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Prognostic significance of the C-reactive protein-triglyceride-glucose index for all-cause and cardiovascular

Mengting Wang1,2, Wenlong Qiu1,2, Rui Chu1,2

  • 1Department of Nephrology, General Hospital of Ningxia Medical University, School of Ningxia Medical University, Yinchuan, 750004, China.

Scientific Reports
|December 24, 2025
PubMed
Summary

The C-reactive protein-triglyceride-glucose index (CTI) independently predicts mortality in peritoneal dialysis (PD) patients. Higher CTI levels are linked to increased risks of all-cause and cardiovascular disease mortality, regardless of diabetes status.

Keywords:
All-cause mortalityC-reactive protein-triglyceride-glucose indexCardiovascular diseasesPeritoneal dialysis

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Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Metabolic Syndrome

Background:

  • Chronic low-grade inflammation and insulin resistance (IR) are common in peritoneal dialysis (PD) patients, potentially increasing mortality.
  • The C-reactive protein-triglyceride-glucose index (CTI) combines inflammatory (CRP) and metabolic (TyG) markers, but its prognostic significance in PD is not established.

Purpose of the Study:

  • To investigate the prognostic value of the C-reactive protein-triglyceride-glucose index (CTI) for all-cause and cardiovascular disease (CVD) mortality in patients undergoing peritoneal dialysis (PD).

Main Methods:

  • A multicenter cohort study included 2,240 Chinese PD patients, with CTI assessed 3 months post-initiation and dichotomized at the median.
  • Mortality outcomes were tracked, and analyses included Kaplan-Meier, Cox regression (with and without propensity score matching), subgroup analyses, and restricted cubic splines (RCS).
  • Incremental predictive value was assessed using C-statistics, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) compared to established risk factors and individual markers (hs-CRP, TyG).

Main Results:

  • A higher CTI was an independent predictor of both all-cause and CVD mortality in PD patients.
  • Patients with CTI ≥ 5.09 had significantly higher risks: 34% for all-cause mortality (HR 1.34) and 39% for CVD mortality (HR 1.39) compared to those with CTI < 5.09.
  • RCS analysis indicated a nearly linear relationship between CTI and mortality risk, consistent across diabetic and non-diabetic subgroups, with modest incremental predictive value over hs-CRP and TyG.

Conclusions:

  • The C-reactive protein-triglyceride-glucose index (CTI) independently and linearly predicts all-cause and CVD mortality in PD patients.
  • CTI demonstrates consistent prognostic value irrespective of diabetes status, supporting its use as a supplementary risk stratification tool.
  • Its simplicity and cost-effectiveness suggest potential for individualized PD care and risk management strategies.