Residual inflammatory risk as a predictor of cardiometabolic multi-morbidity: results from three prospective cohorts

Inflammation and its dynamic changes are intricately linked to cardiovascular diseases. This research aimed to explore the predictive significance of residual inflammatory risk (RIR) in evaluating the likelihood of developing cardiometabolic multi-morbidity (CMM).

Data were sourced from the China Health and Retirement Longitudinal Study (CHARLS), the Health and Retirement Study (HRS) and panzhihua central hospital. Inflammation status was assessed using at least two high-sensitivity C-reactive protein (hsCRP) measurements taken at baseline and follow-up, with a minimum interval of four weeks. High RIR was characterized by an hsCRP level exceeding 2 mg/L. Participants were categorized into four groups: persistent high RIR, increased RIR (initially low, subsequently high hsCRP), attenuated RIR (initially high, subsequently low hsCRP), and persistent low RIR. Multivariable Cox proportional hazards regression and subgroup analyses were employed to examine the relationship between RIR and CMM.

The study included 5,572 participants from the CHARLS (56.26% female, mean age 57.87 years), 3,856 participants from the HRS (60.35% female, mean age 65.74 years), and 2,446 participants from the panzhihua central hospital (54.17% female, mean age 58.65 years). Utilizing Cox proportional hazards regression, participants with persistent high RIR exhibited a significant association with an increased risk of developing CMM compared to those with persistent low RIR (CHARLS: HR = 2.2, 95% CI = 1.79-2.69, P < 0.001; HRS: HR = 1.79, 95% CI = 1.47-2.18, P < 0.001; panzhihua cohort: HR = 3.97, 95% CI = 2.52-6.27, P < 0.001). This association persisted after comprehensive adjustment for potential confounders (CHARLS: HR = 1.81, 95% CI = 1.47-2.23, P < 0.001; HRS: HR = 1.69, 95% CI = 1.38-2.08, P < 0.001; panzhihua cohort: HR = 3.74, 95% CI = 2.34-5.99, P < 0.001). Subgroup analyses further confirmed the robustness of the association between persistent high RIR and CMM across all examined subgroups.

Persistent high RIR was correlated with an increased risk of CMM. Future research is needed to determine whether anti-inflammatory strategies targeting RIR reduction could mitigate CMM risk.