Associations of Five Insulin Resistance-Related Indices With Gout Risk in the 2007-2018 NHANES Cross-Sectional Study

This study investigated the associations between five insulin resistance (IR)-related surrogate indices and gout and compared their associations and discriminative abilities for gout. The indices included the triglyceride-glucose (TyG) index, TyG combined with body mass index (TyG-BMI), lipid accumulation product (LAP), visceral adiposity index (VAI), and metabolic score for insulin resistance (METS-IR).

Data from the 2007-2018 National Health and Nutrition Examination Survey (NHANES) were analyzed. Comparisons between the gout and nongout groups were performed using t-tests and chi-square tests. Multivariable logistic regression and subgroup analyses were used to assess the associations.

Among 14,582 participants (4.80% with gout), adjusted analyses identified the highest METS-IR quartile as the strongest predictor of gout (adjusted OR = 2.823, 95%CI 1.643-4.851), followed by TyG-BMI (OR = 2.290, 95%CI 1.555-3.373). Restricted cubic splines revealed nonlinear associations of TyG and LAP with gout risk, contrasting with linear trends for TyG-BMI, VAI, and METS-IR. Subgroup analyses suggested that elevated TyG and VAI were positively associated with gout in nondiabetic individuals (interaction p < 0.05).

All five IR-related indices showed positive associations with gout, particularly in those with central obesity. These indices showed modest discriminative ability for gout, and further validation is needed.