Predictive performance of insulin resistance surrogate indices for hyperuricemia among Chinese older adults aged over 80 years: based on the China nutrition and health surveillance, 2015–2017

Objective To explore the associations between insulin resistance surrogate indices and hyperuricemia among Chinese older adults aged over 80 years and evaluate the predictive performance of different indices for hyperuricemia, thus providing a scientific basis for the prevention and control of hyperuricemia in this population.

Methods On the basis of the data from the China Nutrition and Health Surveillance (2015–2017), multistage stratified cluster random sampling was employed to select 2 667 participants aged over 80 years from 31 provinces (autonomous regions, municipalities) in China. A questionnaire survey, physical measurements, and laboratory tests were conducted. The triglyceride-glucose (TyG) index was combined with body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) to derive the TyG-BMI, TyG-WC, and TyG-WHtR indices, which, together with the triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio, metabolic score for insulin resistance (METS-IR), were used as insulin resistance surrogate indices. The participants were categorized by ascending quartiles. Hyperuricemia was defined as a serum uric acid concentration ≥ 420 μmol/L in men and ≥ 360 μmol/L in women. Multivariable unconditional logistic regression was adopted to explore the associations between insulin resistance surrogate indices and hyperuricemia. Receiver operating characteristic (ROC) curves were established to compare the predictive performance of different indices for hyperuricemia.

Results Among the 2 667 Chinese older adults, 23.24% had hyperuricemia, and the prevalence of hyperuricemia was statistically different among different groups of body mass index (BMI) (χ² = 38.167), marital status (χ² = 4.012), sleep duration (χ² = 6.452), hypertension (χ² = 12.320), diabetes (χ² = 4.922), and dyslipidemia (χ² = 38.541) (all P < 0.05). The results of multivariable unconditional logistic regression showed that after adjusting for age, sex, BMI, place of residence, educational background, marital status, annual household income per capita, current smoking, current drinking, physical activity level, sleep duration, and the prevalence of hypertension, diabetes, and dyslipidemia, each insulin resistance surrogate index was positively associated with the risk of hyperuricemia. Compared with the lowest group, the highest group of TyG (OR = 1.79, 95%CI: 1.30–2.45), TyG-BMI (OR = 2.41, 95%CI: 1.41–4.13), TyG-WC (OR = 1.84, 95%CI: 1.27–2.67), TyG-WHtR (OR = 1.99, 95%CI: 1.39–2.86), TG/HDL-C (OR = 1.81, 95%CI: 1.31–2.50), and MET-IR (OR = 2.20, 95%CI: 1.32–3.69) had a significantly higher risk of hyperuricemia. ROC analysis suggested that the TyG-WC index had the best predictive performance for the prevalence of hyperuricemia in this population.

Conclusions TyG, TyG-BMI, TyG-WC, TyG-WHtR, TG/HDL-C, and METS-IR are independent risk factors for hyperuricemia in the Chinese older adults aged over 80 years. The TyG-WC index could be used as an elite predictor of hyperuricemia risk, providing a new target for the prevention and treatment of hyperuricemia in this population.