Associations between four non-insulin-based indices of insulin resistance and hyperuricemia in patients with obstructive sleep apnea: a retrospective cross-sectional study

Background: The objective of this study was to investigate the associations between four novel non-insulin-based insulin resistance (IR) indices, namely the triglyceride glucose index (TyG), triglyceride glucose-body mass index (TyG-BMI), triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), and metabolic score for insulin resistance (METS-IR), and the risk of hyperuricemia (HU) in patients with obstructive sleep apnea (OSA). Methods: A total of 708 OSA patients (mean age 57.2 ± 12.6 years, 73.9% males) were retrospectively included in the study. Multivariate logistic regression analysis and restricted cubic spline (RCS) modeling were utilized to assess the relationships between the four IR indices and HU. Additionally, receiver operating characteristic (ROC) curve was employed to evaluate the discriminatory capabilities of these indices. Results: Compared to the non-HU group, the TyG, TyG-BMI, TG/HDL-C, and METS-IR indices were significantly higher in the HU group (all P < 0.001). Multivariate logistic regression analyses revealed that the TyG, TyG-BMI, TG/HDL-C, and METS-IR indices were independently associated with an increased risk of HU (all P < 0.001). Specifically, the odds ratios for HU in the highest quartile compared to the lowest quartile of these indices were as follows: TyG: 2.464 [95% confidence interval (CI): 1.393 - 4.357]; TyG-BMI: 2.987 (95% CI: 1.688 - 5.286); TG/HDL-C: 2.342 (95% CI: 1.352 - 4.057); and METS-IR: 2.076 (95% CI: 1.205 - 3.578). Notably, RCS modeling indicated that TG/HDL-C exhibited a non-linear positive correlation with HU ( P _overall < 0.001, P _non-linear = 0.007), while TyG, TyG-BMI, and METS-IR showed linear positive correlations with HU ( P _overall < 0.001 and P _non-linear > 0.05 for all) after adjusting for confounding factors. Moreover, all four IR indices demonstrated discriminatory abilities for HU by ROC curves (all P < 0.001). Conclusion: The four non-insulin-based IR indices—TyG, TyG-BMI, TG/HDL-C, and METS-IR—were found to be independently and positively associated with an increased risk of HU in OSA patients. These findings highlight the close relationship between IR and hyperuricemia in OSA patients and suggest that these four IR indices could serve as valuable tools for identifying and managing HU, potentially aiding in the prevention of IR-related comorbidities in OSA patients.