Link between C-reactive protein-triglyceride glucose index and cardiovascular disease risk in diverse glycemic statuses: a nationwide prospective cohort study.
6 affiliations
- 1Department of Internal Medicine, Zengcheng Campus, Nanfang Hospital, Southern Medical University, Guangzhou, 511340, China.
- 2Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
- 3Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
- 4Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China. [email protected].
- 5Department of Cardiology, Xiangdong Hospital Affiliated with Hunan Normal University, Liling, 412200, China. [email protected].
- 6Department of Cardiology, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Cardiac Function and Microcirculation, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China. [email protected].
Abstract
Objective
The C-reactive protein-triglyceride-glucose index (CTI) is a novel biomarker that integrates measures of insulin resistance and inflammation. Its association with cardiovascular disease (CVD) risk across various glycemic statuses remains unclear.Methods
This prospective study included 7,584 middle-aged and elderly participants from the China Health and Retirement Longitudinal Study (CHARLS). CTI was calculated using the formula 0.412*Ln(CRP) + Ln(TG × FPG)/2. Cox proportional hazards models and restricted cubic splines were employed to evaluate the relationship between CTI and CVD risk, with subgroup analyses conducted based on gender, age, and glycemic status.Results
Over a median follow-up period of 108.1 months, 1,989 participants (26.23%) developed CVD. The incidence of CVD increased significantly across ascending CTI quartiles (Q1: 20.78% to Q4: 31.65%). A positive linear association was observed that remained consistent across both genders and age groups. Higher CTI quartiles (Q3/Q4) were associated with a significantly elevated risk of CVD, particularly among males (hazard ratio [HR] up to 1.58) and middle-aged individuals (HR 1.57). Notably, an elevated CTI was linked to an increased risk of CVD in participants with normal glucose regulation but not in those classified as prediabetic or diabetic.Conclusions
The CTI serves as an independent predictor of CVD risk within the general middle-aged and elderly population. This association is most pronounced in individuals exhibiting normal glucose regulation, underscoring the potential utility of CTI for early risk stratification as well as the necessity for tailored prevention strategies informed by glycemic status.
Related
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- Associations of the Baseline Level and Change in Triglyceride Glucose-Body Roundness Index With Cardiovascular Diseases: Two Large Prospective Cohorts in Europe and Asia.
- Association of the C-reactive protein–triglyceride–glucose index with adverse cardiovascular outcomes in patients with acute coronary syndrome and type 2 diabetes: findings from an observational cohort study in China
BibTeX
@article{wang2026link,
title = {{Link between C-reactive protein-triglyceride glucose index and cardiovascular disease risk in diverse glycemic statuses: a nationwide prospective cohort study.}},
author = {Li Wang and Shan Peng and Yayan Zhang and Dongyue Huang and Ting Guo and Jia Qin and Jiaqi Chen and Mingming Li and Muyan Chen and Xue Li and Kai Cui and Xiaojin Li and Xiaobo Li and Shifeng Qiu},
journal = {BMC cardiovascular disorders},
year = {2026},
month = jul,
doi = {10.1186/s12872-026-06280-z},
url = {https://europepmc.org/article/MED/42902131},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Link between C-reactive protein-triglyceride glucose index and cardiovascular disease risk in diverse glycemic statuses: a nationwide prospective cohort study.
AU - Li Wang
AU - Shan Peng
AU - Yayan Zhang
AU - Dongyue Huang
AU - Ting Guo
AU - Jia Qin
AU - Jiaqi Chen
AU - Mingming Li
AU - Muyan Chen
AU - Xue Li
AU - Kai Cui
AU - Xiaojin Li
AU - Xiaobo Li
AU - Shifeng Qiu
PY - 2026
DA - 2026/07/01
JO - BMC cardiovascular disorders
DO - 10.1186/s12872-026-06280-z
UR - https://europepmc.org/article/MED/42902131
AB - Objective The C-reactive protein-triglyceride-glucose index (CTI) is a novel biomarker that integrates measures of insulin resistance and inflammation. Its association with cardiovascular disease (CVD) risk across various glycemic statuses remains unclear.Methods This prospective study included 7,584 middle-aged and elderly participants from the China Health and Retirement Longitudinal Study (CHARLS). CTI was calculated using the formula 0.412*Ln(CRP) + Ln(TG × FPG)/2. Cox proportional hazards models and restricted cubic splines were employed to evaluate the relationship between CTI and CVD risk, with subgroup analyses conducted based on gender, age, and glycemic status.Results Over a median follow-up period of 108.1 months, 1,989 participants (26.23%) developed CVD. The incidence of CVD increased significantly across ascending CTI quartiles (Q1: 20.78% to Q4: 31.65%). A positive linear association was observed that remained consistent across both genders and age groups. Higher CTI quartiles (Q3/Q4) were associated with a significantly elevated risk of CVD, particularly among males (hazard ratio [HR] up to 1.58) and middle-aged individuals (HR 1.57). Notably, an elevated CTI was linked to an increased risk of CVD in participants with normal glucose regulation but not in those classified as prediabetic or diabetic.Conclusions The CTI serves as an independent predictor of CVD risk within the general middle-aged and elderly population. This association is most pronounced in individuals exhibiting normal glucose regulation, underscoring the potential utility of CTI for early risk stratification as well as the necessity for tailored prevention strategies informed by glycemic status.
SN - 1471-2261
ER -