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Association of Remnant Cholesterol Inflammation Index with Cardiovascular Risks and All-Cause Mortality in

Qi-Lin Ma1, Lei-Lei Du2, Jia Peng1

  • 1Department of Cardiovascular Medicine, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.

Diabetes & Metabolism Journal
|October 2, 2025
PubMed

Insights

The Remnant Cholesterol Inflammation Index (RCII) predicts mortality and cardiovascular disease (CVD) risk in diabetes and prediabetes. This index combines remnant cholesterol and inflammation, aiding early identification of high-risk individuals.

Area of Science:

  • Cardiovascular Medicine
  • Metabolic Disorders
  • Biomarker Discovery

Background:

  • Remnant cholesterol (RC) and low-grade inflammation are known cardiovascular disease (CVD) risk factors in diabetes.
  • The combined prognostic impact of RC and inflammation in dysglycemia is not well understood.
  • This study investigates the Remnant Cholesterol Inflammation Index (RCII) for risk prediction in diabetes/prediabetes.

Purpose of the Study:

  • To evaluate the Remnant Cholesterol Inflammation Index (RCII) as a predictor of all-cause mortality and CVD risk.
  • To assess the synergistic effect of remnant cholesterol and hsCRP in individuals with diabetes or prediabetes.
  • To identify a novel biomarker for early risk stratification in dysglycemic populations.

Main Methods:

  • Utilized data from 2206 US adults with diabetes/prediabetes (NHANES 2015-2018).
  • Calculated RCII as [RC (mg/dL) × hsCRP (mg/L)]/10.
  • Employed Cox and logistic regression for mortality and CVD risk prediction, respectively.

Main Results:

  • Higher RCII quartiles showed graded associations with all-cause mortality (HR 2.45 for Q4 vs. Q1).
  • Significant dose-dependent relationships were observed for CVD risk and mortality.
  • Subgroup analyses indicated consistent mortality associations and sex-specific CVD interactions.

Conclusions:

  • The RCII serves as a valuable biomarker for predicting all-cause mortality and CVD risks in individuals with diabetes or prediabetes.
  • The index highlights the combined impact of remnant cholesterol and inflammation on adverse outcomes.
  • RCII may facilitate early identification of high-risk individuals for targeted interventions.
Abstract

Keywords:
CholesterolDiabetes mellitusHeart disease risk factorsInflammationMortalityPrediabetic state

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