China: Study on TyG Index and Hyperuricemia Risk

A recent study published in Scientific Reports suggested a significant independent correlation between the triglyceride-glucose (TyG) index and hyperuricemia risk in patients with diabetic kidney disease (DKD).

Due to rapid economic growth and improving the standard of living, hyperuricemia has become a global health problem. Studies have reported hyperuricemia to play a critical role in gout development and an independent risk factor for many diseases, which increases mortality and morbidity risk. However, there is no clarity on the pathogenesis of hyperuricemia due to the complexity of metabolic regulation. Therefore, early identification of high-risk hyperuricemia groups can facilitate early intervention, which is very relevant for bettering the patient quality of life and reducing the burden on the economy and healthcare system.

TyG index is a combination of triglycerides and fasting plasma glucose and can be used as an economical, simple, and reliable alternative marker of insulin resistance, compared with HOMA-IR.

Against the above background, Xiaoguang Fan, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou Henan, China, and colleagues aimed to determine whether TyG independently predicts hyperuricemia in diabetic kidney disease patients by conducting a longitudinal and cross-sectional study.

The authors enrolled 6,471 patients in the cross-sectional analysis, and 3,634 patients without hyperuricemia were included in the longitudinal study. They were followed for a median of 23 months. Hyperuricemia was defined as a serum uric acid level of more than 420 umol/L (7 mg/dL). 19.58% of participants in the study had hyperuricemia.

Findings

• Multivariate logistics regression analysis in the cross-sectional study showed that ORs for hyperuricemia in the TyG quartiles second, third, and fourth were 1.40, 1.69, and 4.53, respectively, versus the first quartile.
• Longitudinally, the Kaplan–Meier survival analysis revealed that higher TyG levels predicted a higher incidence of hyperuricemia.
• The Multivariate Cox regression model showed that hazard ratios (HRs) for hyperuricemia in the TyG index's upper quartiles were 1.69, 2.23, and 2.50 compared with the first quartile.
• The subgroup analyses showed that the association between TyG levels and hyperuricemia was strong in patients with diabetic kidney disease.

"We demonstrated a significant independent association of the TyG index and hyperuricemia risk in patients with diabetic kidney disease," the authors wrote. "Besides other known risk factors, providing more economical and simpler options that can differentiate high-risk populations for the implementation of early-stage management may reduce the occurrence of hyperuricemia and related diseases."

"Rigorous clinical studies will be needed to explore further the mechanism and relationship involved in the association of the TyG index and hyperuricemia."

Reference

Li, Q., Shao, X., Zhou, S. et al. Triglyceride-glucose index is significantly associated with the risk of hyperuricemia in patients with diabetic kidney disease. Sci Rep 12, 19988 (2022). https://doi.org/10.1038/s41598-022-23478-1