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The association between the C-reactive protein-triglyceride-glucose index and cardiovascular diseases: A cohort study
Xinxin Xu1, Jianfeng Liu1, Yazhao Sun1
1Department of Cardiology, Cangzhou People's Hospital, Cangzhou, Hebei, China.
Insights
The C-reactive protein-triglyceride-glucose index (CTI) is linked to higher cardiovascular disease (CVD) risk. Increased CTI levels, reflecting inflammation and insulin resistance, predict a greater likelihood of developing CVD.
Area of Science:
- Cardiology
- Metabolic Syndrome
- Biomarkers
Background:
- Inflammation and insulin resistance (IR) are established risk factors for cardiovascular disease (CVD).
- The C-reactive protein-triglyceride-glucose index (CTI) is a novel composite biomarker assessing inflammation and IR severity.
- Understanding novel biomarkers for CVD risk prediction is crucial.
Purpose of the Study:
- To investigate the association between the C-reactive protein-triglyceride-glucose index (CTI) and the risk of developing cardiovascular disease (CVD).
- To evaluate CTI as a predictive marker for CVD in an aging population.
Main Methods:
- Utilized data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011-2020.
- Calculated CTI using C-reactive protein (CRP), triglycerides (TG), and fasting blood glucose (FBG).
- Employed multivariable Cox regression, restricted cubic splines (RCS), and subgroup analyses to assess CVD risk.
Main Results:
- A cohort of 5,642 participants aged 45+ was analyzed, with a 23.70% CVD incidence.
- Each unit increase in CTI was associated with an 11% increased CVD risk (HR=1.11, 95% CI=1.01-1.23).
- RCS analysis indicated a nonlinear relationship between CTI and CVD risk, with heterogeneous effects in subgroups.
Conclusions:
- Elevated CTI levels, both continuous and categorical, are significantly associated with increased cardiovascular disease risk.
- A nonlinear relationship exists between CTI and CVD risk.
- CTI demonstrates potential as a valuable biomarker for CVD risk stratification.
Background:
Inflammation and insulin resistance (IR) are both risk factors for cardiovascular disease (CVD). The C-reactive protein-triglyceride-glucose index (CTI) is a novel biomarker that comprehensively assesses the severity of inflammation and IR. This study investigates the association between CTI and the risk of CVD.
Methods:
Data from the China Health and Retirement Longitudinal Study (CHARLS) conducted between 2011 and 2020 were utilized, focusing on individuals aged 45 years and older. The CTI was calculated as 0.412 × Ln (C-reactive protein [CRP, mg/L]) + Ln (triglycerides [TG, mg/dL] × fasting blood glucose [FBG, mg/dL]/ 2). Self-reported CVD events were used as the primary outcome measure. Multivariable Cox regression, restricted cubic splines (RCS) analysis, and subgroup analyses were performed to examine the association between CTI and CVD risk.
Results:
This study included 5,642 participants, with a CVD incidence rate of 23.70% (1,337 cases). After adjusting for covariates, each unit increase in the CTI was associated with an 11% increase in the risk of CVD (hazard ratio (HR) = 1.11, 95% confidence interval (CI) = 1.01-1.23). Similar results were observed when CTI was analyzed as a categorical variable (quartiles). RCS analyses revealed a nonlinear relationship between CTI and CVD risk. Subgroup analysis revealed no significant associations in certain subgroups, suggesting that the effect of the association may be heterogeneous.
Conclusion:
Higher CTI (whether treated as a continuous or categorical variable) was significantly associated with an increased risk of CVD. A nonlinear relationship between CTI and CVD risk was observed.
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