INS and arthritic joint disease: The TyG index takes into account two factors: glucose metabolism and lipid metabolism, while impaired glucose metabolism is a risk factor for arthritis (27), glucose metabolism can provide energy to immune cells to maintain autoimmune function, and insulin can regulate blood sugar indirectly affect the immune response of cartilage and synovium (28), or directly act on immune cells and affect their proliferation response and signal transduction to regulate the immune response (29).