Usefulness of Triglyceride-glucose Index for estimating Hyperuricemia risk: Insights from a general Population

ABSTRACT

Objectives: Hyperuricemia is a metabolic abnormality that has cast an enormous burden on global healthcare. Previous studies have revealed the close association between insulin resistance and hyperuricemia. Therefore, monitoring insulin sensitivity may be a possible way to prevent hyperuricemia. Recent studies have demonstrated the usefulness of triglyceride-glucose index (TyG) as a simple surrogate of insulin resistance. Hence, our study aimed to explore the impact of TyG on hyperuricemia and its value to improve the risk stratification and prevention of hyperuricemia.

Methods: This cross-sectional study included 6466 subjects (mean age: 59.57 years, 60.19% females) from northeast China between September 2017 to May 2018. TyG was determined as ln[fasting TG(mg/dL)×FPG(mg/dL)/2]. Hyperuricemia was defined as serum uric acid ≥ 357 μmol/L for females and ≥ 417 μmol/L for males.

Results: The prevalence of hyperuricemia was 5.24%. In the full model, each SD increment of TyG caused a 12.528 μmol/L elevation of serum urate concentration and a 54.1% additional risk for hyperuricemia. When dividing TyG into quartiles, the top quartile had a 2.730 times risk for hyperuricemia than the bottom one. Moreover, smooth curve fitting demonstrated this association was linear. Additionally, subgroup analysis revealed the association was robust to several risk factors of hyperuricemia. Finally, AUC displayed an improvement when introducing TyG into clinical risk factors (0.751 vs 0.772, p < 0.001), category-free net reclassification index (0.304, 95% CI: 0.195–0.413, P < 0.001) and integrated discrimination index (0.009, 95% CI: 0.004–0.013, P < 0.001) also showed the improvement from TyG.

Conclusion: Our work revealed the linear and robust association between TyG and hyperuricemia. Furthermore, our results suggest the importance of simultaneous glycemic and lipids control in the prevention of hyperuricemia. Most importantly, our findings implicate the value of TyG to optimize the risk stratification and prevention of hyperuricemia.

KEYWORDS:

• Dyslipidemia
• hyperglycemia
• hyperuricemia
• insulin resistance
• triglyceride-glucose index

Acknowledgments

We thank neurologists and staffs from central hospital and CDC of Chaoyang and Lingyuan city in Liaoning province who work hard to ensure the reliability and accuracy of data.

Availability of data and materials

The datasets used and analyzed during this study are available from the corresponding author on reasonable request.

Author contributions

LX and SL were responsible for the concept and design of the study. LJ and WS were responsible for the study coordination and conduct. WS contributed to the drafting of the manuscript. LJ, YT and WS collected and analyzed the data. WS, LJ interpreted the data. All authors read and approved the final manuscript.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Ethics approval and consent to participate

The study was granted approval by the Central Ethics Committee at the China National Center for Cardiovascular Disease. Written informed consent was obtained from all participants.

Additional information

Funding

This paper was funded by the Department of Science and Technology of Liaoning Province under grant [2018225065] and National Key R&D Program of China under grant [2017YFC1310902].