Clinical Report: TyG Index Association with Serum Uric Acid Levels and Hyperuricaemia

Overview

This systematic review and meta-analysis evaluated the relationship between the triglyceride-glucose (TyG) index and serum uric acid (SUA) levels, focusing on hyperuricaemia (HUA) and gout. Findings indicate that the TyG index is significantly higher in patients with HUA and gout compared to non-affected individuals, supporting its role as a marker of insulin resistance linked to elevated SUA.

Background

Hyperuricaemia (HUA), characterized by elevated serum uric acid levels, is a precursor to gout and an independent risk factor for cardiovascular disease, diabetes, and chronic kidney disease. Insulin resistance underlies many metabolic diseases and is traditionally assessed by the hyperinsulinaemic euglycaemic glucose clamp technique, which is complex and costly. The TyG index, calculated from triglyceride and fasting glucose levels, offers a convenient and affordable alternative to assess insulin resistance and has been linked to various diseases. Exploring the relationship between the TyG index and HUA/gout may provide valuable insights for early prevention and management.

Data Highlights

The meta-analysis included observational studies comparing TyG index values between hyperuricaemic and non-hyperuricaemic populations, as well as between gout and non-gout patients. The TyG index was calculated as Ln (Fasting Triglycerides [mg/dL] × Fasting Plasma Glucose [mg/dL]/2). Quality assessments were performed using the Newcastle-Ottawa Scale and AHRQ methodology checklist. The analysis focused on differences in TyG index levels and odds ratios for HUA associated with TyG index values.

Key Findings

• The TyG index is significantly elevated in patients with hyperuricaemia compared to non-hyperuricaemic individuals.
• Patients with gout exhibit higher TyG index values than those without gout, indicating a link between insulin resistance and gout pathogenesis.
• The TyG index serves as a practical and cost-effective surrogate marker for insulin resistance in clinical and epidemiological studies related to HUA and gout.
• Elevated TyG index correlates with increased odds of developing hyperuricaemia, supporting its predictive value.
• Systematic review and meta-analysis provide stronger evidence than individual observational studies for the association between TyG index and serum uric acid-related conditions.

Clinical Implications

Clinicians can utilize the TyG index as a simple, accessible tool to identify patients at higher risk for hyperuricaemia and gout due to underlying insulin resistance. Early detection through TyG index measurement may facilitate timely interventions to prevent progression and complications. Incorporating TyG index assessment into routine metabolic evaluations could enhance risk stratification and management strategies for patients with elevated serum uric acid.

Conclusion

The TyG index is a valuable marker associated with elevated serum uric acid levels and increased risk of hyperuricaemia and gout. Its ease of measurement and strong correlation with insulin resistance make it a useful tool for early identification and management of these conditions.

References

1. Feng et al. 2025 -- The relationship between the triglyceride-glucose index and serum uric acid levels: a systematic review and meta-analysis