Association Between TyG‐WC and Gout in American Adults: A Cross‐Sectional Study of NHANES 2003–2018
Shenlong Yi, Keyu Tao, Menglin Fan, Zicong Ren, Wei Wang, Xiaohong Zhou, Bijiang Wan, Qiwang HeABSTRACT
Background and Aims
The triglyceride‐glucose (TyG) index is widely used as a surrogate marker of insulin resistance. Indices that combine TyG with anthropometric measures may better reflect metabolic dysfunction and central adiposity. However, evidence regarding the association between TyG‐waist circumference (TyG‐WC) and gout among U.S. adults remains limited. This study examined the association between TyG‐WC and self‐reported physician‐diagnosed gout among U.S. adults and compared the discriminative performance of TyG‐WC with TyG, TyG‐waist‐to‐height ratio (TyG‐WHtR), and TyG‐body mass index (TyG‐BMI).
Methods
We analyzed data from 9818 adults aged 20 years or older from the National Health and Nutrition Examination Survey from 2003 to 2018. TyG and TyG‐related anthropometric indices were calculated using fasting triglyceride, fasting glucose, waist circumference, height, and BMI. Survey‐weighted logistic regression, restricted cubic spline (RCS) analysis, receiver operating characteristic (ROC) curve analysis, and exploratory mediation analysis were performed.
Results
Higher TyG‐WC was associated with greater odds of self‐reported physician‐diagnosed gout. Compared with participants in the lowest TyG‐WC quartile, those in the highest quartile had higher odds of gout after adjustment for covariates, including serum uric acid (OR = 2.71, 95% CI: 1.72–4.42, p < 0.001). RCS analysis suggested an approximately linear association. In the exploratory ROC analysis, TyG‐WC showed the highest numerical AUC among the evaluated TyG‐related indices. Exploratory mediation analysis suggested that serum uric acid may partly explain the observed association.
Conclusion
Among U.S. adults, higher TyG‐WC was associated with a greater prevalence of self‐reported physician‐diagnosed gout. TyG‐WC showed modest discriminative performance and a numerically higher AUC than other TyG‐related indices. Because of the cross‐sectional design, these findings should be interpreted as associations and require confirmation in prospective studies.