Abstract
The global burden of gout is substantial and expected to increase. We investigated the relationship between the triglyceride-glucose (TyG) index, a biomarker of insulin resistance, and gout risk in the general population over time. This study was conducted using data from the National Health Screening Cohort Database of South Korea (2002-2019) among 300,107 participants who had no history of gout and underwent more than three repeated TyG index measurements. During the median of 9.62 years (interquartile range 8.72-10.53), 14,116 individuals (4.72%) developed gout. In a multivariable time-dependent Cox proportional hazards model, a per-unit increase in the TyG index significantly increased gout risk (hazard ratio [HR] 1.150; 95% confidence interval [CI] 1.116-1.184). The multivariate Cox proportional hazards model for average TyG index quartiles was positively associated with the incidence risk of gout, accompanied by a significant trend (HR 1.326, 95% CI 1.260-1.397). This association followed a J-shaped pattern with increased risk. Our findings highlight a strong link between elevated TyG index and gout incidence in the general population, suggesting that the TyG index may serve as a valuable predictor of gout risk.