Association between three non-insulin-based indexes of insulin resistance and hyperuricemia

  • Xing Zhen Liu
  • Xia Xu
  • Jian Qin ZhuEmail author
  • Dong Bao ZhaoEmail author
Original Article



The association between hyperuricemia and insulin resistance (IR) has been demonstrated by many studies, but the traditional IR indexes are too impractical to be used in clinical practice for the recognition of the IR state in individuals with hyperuricemia. Therefore, we aimed to further investigate the association between hyperuricemia and three non-insulin-based IR indexes in this large-scale cross-sectional study.


A total of 174,695 adults without self-reported use of antihyperuricemic agents, hypoglycemic agents, or lipid-lowering drugs were included in the current analysis. The triglyceride to high-density lipoprotein cholesterol ratio (TG/HDLc), the product of fasting triglycerides and glucose (TyG), and metabolic score for IR (METS-IR) were calculated. Then, logistic regression analyses were applied to explore their association with hyperuricemia.


The TG/HDLc, TyG, and METS-IR all had positive correlations with uric acid level. However, only TG/HDLc and TyG were significantly associated with hyperuricemia in both sexes and body mass index (BMI) classification (the ORs of the highest quartile for each were 6.751 and 1.505 in females and 6.487 and 1.646 in males, respectively). The AUC values of TG/HDLc and TyG to discriminate hyperuricemia were also statistically significant in both sexes and BMI classification (all greater than 0.7).


TG/HDLc and TyG are strongly associated with hyperuricemia regardless of BMI classification. These two obtainable and cost-effective non-insulin-based IR indexes could be potential monitors during the management of hyperuricemia and prevention of its IR-driven comorbidities.

Key Points

In this large-scale study, we identified TG/HDLc and TyG as indicators for identification of IR in patients with hyperuricemia.

These simple and practical IR indicators are of substantial clinical importance for implementing preventive strategies against IR-driven comorbidities of hyperuricemia.


Hyperuricemia Insulin resistance METS-IR TG/HDLc TyG index 



In the preparation and implementation of this study, we get a lot of selfless help. All of our authors thank all those who have helped us.


This work was supported by the National Natural Science Foundation of China (grant number 81671595).

Compliance with ethical standards

This study was approved by the ethics committee of Hangzhou Aeronautical Sanatorium of the Chinese Air Force.




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Copyright information

© International League of Associations for Rheumatology (ILAR) 2019

Authors and Affiliations

  1. 1.The First Convalescence AreaHangzhou Aeronautical Sanatorium of Chinese Air ForceHangzhouChina
  2. 2.Department of Rheumatology, Changhai HospitalNaval Military Medical University (The Second Military Medical University)ShanghaiChina
  3. 3.Department of RheumatologyJingjiang People’s HospitalJingjiangChina

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