Association of high sensitivity C-reactive protein-triglyceride glucose index and chronic kidney disease: a
Fengxu Zhang1, Zhengfang Wang1, Han Zhang1
1Health Management Center, Beijing Aerospace General Hospital, Beijing, China.
Insights
The high-sensitivity C-reactive protein-triglyceride glucose index (CTI) is linked to a higher prevalence of chronic kidney disease (CKD). This novel biomarker shows better diagnostic performance than individual markers for identifying CKD risk.
Area of Science:
- Nephrology
- Metabolic Medicine
- Inflammation Research
Background:
- Chronic kidney disease (CKD) is a global health issue linked to metabolic inflammation and insulin resistance.
- The high-sensitivity C-reactive protein-triglyceride glucose index (CTI) integrates inflammatory and metabolic markers.
- The association between CTI and CKD in the general population requires further investigation.
Purpose of the Study:
- To examine the cross-sectional relationship between the CTI and CKD prevalence.
- To evaluate the diagnostic performance of CTI for CKD.
- To explore the dose-response relationship and heterogeneity of the CTI-CKD association.
Main Methods:
- Included 10,287 adults from a health examination population.
- Calculated CTI using high-sensitivity C-reactive protein (hs-CRP) and the triglyceride-glucose (TyG) index.
- Used logistic regression and ROC curve analysis to assess CTI's association and diagnostic value for CKD (eGFR <60 mL/min/1.73 m²).
Main Results:
- A higher CTI was independently associated with increased CKD odds (OR=2.25 per unit increase).
- The highest CTI quartile showed significantly higher CKD risk compared to the lowest (OR=2.17).
- CTI demonstrated superior diagnostic performance (AUC=0.69) over TyG index (AUC=0.66) and hs-CRP (AUC=0.59).
Conclusions:
- Elevated CTI levels are independently and nonlinearly associated with higher CKD prevalence.
- CTI serves as a valuable tool for CKD risk stratification, outperforming individual markers.
- The CTI is particularly useful for early risk identification in specific subgroups like males and younger individuals.
Background:
Chronic kidney disease (CKD) represents a significant global health burden. Its pathogenesis is closely linked to a state of metabolic inflammation, involving insulin resistance and chronic low-grade inflammation. The high-sensitivity C-reactive protein-triglyceride glucose index (CTI) is a novel composite biomarker integrating inflammatory and metabolic information, yet its association with CKD in the general population remains unclear.
Objective:
This study aimed to investigate the cross-sectional association between the CTI and the prevalence of CKD in a health examination population.
Methods:
A total of 10-287 adults who underwent routine health check-ups were included. The CTI was calculated as the product of high-sensitivity C-reactive protein (hs-CRP) and the triglyceride-glucose (TyG) index. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m². Logistic regression models were used to assess the association of CTI (as a continuous variable and in quartiles) with CKD. Diagnostic performance was evaluated using the area under the receiver operating characteristic curve (AUC). The shape of the association and its heterogeneity were explored using restricted cubic splines and subgroup analyses.
Results:
A total of 163 (1.58%) participants were identified as CKD. After full adjustment for confounders, each unit increase in CTI was associated with a 2.25-fold increased odds of CKD (OR = 2.25, 95%CI: 1.66-3.06). Compared to participants in the lowest CTI quartile, those in the highest quartile had a 2.17-fold higher risk of CKD (OR = 2.17, 95% CI: 1.25-3.76; P for trend = 0.001). A nonlinear dose-response relationship was observed between CTI and CKD (P for nonlinearity = 0.012). The CTI demonstrated superior diagnostic performance for CKD (AUC = 0.69, 95% CI: 0.64-0.73) compared to its individual components, the TyG index (AUC = 0.66) and hs-CRP (AUC = 0.59). Subgroup analyses revealed that the association was particularly pronounced in males, individuals aged <60 years, and those with a history of alcohol consumption.
Conclusion:
In a health examination population, a higher CTI level was independently and nonlinearly associated with an increased prevalence of CKD, and it showed better diagnostic performance than individual inflammatory or metabolic markers alone. The CTI may serve as a useful tool for identifying individuals at high risk for CKD, especially for early risk stratification in specific subgroups.
Related Concept Videos
01:28Chronic Kidney Disease III: Interprofessional Care
01:25Chronic Kidney Disease I: Introduction
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:24Chronic Kidney Disease II: Clinical Manifestations
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention