoidosis by the radiologist, treating clinician, and reviewer. Clinical data were obtained through review of the military electronic medical record.</p><p><strong>Results: </strong>Longitudinal imaging with positron emission tomography/computed tomography, magnetic resonance imaging, and bone scintigraphy assisted in the identification of active disease and clinical remission. Imaging progression of asymptomatic lesions was associated with the eventual development of bone pain 1 to 3 years later. Clinical remission was achieved in all six cases of osseous sarcoidosis and effective doses for TNF inhibition were adalimumab 40 mg subcutaneously every 1 to 2 weeks and infliximab 5 mg/kg every 6 to 8 weeks. Time to complete imaging response ranged from 3 to 8 months.</p><p><strong>Conclusions: </strong>Longitudinal imaging with bone scintigraphy, positron emission tomography/computed tomography, and magnetic resonance imaging demonstrated several benefits including evaluation for occult disease, surveillance of asymptomatic lesions, and evaluation of treatment response. TNF inhibition with adalimumab or infliximab was successful in all cases, and complete resolution of osseous lesions was demonstrated in 5 of 6 patients. Discontinuation of TNF inhibition led to disease recurrence in 2 cases, which prompted the use of long-term immunosuppressive therapy in all treated patients.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e73-e83"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Stiff Neck: Diffuse Syndesmophytes in Psoriatic Arthritis.","authors":"Loron Ashcroft, David DeMasters","doi":"10.1097/RHU.0000000000002229","DOIUrl":"10.1097/RHU.0000000000002229","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e94"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Snapshot of a Decade: Idiopathic Inflammatory Myopathies in Chile-A 10-Year Short Report.","authors":"Paulina Ramirez, Andres Giglio, Ignacio Dominguez, Fabiola Garrido, Francisco Gutierrez","doi":"10.1097/RHU.0000000000002230","DOIUrl":"10.1097/RHU.0000000000002230","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic inflammatory myopathies (IIMs) are rare autoimmune diseases with limited epidemiological data from Latin America.</p><p><strong>Objective: </strong>To characterize IIMs through incident rate patterns and clinical features in a major Chilean referral center over a 10-year period.</p><p><strong>Methods: </strong>Historical cohort study (2012-2021) reviewing clinical records from rheumatology outpatient clinic of patients with IIM diagnosis. Incident rates were calculated as IIM cases per specialty consultations. Clinical characteristics, antibody profiles, and treatment outcomes were analyzed. Both consultation-based and population-based estimates for incidence and prevalence were determined.</p><p><strong>Results: </strong>Among 3,594,047 specialty consultations, 100 IIM cases were identified (2.78 cases per 100,000 consultations; 95% confidence interval, 2.27-3.39). Mean annual incidence was 0.58 cases per 100,000 adults (95% confidence interval, 0.47-0.69), with 2021 prevalence ranging from 5.07 to 8.57 per 100,000 adults, depending on the denominator population. Dermatomyositis was the most frequent subtype (71%).</p><p><strong>Conclusions: </strong>This first consultation-based analysis of IIMs in Chile provides baseline data for health care resource utilization. The methodology offers a practical approach for rare disease epidemiology in similar health care settings, whereas the findings align with international reports.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"205-209"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Lupus Foundation of America Rapid Evaluation of Activity in Lupus Patient-Reported Outcome Predicts Health-Related Quality of Life, Fatigue, and Work Productivity Impairment: Data From the Almenara Lupus Cohort.","authors":"Manuel F Ugarte-Gil, Rocío V Gamboa-Cárdenas, Victor R Pimentel-Quiroz, Cristina Reátegui-Sokolova, Claudia Elera-Fitzcarrald, Samira García-Hirsh, César Pastor-Asurza, Zoila Rodriguez-Bellido, Risto Perich-Campos, Graciela S Alarcón","doi":"10.1097/RHU.0000000000002204","DOIUrl":"10.1097/RHU.0000000000002204","url":null,"abstract":"<p><strong>Objective: </strong>The study aims to evaluate the impact of patient-reported disease activity in other patient-reported outcomes (PROs) in systemic lupus erythematosus (SLE) patients.</p><p><strong>Methods: </strong>SLE patients from the Almenara Lupus Cohort were included, and visits were performed every 6 months. Disease activity was assessed with the Lupus Foundation of America Rapid Evaluation of Activity in Lupus (LFA-REAL) PRO, health-related quality of life (HRQoL) with the LupusQoL, fatigue with the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and work productivity impairment with the work productivity and activity impairment (WPAI). Generalized estimating equations were performed for each domain of the LupusQoL, the FACIT-F, and the WPAI. The LFA-REAL PRO measured at the previous visit; multivariable models were adjusted for possible confounders measured at the same visit as the LFA-REAL PRO. The Β (regression unstandardized coefficient) is reported per an increase of 10 units of the LFA-REAL PRO.