Decoding the lipid etiology of atherogenic index of plasma and gout: establishing the causal role of triglycerides through NHANES, Mendelian randomization, and network pharmacology.

Notably, despite the absence of a significant indirect effect through AIP, TG exhibited a highly significant total effect on gout, driven by a strong direct effect independent of the AIP pathway (ADE = 0.1013, p < 2 × 10 −16 ) (Fig. 2 G, H, I, J) (File S1 : Table S13 – S17 ).

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However, in the fully adjusted model (Model 3, Table 3 ), hypertension showed a borderline association (OR = 4.591, 95% CI: 0.996–21.174, p = 0.051) that did not reach statistical significance, while diabetes was no longer significant ( p > 0.05).

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UGT1A6 (OR = 0.81, FDR = 0.08) and MICA (OR = 1.12, FDR = 0.09) showed borderline significance.

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