Association Between TCBI (Triglycerides, Total Cholesterol, and Body Weight Index) and Hyperuricemia：a retrospective cross-sectional study

Abstract Background The triglycerides, total cholesterol, and body weight index (TCBI) is a novel biomarker that integrates nutritional and metabolic status. Its potential association with hyperuricemia (HUA) remains unclear. This study aimed to investigate the independent association between TCBI and HUA. Methods We conducted a retrospective cross-sectional study of 3,775 participants (708 HUA cases and 3,067 controls). The association of standardized TCBI with HUA was assessed using univariable and multivariable logistic regression (adjusting for age, sex, BMI, glucose, and LDL-C), quartile analysis, and restricted cubic splines (RCS). Stratified analyses and interaction tests were performed by sex and BMI. Predictive utility was evaluated by the area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results After full adjustment, each standard deviation increase in TCBI was independently associated with a 13.5% higher HUA risk (OR = 1.135, 95% CI: 1.033–1.271, P = 0.017). A significant, non-linear dose-response relationship was observed (P < 0.001). Stratified analyses revealed a stronger association in women and a significant modifying effect of BMI (P = 0.03). Adding TCBI to a base model modestly improved discrimination (ΔAUC = 0.005, P < 0.001) and significantly enhanced risk reclassification (NRI = 14.97%, P = 0.019). Conclusion TCBI is an independent, non-linear risk factor for HUA, with effect modification by sex and BMI. Its ability to significantly improve risk reclassification positions TCBI as a simple and clinically valuable indicator for refining HUA risk stratification, warranting validation in prospective cohorts.