After removing rs780094 in the GCKR gene according to leave-one-out analysis, recalculating the main IVW estimate suggested a causal effect of fasting insulin on increased serum urate (β = 0.802, 95% CI: 0.514–1.090, P < 0.001) and risk of gout (OR = 3.293, 95% CI: 1.030–10.532, P = 0.045) (Figures 1, 2 and Supplementary Figure 2). The gene discussed is INS; the disease is gout.