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Triglyceride-Glucose Index for predicting gout flare risk post-urate-lowering therapy: a prospective cohort study


1, 2, 3, 4, 5

 

  1. Department of Paediatrics, Qilu hospital of Shandong University, Jinan, China.
  2. Department of Paediatrics, Qilu hospital of Shandong University, Jinan, China.
  3. Department of Paediatrics, Qilu hospital of Shandong University, Jinan, China.
  4. Department of Organ Transplantation, Qilu Hospital of Shandong University, Jinan, China. yangmengf@163.com
  5. Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, Qingdao, China. qddxyf@163.com

CER19729
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PMID: 42446716 [PubMed]

Received: 25/01/2026
Accepted : 25/06/2026
In Press: 09/07/2026

Abstract

OBJECTIVES:
Although urate-lowering therapy (ULT) is a cornerstone of gout management, some patients still experience recurrent gout flares. This study aimed to determine the predictive value of the triglyceride-glucose (TyG) index for the risk of gout flares in patients with gout after ULT.
METHODS:
A prospective cohort study enrolled 384 gout patients, stratified by baseline TyG index into high (≥9.0), moderate (8.5≤TyG index<9.0), and low (<8.5) groups. All received standardised ULT (febuxostat + low-dose colchicine) with 12-week follow-up to record target serum urate achievement and gout flare frequency.
RESULTS:
A total of 362 patients completed the follow-up. The rate of achieving the target SU level (<6 mg/dL) at week 4 was significantly lower in the high TyG index group than in the low TyG index group (17.6% vs. 34.2%, p<0.01). No significant differences were observed among the three groups at week 8 or week 12 of achieving the target SU level. However, the high TyG index group had a significantly higher frequency of gout flares compared with the moderate and low TyG index groups (0.975 vs. 0.632 and 0.419, p<0.001).
CONCLUSIONS:
The TyG index can serve as an effective predictor of gout flare risk after ULT, with those having a high TyG index exhibiting a higher risk, which might be related to the insulin resistance status. Incorporating the TyG index into routine clinical assessments may provide a novel metabolic strategy for personalised prevention and treatment of gout.

DOI: https://doi.org/10.55563/clinexprheumatol/cgke03

Rheumatology Article