Associations Between a Surrogate Index of Insulin Resistance and Hyperuricemia in Young and Middle-Aged Patients With Type 2 Diabetes Mellitus.

BACKGROUND

This study is aimed at examining the associations between insulin resistance (IR) surrogate indices, including TyG, TyG-BMI, TG/HDL-C, and METS-IR, and hyperuricemia (HUA) in young and middle-aged patients with Type 2 diabetes mellitus (T2DM).

METHODS

A total of 1005 patients with T2DM were included in this cross-sectional study. Participants were classified into HUA and nonhyperuricemia (NHUA) groups according to serum uric acid concentrations and further stratified by age into young (18-44 years) and middle-aged (45-59 years) subgroups. Multivariable logistic regression analyses were performed to assess the associations between IR surrogate indices and HUA. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the discriminatory ability of these indices for HUA across sex- and age-specific subgroups.

RESULTS

All IR surrogate indices were significantly higher in the HUA group than in the NHUA group. TyG and TG/HDL-C showed stable associations with HUA across the regression models, while the association for TyG-BMI was attenuated after additional adjustment when modeled continuously, although individuals in the highest quartile remained associated with higher odds of HUA. METS-IR was associated with HUA only in unadjusted models. Age-stratified analyses showed that none of the IR surrogate indices remained significantly associated with HUA after multivariable adjustment in younger patients, whereas TyG and TG/HDL-C remained associated with higher odds of HUA in middle-aged patients. ROC analyses indicated limited to moderate discriminatory performance (AUC < 0.75). TyG-BMI showed the highest AUC in younger patients (AUC = 0.715), while TG/HDL-C demonstrated relatively higher specificity in middle-aged patients. Sex-stratified analyses showed slightly higher AUC values in males than in females, although overall discrimination remained modest.

CONCLUSION

IR surrogate indices showed varying associations with HUA in young and middle-aged patients with Type 2 diabetes. TyG and TG/HDL-C showed relatively stable associations with HUA across the regression models, whereas the associations for TyG-BMI and METS-IR were attenuated after additional adjustment. Overall, these indices demonstrated limited discriminatory performance and are not suitable as standalone diagnostic tools but may serve as adjunctive markers for preliminary risk stratification.