Comparison of the predictive value of four insulin resistance surrogates and hyperuricemia in women with recurrent pregnancy loss: A cross‐sectional study

Abstract Background Insulin resistance (IR), hyperuricemia (HUA), and recurrent pregnancy loss (RPL) elevate the risk of cardiovascular disease and metabolic disorders, while also impacting reproductive health. The relationship between IR, HUA, and RPL has not been thoroughly investigated. This study investigates the relationship between four IR surrogates and the risk of HUA in RPL patients. Methods Data from a real‐world study on RPL in China were analyzed using multivariable regression to determine the relationship between HUA and triglyceride and glucose (TyG) index, triglyceride glucose‐body mass index (TyG‐BMI), triglyceride to high‐density lipoprotein cholesterol (TG/HDL‐c) ratio, and metabolic score for insulin resistance (METS‐IR). The predictive ability of these surrogates for detecting HUA in RPL patients was evaluated using the area under the curve and receiver operating characteristic analysis. Sensitivity analysis was performed using bootstrapping resampling. Results The study included 769 patients with a mean age of 30 ± 4 years old, 8.32% of whom had HUA. Four IR surrogates were closely related to HUA in patients of RPL after adjusting for age, menstrual cycle, creatinine, alanine transaminase, aspartate transaminase, total cholesterol, homocysteine, and low‐density lipoprotein, with area under the curve values of TyG index (OR = 0.693, 95% confidence interval [CI]: 0.626, 0.759), TyG‐BMI (OR = 0.731 95% CI: 0.657, 0.805), TG/HDL‐C (OR = 0.703, 95% CI: 0.641, 0.764), and METS‐IR (OR = 0.728, 95% CI: 0.655, 0.799). Bootstrap resampling yielded similar results. Conclusions The TyG index, TyG‐BMI, TG/HDL‐c, and METS‐IR significantly correlated with HUA in patients with RPL. The TyG‐BMI had the highest predictive value of the four IR surrogates.