Prevalence of Metabolic Syndrome in Gout Patients and Its Relationship With Metabolic Markers: A Propensity Score Matching Study

Objective To evaluate the association between metabolic markers and metabolic syndrome (MetS) in gout patients, and to assess the predictive performance of the triglyceride‐glucose (TyG) index and triglyceride/high‐density lipoprotein cholesterol (THR) ratio. Methods In this cross‐sectional study, 502 gout patients (97.8% male) admitted between February 2023 and February 2024 were enrolled. MetS was defined according to the International Diabetes Federation criteria. Four metabolic markers—TyG, THR, serum uric acid/creatinine (SUA/Cr) ratio, and C‐reactive protein/HDL‐C ratio—were measured. Multivariate logistic regression identified independent predictors of MetS, while receiver operating characteristic (ROC) curves evaluated diagnostic accuracy. Propensity score matching and restricted cubic spline analyses were also performed to adjust for confounders and explore dose–response relationships. Results The prevalence of MetS was 62.4%. Patients with MetS exhibited significantly higher weight, systolic blood pressure (SBP), TyG, and THR values compared to non‐MetS subjects (all p < 0.05). After adjustment, TyG (OR = 3.94, 95% CI: 2.60, 5.98) and THR (OR = 1.66, 95% CI: 1.33, 2.07) remained independently associated with MetS. ROC analysis revealed AUCs of 0.771 for TyG and 0.776 for THR; a combined model achieved an AUC of 0.820. A non‐linear dose–response relationship was also observed. Conclusion Elevated TyG and THR indices are robust, independent predictors of MetS in gout patients. These cost‐effective markers may facilitate early screening and risk stratification in clinical practice.