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The Evolving Role of High-Sensitivity C-Reactive Protein for Mortality Prediction Across the Spectrum of

Jing Li1,2,3,4, Shuohua Chen5, Xiaoli Zhang1,2,3

  • 1Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Diabetes, Obesity & Metabolism
|May 10, 2026
PubMed

Insights

High-sensitivity C-reactive protein (hsCRP) predicts mortality in cardiovascular-kidney-metabolic (CKM) syndrome, but its impact lessens as CKM stages advance. Stage-specific assessment is key for managing CKM syndrome risk.

Area of Science:

  • Cardiology
  • Nephrology
  • Metabolic Diseases
  • Biomarkers

Background:

  • High-sensitivity C-reactive protein (hsCRP) is a key inflammatory marker in cardiovascular-kidney-metabolic (CKM) syndrome.
  • The prognostic significance of hsCRP across different stages of CKM syndrome requires further elucidation.

Purpose of the Study:

  • To investigate the association between hsCRP levels and all-cause mortality across progressive stages of CKM syndrome.
  • To determine if the prognostic value of hsCRP varies depending on the severity of CKM syndrome.

Main Methods:

  • Prospective analysis of 86,829 participants from the Kailuan Study.
  • Stratification of participants by American Heart Association-defined CKM stages (0-4).
  • Multivariable Cox models used to assess hazard ratios for mortality based on ln(hsCRP) and dichotomized hsCRP levels.

Main Results:

  • A significant association between hsCRP and higher mortality was observed across all CKM stages.
  • The strength of this association progressively attenuated with advancing CKM stages (p for interaction < 0.001).
  • Early CKM stages showed steeper mortality risk curves associated with hsCRP, which plateaued in later stages.

Conclusions:

  • The predictive value of hsCRP for mortality decreases as CKM syndrome progresses.
  • Early CKM stages appear more driven by inflammation, while later stages involve complex multiorgan dysfunction.
  • Stage-specific risk assessment integrating hsCRP is recommended for CKM syndrome management.
Abstract

Keywords:
cardiovascular–kidney–metabolic syndromecohorthigh‐sensitivity C‐reactive proteinmortality

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