{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:09:25Z","timestamp":1787062165795,"version":"build-2736575974"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T00:00:00Z","timestamp":1759363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The triglyceride-glucose (TyG) index has recently emerged as a simple surrogate marker of insulin resistance. However, the relationships among the TyG index, obesity, and hyperuricemia in individuals with T2DM remain unclear. This study investigates the associations of the TyG index and obesity with hyperuricemia in T2DM, and the possible role of obesity in these associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-sectional study, 1,159 adults with T2DM were enrolled. The TyG index was calculated as ln [fasting triglyceride (mg\/dl) \u00d7 fasting plasma glucose (mg\/dl)\/2]. Participants were stratified into hyperuricemia and non-hyperuricemia groups based on serum uric acid levels. Multivariable logistic regression and subgroup analyses were performed to assess the association between the TyG index and hyperuricemia. Mediation analysis quantified BMI\u2019s contribution to this relationship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of hyperuricemia was 30.7%. After adjustment for age, gender, HbA1c, diabetes duration, eGFR, HDL-C, LDL-C, hypertension, hyperlipidemia, coronary heart disease, smoking status, and alcohol consumption, each unit increase in the TyG index was independently associated with a 36% elevated risk of hyperuricemia (OR = 1.36, 95% CI: 1.10-1.68). Subgroup analyses showed consistent associations across different patient subgroups. Mediation analysis indicated that BMI accounted for 20.0% of the relationship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The TyG index and BMI were both associated with hyperuricemia in Chinese patients with T2DM, with BMI potentially representing an indirect link.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2025.1637543","type":"journal-article","created":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T18:11:38Z","timestamp":1759428698000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Association between the triglyceride-glucose index and hyperuricemia: potential role of obesity in patients with Type 2 diabetes mellitus"],"prefix":"10.3389","volume":"16","author":[{"given":"Dou","family":"Tang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Xuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanfan","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leiqun","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.redox.2022.102271","article-title":"U-shaped association of uric acid to overall-cause mortality and its impact on clinical management of hyperuricemia","volume":"51","author":"Crawley","year":"2022","journal-title":"Redox Biol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1080\/16549716.2021.1874652","article-title":"Demographic, regional and temporal trends of hyperuricemia epidemics in mainland China from 2000 to 2019: a systematic review and meta-analysis","volume":"14","author":"Li","year":"2021","journal-title":"Glob Health Action"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.791983","article-title":"Prevalence of hyperuricemia among chinese adults: findings from two nationally representative cross-sectional surveys in 2015\u201316 and 2018\u201319","volume":"12","author":"Zhang","year":"2022","journal-title":"Front Immunol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1186\/s12944-024-02146-5","article-title":"Nonlinear association of triglyceride-glucose index with hyperuricemia in US adults: a cross-sectional study","volume":"23","author":"Qiu","year":"2024","journal-title":"Lipids Health Dis"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-016-0749-3","article-title":"The role of uric acid for predicting future metabolic syndrome and type 2 diabetes in older people","volume":"21","author":"Chang","year":"2017","journal-title":"J Nutr Health Aging"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200012213432501","article-title":"Phenylpropanolamine and the risk of hemorrhagic stroke","volume":"343","author":"Kernan","year":"2000","journal-title":"N Engl J Med"},{"key":"B7","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1038\/s41392-024-01916-y","article-title":"Hyperuricemia and its related diseases: mechanisms and advances in therapy","volume":"9","author":"Du","year":"2024","journal-title":"Signal Transduct Target Ther"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1424207","article-title":"Plasma aldosterone concentrations elevation in hypertensive patients: the dual impact on hyperuricemia and gout","volume":"15","author":"Song","year":"2024","journal-title":"Front Endocrinol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S376857","article-title":"Prevalence of hyperuricemia and