Objective To explore the associations between triglyceride glucose (TyG)-obesity composite indices and the risk of hyperuricemia (HUA) in Qingdao, China, providing a basis for the prevention and management of HUA.

Methods A prospective cohort study was conducted, encompassing a total of 3 294 adults recruited in the baseline survey from 2006 to 2009 and participating the follow-up survey from 2012 to 2015 and 2019 to 2023. Cox proportional hazards regression was adopted to analyze the associations of baseline TyG-body mass index (TyG-BMI) and TyG-waist circumference (TyG-WC) with the risk of HUA. The restricted cubic spline method was used to analyze the dose-response relationships of baseline TyG-BMI and TyG-WC with the risk of HUA. Subgroup analyses were performed based on covariates such as gender and age, and their interactions with the TyG-obesity composite indices were analyzed.

Results A total of 430 (13.1%) adults were identified with HUA. Multivariate Cox regression analysis showed that the highest quartiles of baseline TyG-BMI and TyG-WC increased the risk of HUA by 48% (HR = 1.48, 95%CI: 1.10–1.99) and 46% (HR = 1.46, 95%CI: 1.08–1.99) compared with the lowest quartiles. Restricted cubic splines indicated linear dose-response relationships of baseline TyG-BMI (P_overall < 0.001, P_non-linear = 0.639) and TyG-WC (P_overall < 0.001, P_non-linear = 0.776) with the risk of HUA. Subgroup analyses showed that the highest quartiles of baseline TyG-obesity composite indices in females, rural adults, and hypertension adults were higher than those in males, urban adults, and non-hypertension adults (all P < 0.05). No significant interactions were observed with TyG-obesity composite indices (all P > 0.05).

Conclusion Elevated baseline levels of TyG-BMI and TyG-WC are associated with an increased risk of HUA, particularly among females, rural adults, and hypertension adults.