</p><p><strong>Results: </strong>A total of 316 patients and 1116 visits were included. Mean (SD) LFA-REAL PRO at baseline was 240.9 (182.1). LFA-REAL PRO predicted a worse HRQoL in all domains of the LupusQoL, the WPAI, and the FACIT-F, even after adjustment for confounders.</p><p><strong>Conclusions: </strong>A higher patient-reported disease activity predicted a worse HRQoL and fatigue as well as a higher work productivity impairment in SLE patients. Patient-reported disease activity should be included in the evaluation of SLE patients on a regular basis as such provides the patients' own perception of their disease. This may have an impact on their adherence to treatment and may result in better outcomes.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"162-165"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher Rates of Depression in Polymyalgia Rheumatica Are Strongly Associated With Poor Physical Function.","authors":"Jessica L Leung, Natalie Deeble, Victor Yang, David F L Liew, Russell R C Buchanan, Claire E Owen","doi":"10.1097/RHU.0000000000002219","DOIUrl":"10.1097/RHU.0000000000002219","url":null,"abstract":"<p><strong>Objective: </strong>To assess the prevalence of and risk factors for depression in a cohort of patients with polymyalgia rheumatica (PMR) compared with a cohort of participants without PMR (control group).</p><p><strong>Methods: </strong>In a longitudinal cohort study, patients with recently diagnosed PMR (within 3 months of starting treatment) were recruited together with matched control subjects. Assessments were undertaken 3 and 21 months after initiation of steroid therapy. Mood was assessed using the Hospital Anxiety and Depression Scale (HADS) and the 36-item Short-Form Survey (SF-36) Mental Health (MH) scale, with scores ≥8 on the HADS and ≤56 on the SF-36 MH Scale indicating depression. Other data collected included current prednisolone dose, PMR-Activity Score, pain visual analog scale, SF-36, and Health Assessment Questionnaire Disability Index.</p><p><strong>Results: </strong>Thirty-six subjects with PMR and 32 control subjects were recruited. At baseline, depression rates were significantly higher in PMR cases than in control subjects (22.2% vs. 3.1% and 25.0% vs. 0.0% as determined by HADS and SF-36 MH Scale, respectively). After adjusting for a previous diagnosis of depression, poor physical function (Health Assessment Questionnaire Disability Index) had the strongest association with depression determined by SF-36 MH Scale, with odds ratios of 8.19 (95% confidence interval, 1.06-63.46; p = 0.04) and 13.25 (95% confidence interval, 1.15-152.31; p = 0.04) at baseline and follow-up, respectively. Other significant associations with depression were identified with current prednisolone dose, disease activity (PMR-Activity Score), pain (pain visual analog scale and SF-36 Bodily Pain Scale), and fatigue (SF-36 Vitality Scale).</p><p><strong>Conclusion: </strong>Depression affects up to 1 in 4 patients with PMR. The strongest association is with poor physical function, highlighting the psychological impact of physical limitations in PMR and the need to address comorbid depression to optimize patient outcomes.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"170-174"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Klotho and Gout in Middle-Aged and Older Adults: National Health and Nutrition Survey (2007-2016).","authors":"Chaolan Wang, Ke Lin, Yan Jiang, Kangrong Wu, Hong Zhang, Jian Chen, Na Li, Wanpei Luo, Tianbao Liu, Shuang Du","doi":"10.1097/RHU.0000000000002192","DOIUrl":"10.1097/RHU.0000000000002192","url":null,"abstract":"<p><strong>Background: </strong>Klotho, which is known to negatively regulate metabolic disorders and kidney disease, has a role in gout that remains unclear. This research explored how klotho levels correlate with the prevalence of gout.</p><p><strong>Methods: </strong>Participants aged 40 to 79 from the National Health and Nutrition Examination Survey (2007-2016) were examined in both lines. The connection between klotho levels and gout was analyzed through weighted multivariate logistic regression. Restricted cubic splines were used to assess linearity and investigate the dose-response relationship. To ensure the stability of the results, subgroup and sensitivity analyses were conducted.</p><p><strong>Results: </strong>In total, 9660 individuals participated, with the weighted sample size calculated at 88,892,738.77. The group included 47.79% males (4793), with the median age being 57.00 years. Upon adjusting for all covariates, the multivariate analysis indicated an odds ratio of 0.51 (95% confidence interval [CI]: 0.33~0.78, p = 0.003) for the likelihood of occurrence of gout. When compared with the lowest klotho quartile Q1 (≥151.3, <655.3 pg/mL), the adjusted odds ratios for the subsequent quartiles Q2 (≥655.5, <800.9 pg/mL), Q3 (≥801.0, <991.6 pg/mL), and Q4 (≥991.7, ≤3998.5 pg/mL) were 0.97 (95% CI: 0.68~1.38), 0.78 (95% CI: 0.50~1.21), and 0.48 (95% CI: 0.32~0.73), respectively. Analyses focusing on subgroups and sensitivity confirmed these results.</p><p><strong>Conclusions: </strong>This research found a negative correlation between serum α-klotho concentrations and the occurrence of gout. Those with the highest levels of klotho exhibited the lowest likelihood of gout, indicating potential importance for future studies and clinical uses.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"127-133"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}