Association Between TyG-WC and Gout in American Adults: A Cross-Sectional Study of NHANES 2003-2018.

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.