associated factors among type 2 diabetic patients in Jordan","volume":"15","author":"Abujbara","year":"2022","journal-title":"Int J Gen Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1186\/s12902-023-01408-0","article-title":"Prevalence of hyperuricemia among type 2 diabetes mellitus patients in Africa: a systematic review and meta-analysis","volume":"23","author":"Alemayehu","year":"2023","journal-title":"BMC Endocr Disord"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1177\/20420188231198620","article-title":"Prevalence and associated factors of hyperuricemia among Chinese patients with diabetes: a cross-sectional study","volume":"14","author":"Sun","year":"2023","journal-title":"Ther Adv Endocrinol Metab"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S362248","article-title":"Relationship between four non-insulin-based indexes of insulin resistance and serum uric acid in patients with type 2 diabetes: a cross-sectional study","volume":"15","author":"Han","year":"2022","journal-title":"Diabetes Metab Syndr Obes"},{"key":"B13","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1186\/s13098-022-00927-5","article-title":"Association between the triglyceride-glucose (TyG) index and increased blood pressure in normotensive subjects: a population-based study","volume":"14","author":"Lee","year":"2022","journal-title":"Diabetol Metab Syndrome"},{"key":"B14","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.ejim.2024.08.026","article-title":"Triglyceride glucose (TyG) index: A promising biomarker for diagnosis and treatment of different diseases","volume":"131","author":"Sun","year":"2025","journal-title":"Eur J Internal Med"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.2147\/RMHP.S243381","article-title":"Triglycerides and total cholesterol concentrations in association with hyperuricemia in chinese adults in qingdao, China","volume":"13","author":"Cui","year":"2020","journal-title":"Risk Manag Healthc Policy"},{"key":"B16","doi-asserted-by":"publisher","first-page":"e3456","DOI":"10.1097\/MD.0000000000003456","article-title":"An invert U-shaped curve: relationship between fasting plasma glucose and serum uric acid concentration in a large health check-up population in China","volume":"95","author":"Li","year":"2016","journal-title":"Med (Baltimore)"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1080\/00325481.2019.1624581","article-title":"Usefulness of triglyceride-glucose index for estimating hyperuricemia risk: insights from a general population","volume":"131","author":"Shi","year":"2019","journal-title":"Postgrad Med"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/4272715","article-title":"Positive association between the triglyceride-glucose index and hyperuricemia in chinese adults with hypertension: an insight from the China H-type hypertension registry study","volume":"2022","author":"Yu","year":"2022","journal-title":"Int J Endocrinol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/5582306","article-title":"Association between the triglyceride glucose index and hyperuricemia in patients with primary hypertension: a cross-sectional study","volume":"2023","author":"Liu","year":"2023","journal-title":"Int J Endocrinol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.orcp.2023.09.007","article-title":"Associations between obesity parameters and hyperuricemia by sex, age, and diabetes mellitus: A nationwide study in Korea","volume":"17","author":"Bae","year":"2023","journal-title":"Obes Res Clin Pract"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1002\/art.41067","article-title":"Population impact attributable to modifiable risk factors for hyperuricemia","volume":"72","author":"Choi","year":"2020","journal-title":"Arthritis Rheumatol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1186\/s13098-024-01268-1","article-title":"Relationship between gout, hyperuricemia, and obesity-does central obesity play a significant role?-a study based on the NHANES database","volume":"16","author":"Mao","year":"2024","journal-title":"Diabetol Metab Syndr"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2025.112103","article-title":"HOMA-IR and TyG index differ for their relationship with dietary, anthropometric, inflammatory factors and capacity to predict cardiovascular risk","volume":"222","author":"Sergi","year":"2025","journal-title":"Diabetes Res Clin Pract"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.4093\/dmj.2020.0109","article-title":"High incidence of chronic kidney disease among Iranian diabetic adults: using CKD-EPI and MDRD equations for estimated glomerular filtration rate","volume":"45","author":"Moazzeni","year":"2021","journal-title":"Diabetes Metab J"},{"key":"B25","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/s12933-024-02122-4","article-title":"Interacting and joint effects of triglyceride-glucose index (TyG) and body mass index on stroke risk and the mediating role of TyG in middle-aged and older Chinese adults: a nationwide prospective cohort study","volume":"23","author":"Huo","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1186\/s12967-020-02590-8","article-title":"Association of hypertension and hypertriglyceridemia on incident hyperuricemia: an 8-year prospective cohort study","volume":"18","author":"Zhang","year":"2020","journal-title":"J Transl Med"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1111\/ene.15416","article-title":"Nonalcoholic fatty liver disease, serum cytokines, and dementia among rural-dwelling older adults in China: A population-based study","volume":"29","author":"Wang","year":"2022","journal-title":"Eur J Neurol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1037\/a0020761","article-title":"A general approach to causal mediation analysis","volume":"15","author":"Imai","year":"2010","journal-title":"psychol Methods"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1740","DOI":"10.1186\/s12889-023-16669-6","article-title":"A predictive model for hyperuricemia among type 2 diabetes mellitus patients in Urumqi, China","volume":"23","author":"Abudureyimu","year":"2023","journal-title":"BMC Public Health"},{"key":"B30","doi-asserted-by":"publisher","first-page":"R116","DOI":"10.1186\/ar2519","article-title":"Menopause, postmenopausal hormone use and serum uric acid levels in US women \u2013 The Third National Health and Nutrition Examination Survey","volume":"10","author":"Hak","year":"2008","journal-title":"Arthritis Res Ther"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8030296","article-title":"The prevalence of hyperuricemia sharply increases from the late menopausal transition stage in middle-aged women","volume":"8","author":"Cho","year":"2019","journal-title":"J Clin Med"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2015.91","article-title":"Global epidemiology of gout: prevalence, incidence and risk factors","volume":"11","author":"Kuo","year":"2015","journal-title":"Nat Rev Rheumatol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2017.12.033","article-title":"The link between insulin resistance parameters and serum uric acid is mediated by adiposity","volume":"270","author":"Mazidi","year":"2018","journal-title":"Atherosclerosis"},{"key":"B34","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1111\/jch.14405","article-title":"Mediation effect of obesity on the association between triglyceride-glucose index and hyperuricemia in Chinese hypertension adults","volume":"24","author":"Sun","year":"2022","journal-title":"J Clin Hypertens (Greenwich)"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqz309","article-title":"Race affects the association of obesity measures with insulin sensitivity","volume":"111","author":"Tay","year":"2020","journal-title":"Am J Clin Nutr"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1007\/s00011-009-0031-9","article-title":"Insulin resistance acts as an independent risk factor exacerbating high-purine diet induced renal injury and knee joint gouty lesions","volume":"58","author":"Miao","year":"2009","journal-title":"Inflammation Res"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3390\/ijms22179221","article-title":"Molecular biological and clinical understanding of the pathophysiology and treatments of hyperuricemia and its association with metabolic syndrome, cardiovascular diseases and chronic kidney disease","volume":"22","author":"Yanai","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1097\/MED.0b013e3283444b09","article-title":"Obesity, insulin resistance and free fatty acids","volume":"18","author":"Boden","year":"2011","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19127160","article-title":"Insulin resistance and urolithiasis as a challenge for a dietitian","volume":"19","author":"Lubawy","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2022.1095211","article-title":"Obesity-related kidney disease: beyond hypertension and insulin-resistance","volume":"13","author":"Arabi","year":"2023","journal-title":"Front Endocrinol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.117.09508","article-title":"Temporal relationship between hyperuricemia and insulin resistance and its impact on future risk of hypertension","volume":"70","author":"Han","year":"2017","journal-title":"Hypertension"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1637543\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T18:11:39Z","timestamp":1759428699000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1637543\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,2]]},"references-count":41,"alternative-id":["10.3389\/fendo.2025.1637543"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1637543","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,2]]},"article-number":"1637543"}}