Association of the C-reactive protein–triglyceride glucose index with self-reported stroke among U.S. adults: a cross-sectional analysis of the National Health and Nutrition Examination Survey
- 1The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China.
Abstract
Systemic inflammation and insulin resistance are implicated in the pathophysiology of stroke. The C-reactive protein–triglyceride glucose index (CTI) integrates inflammatory and metabolic information, but its association with self-reported stroke in a representative U.S. population remains uncertain. We examined the association between CTI and self-reported stroke and explored potential nonlinear patterns. This cross-sectional analysis used National Health And Nutrition Examination Survey data from 2005 to 2010 and included 6053 adults aged 20 years or older. CTI was calculated as 0.412 × Ln(CRP [mg/L]) + Ln(TG [mg/dL] × FPG [mg/dL]/2). Stroke was defined by self-reported physician diagnosis. Survey-weighted multivariable logistic regression, restricted cubic spline analysis, and subgroup analyses were performed. Multiple imputation and sensitivity analyses excluding participants with coexisting cardiovascular disease were conducted to assess robustness. In Model 3, continuous CTI was not significantly associated with self-reported stroke (odds ratio [OR] = 1.17; 95% confidence interval [CI]: 0.93–1.48; P = .200). Multiple imputation yielded consistent results (OR = 1.28; 95% CI: 0.94–1.74; P = .125). After excluding 496 participants with coexisting cardiovascular disease, the association remained nonsignificant (OR = 1.30; 95% CI: 0.90–1.86; P = .155; P for trend = .723). Evidence of nonlinearity was observed in the unadjusted model (P for nonlinearity = .0172) but not after covariate adjustment (Model 2, P = .3420; Model 3, P = .6407). Significant interactions were observed for age, marital status, body mass index, and diabetes status (P for interaction = .002, .025, .001, and .001, respectively). The nonlinear pattern observed in the unadjusted analysis was attenuated after covariate adjustment, and the fully adjusted linear association was not statistically significant. These cross-sectional findings are hypothesis-generating and require confirmation in prospective studies with clinically adjudicated stroke outcomes.
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BibTeX
@article{gong2026association,
title = {{Association of the C-reactive protein–triglyceride glucose index with self-reported stroke among U.S. adults: a cross-sectional analysis of the National Health and Nutrition Examination Survey}},
author = {Can Gong and Shali Jiang and Yixiang Lian},
journal = {Medicine},
year = {2026},
month = oct,
doi = {10.1097/md.0000000000051315},
url = {https://europepmc.org/article/PMC/PMC13727170},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Association of the C-reactive protein–triglyceride glucose index with self-reported stroke among U.S. adults: a cross-sectional analysis of the National Health and Nutrition Examination Survey
AU - Can Gong
AU - Shali Jiang
AU - Yixiang Lian
PY - 2026
DA - 2026/10/30
JO - Medicine
DO - 10.1097/md.0000000000051315
UR - https://europepmc.org/article/PMC/PMC13727170
AB - Systemic inflammation and insulin resistance are implicated in the pathophysiology of stroke. The C-reactive protein–triglyceride glucose index (CTI) integrates inflammatory and metabolic information, but its association with self-reported stroke in a representative U.S. population remains uncertain. We examined the association between CTI and self-reported stroke and explored potential nonlinear patterns. This cross-sectional analysis used National Health And Nutrition Examination Survey data from 2005 to 2010 and included 6053 adults aged 20 years or older. CTI was calculated as 0.412 × Ln(CRP [mg/L]) + Ln(TG [mg/dL] × FPG [mg/dL]/2). Stroke was defined by self-reported physician diagnosis. Survey-weighted multivariable logistic regression, restricted cubic spline analysis, and subgroup analyses were performed. Multiple imputation and sensitivity analyses excluding participants with coexisting cardiovascular disease were conducted to assess robustness. In Model 3, continuous CTI was not significantly associated with self-reported stroke (odds ratio [OR] = 1.17; 95% confidence interval [CI]: 0.93–1.48; P = .200). Multiple imputation yielded consistent results (OR = 1.28; 95% CI: 0.94–1.74; P = .125). After excluding 496 participants with coexisting cardiovascular disease, the association remained nonsignificant (OR = 1.30; 95% CI: 0.90–1.86; P = .155; P for trend = .723). Evidence of nonlinearity was observed in the unadjusted model (P for nonlinearity = .0172) but not after covariate adjustment (Model 2, P = .3420; Model 3, P = .6407). Significant interactions were observed for age, marital status, body mass index, and diabetes status (P for interaction = .002, .025, .001, and .001, respectively). The nonlinear pattern observed in the unadjusted analysis was attenuated after covariate adjustment, and the fully adjusted linear association was not statistically significant. These cross-sectional findings are hypothesis-generating and require confirmation in prospective studies with clinically adjudicated stroke outcomes.
SN - 0304-5412
SN - 1536-5964
SN - 0025-7974
ER -