The association between the triglyceride-glucose index and serum uric acid: a systematic review and meta-analysis

The triglyceride-glucose (TyG) index has emerged as a surrogate marker for insulin resistance. This systematic review and meta-analysis of observational studies aimed to investigate the association between the TyG index and hyperuricaemia and gout, which represent two consecutive disease stages. Seven electronic databases, including PubMed, Embase, Web of Science, China BioMedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), VIP, and Wanfang, were searched from inception to 15 April 2025. A random-effects model was applied to account for inherent clinical heterogeneity among studies, with statistical heterogeneity evaluated using Cochrane’s Q-test and the I² statistic. Meta-regression, subgroup analyses, and sensitivity analyses were conducted to explore the potential sources of heterogeneity. A Bonferroni correction was applied for multiple comparisons. Publication bias was assessed using funnel plots, as well as Egger’s and Begg’s tests. A total of 2,865 records were obtained, and 34 studies were included in this systematic review and meta-analysis. 32 studies examined the association between TyG index and hyperuricaemia and were included in the meta-analysis. The results showed that the TyG index was significantly higher in patients with hyperuricaemia (HUA group) compared to those without hyperuricaemia (NUA group), with a mean difference (MD = 0.31, 95% CI: 0.25 to 0.37, P < 0.00001, I2 = 99%). Additionally, the TyG index was associated with an increased risk of hyperuricaemia (OR = 2.28, 95% CI: 1.85 to 2.81, P < 0.00001, I2 = 92%). Two studies focused on the relationship between TyG index and gout. The narrative synthesis of the evidence suggested that TyG index tended to be higher in gout patients than in non-gout patients. The TyG index is a simple and valuable marker of insulin resistance. This study provides evidence of an association between TyG index and hyperuricaemia, and highlights a possible link with gout, although further studies are needed to confirm this finding.