Abstract
OBJECTIVE: Gout is a common inflammatory arthritis with a rising prevalence among young adults in China, imposing a substantial burden on patients and society. This study aims to examine the association between the triglyceride-glucose (TyG) index and the presence of gout among young Chinese adults. METHODS: We conducted a retrospective, age- and sex-matched (1:4) case-control study at Meizhou People's Hospital (2019-2023). Continuous variables were summarized as mean ± SD or median (IQR) and compared with Student's t test or the Mann-Whitney U-test. The association between the TyG index and prevalent gout was examined using multivariable logistic regression; multicollinearity was assessed. The diagnostic performance of the TyG index was evaluated by receiver operating characteristic, and Spearman correlation assessed TyG vs uric acid (UA), white blood cell count (WBC), systemic immune-inflammation index (SII), and high-density lipoprotein cholesterol (HDL-C). RESULTS: The study included 447 gout patients and 1788 controls (average age 34.5 ± 6.9 years). Median TyG was higher in the gout group than in controls (4.86 [0.44] vs 4.63 [0.40]; P < 0.001). In multivariable logistic regression, higher TyG was independently associated with gout (adjusted OR = 2.454; 95% CI: 1.496-4.026, P < 0.001). TyG yielded an AUC of 0.709 (95% CI: 0.683-0.736), with an optimal cutoff of 4.735 (sensitivity 0.669; specificity 0.638). TyG correlated positively with UA (r = 0.3393), WBC (r = 0.3250), and SII (r = 0.2069) and inversely with HDL-C (r = -0.4913); all P < 0.001. CONCLUSION: In this cross-sectional study of young Chinese adults, higher TyG was independently associated with the presence of gout and showed acceptable discrimination. As a routinely available metric, TyG may aid risk stratification and case-finding; prospective studies are needed to define actionable thresholds and clarify temporality.