The joint associations of TyG index and hsCRP with hyperuricemia among Chinese adults: a cross-sectional study

This study investigated the independent and combined effects of the triglyceride glucose (TyG) index and high-sensitivity C-reactive protein (hsCRP) levels on hyperuricemia (HUA), aiming to provide a scientific basis for early identification and intervention.

Participants were categorized into four groups based on the median TyG index (8.66) and the established clinical cutoff for hsCRP (1 mg/L). Restricted cubic spline (RCS) model was employed to test for nonlinear trends between HUA and both the TyG index and hsCRP levels separately. A multivariable logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for HUA across the TyG-hsCRP groups, with the low TyG/low hsCRP group serving as the reference.

The study included 5,303 participants with a mean age of 49.31 ± 12.13 years, of whom 3,063 (57.76%) were male. RCS model analysis revealed a linear association between the TyG index and HUA (P_-nonlinear = 0.52), while hsCRP demonstrated a nonlinear association with HUA (P_-nonlinear = 0.01). Multivariable logistic regression demonstrated that compared to the reference group (TyG < 8.66 and hsCRP < 1 mg/L), the risk of HUA increased progressively across exposure groups. The highest risk was observed in participants with combined elevation of both markers (OR = 2.25; 95% CI: 1.69-3.00). Subgroup analyses confirmed this association pattern, particularly demonstrating significant joint associations in women and individuals aged < 65 years.

The combined elevation of both TyG index and hsCRP levels significantly increases the risk of hyperuricemia, demonstrating a clinically meaningful compound association. This association supports the utility of dual-marker assessment for precise early screening and improved risk stratification. Key Points • Elevated TyG index and increased hsCRP levels jointly exhibit a significant combined association, correlating with the risk of hyperuricemia (OR = 2.25), suggesting that combined assessment of these two markers in clinical practice may more effectively identify high-risk individuals than evaluating either marker alone. • The TyG index exhibits a linear correlation with risk, whereas hsCRP shows a nonlinear association, suggesting that the two may participate in disease development through distinct mechanisms. This provides clues for exploring differentiated intervention targets. • The combined effect is particularly pronounced in women and individuals under 65 years of age. In clinical screening, dual-marker combined testing can be prioritized for specific populations to achieve more precise early prevention.