Association between triglyceride-glucose index and incidence risk of gout: a nationwide cohort study

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. © The Author(s) 2025.