Related Experiment Videos
Association between the C-reactive protein-triglyceride-glucose index and coronary heart disease in metabolic
Kaiyue Shen1, Jiajia Zhao1, Kunkun Li1
1Department of Gastroenterology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China.
Insights
The C-reactive protein-triglyceride-glucose index (CTI) effectively identifies coronary heart disease (CHD) risk in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). A developed nomogram aids in assessing individual CHD risk and guiding further cardiovascular evaluation.
Area of Science:
- Cardiology
- Hepatology
- Biomarkers
Background:
- Metabolic dysfunction-associated steatotic liver disease (MASLD) is linked to coronary heart disease (CHD), yet effective biomarkers for CHD risk stratification in MASLD patients are limited.
- The C-reactive protein-triglyceride-glucose index (CTI) integrates systemic inflammation and insulin resistance markers, showing potential for cardiovascular risk assessment.
Purpose of the Study:
- To investigate the association between the CTI and the presence and severity of CHD in patients diagnosed with MASLD.
- To develop a predictive nomogram for individualized CHD risk assessment in MASLD patients using CTI and other clinical factors.
Main Methods:
- A cohort of 611 MASLD patients undergoing coronary angiography was analyzed.
- Logistic regression, subgroup analyses, and restricted cubic spline (RCS) analyses were employed to assess CTI's association with CHD and lesion severity.
- A nomogram was constructed using LASSO and multivariable logistic regression, and its discriminative performance was validated.
Main Results:
- CTI was independently associated with CHD presence (OR 2.48) and correlated with coronary stenosis severity in MASLD patients.
- CTI demonstrated superior discriminative ability for CHD compared to other insulin resistance indices.
- The final nomogram, incorporating CTI and other predictors, achieved an AUC of 0.845 for CHD discrimination.
Conclusions:
- Elevated CTI levels are significantly associated with both the presence and severity of CHD in patients with MASLD.
- The developed nomogram offers a valuable tool for identifying MASLD patients who may benefit from intensified cardiovascular risk management and further evaluation.
Background:
Metabolic dysfunction-associated steatotic liver disease (MASLD) is strongly associated with coronary heart disease (CHD), but convenient and effective biomarkers for identifying CHD risk in patients with MASLD remain limited. The C-reactive protein-triglyceride-glucose index (CTI) reflects both systemic inflammation and insulin resistance, and may add value to cardiovascular risk stratification. This study examined the association of CTI with the presence and severity of CHD in patients with MASLD and developed a nomogram for individualized CHD assessment.
Methods:
This study included 611 patients with MASLD who underwent coronary angiography. Participants were classified according to coronary angiography findings. Logistic regression was first performed to assess the association between CTI and CHD, followed by subgroup and restricted cubic spline (RCS) analyses. Among patients with CHD, the association between CTI and coronary lesion severity was assessed. Receiver operating characteristic (ROC) analysis and DeLong's test were applied to compare the discriminative performance of CTI with other simple insulin resistance-related indices. Independent predictors of CHD were identified using the least absolute shrinkage and selection operator (LASSO) regression and multivariable logistic regression, and a nomogram model was subsequently established and internally validated.
Results:
Among the 611 patients with MASLD, 387 (63.3%) had CHD. CTI was independently associated with odds of CHD (OR 2.48, 95% CI 1.69-3.63, P < 0.001) and higher CTI levels corresponded to greater coronary stenosis severity. The association between CTI and CHD was generally stable across common subgroups, but it was stronger in patients aged ≥55 years. CTI showed significantly better discriminative ability for CHD than other simple indices of insulin resistance. Smoking status, age, neutrophils (NEUT), non-high-density lipoprotein cholesterol (non-HDL-C), serum albumin (ALB), CTI, and subclinical carotid atherosclerosis (SCAS) were included in the final nomogram. The AUC was 0.845 (95% CI 0.815-0.876), indicating good discrimination for CHD.
Conclusions:
Higher CTI was associated with CHD presence and greater coronary lesion burden among MASLD patients. The nomogram may help identify patients who warrant further cardiovascular evaluation.
Related Concept Videos
01:30Coronary Artery Disease I: Introduction
01:25Blood Studies for Cardiovascular System III: Serum Lipid Profile
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
01:24Overview of Lipid Metabolism
Lipolysis: The Breakdown of Lipids:
Lipolysis is the process of breaking down lipids, particularly triglycerides, into glycerol and fatty acids. This process typically occurs in the adipose tissue and is triggered by various hormones, including glucagon and...