C-Reactive Protein-Triglyceride-Glucose Index, Inflammatory-Metabolic Burden, and Prevalent Stroke in U.S. Adults: NHANES 1999-2010
- 1Fengyang People's hospital
Abstract
BackgroundThe C-reactive protein-triglyceride-glucose index (CTI) integrates inflammatory and metabolic markers, but recent studies have already linked CTI to stroke and cardiovascular outcomes. Whether CTI provides information beyond established risk factors in the U.S. general population remains uncertain.
MethodsWe analyzed 11,809 adults from NHANES 1999-2010 with fasting laboratory, stroke, covariate, and survey-design data. Stroke was defined by self-reported physician diagnosis. Survey-weighted logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). We evaluated restricted cubic splines, exploratory subgroup interactions, and sensitivity to excluding CRP >10 mg/L. CTI was compared with TyG and its component biomarkers, and incremental value was quantified using weighted C-statistics, integrated discrimination improvement, and continuous net reclassification improvement.
ResultsAmong 11,809 participants, 411 reported stroke. CTI was associated with prevalent stroke before cardiometabolic adjustment (unadjusted OR = 2.05, 95% CI: 1.74-2.42; demographically adjusted OR = 1.57, 95% CI: 1.31-1.89; both P < 0.001), but the fully adjusted association was attenuated (OR = 1.22, 95% CI: 0.98-1.53; P = 0.080). There was no evidence of non-linearity, and subgroup interaction tests, including the CTI-by-age interaction, were not statistically significant. Adding CTI to traditional covariates minimally changed discrimination (weighted C-statistic, 0.846 to 0.847).
ConclusionsCTI reflects an inflammatory-metabolic burden phenotype, but its association with prevalent stroke was largely accounted for by traditional risk factors, and it provided negligible incremental discrimination in this cross-sectional analysis.
Related
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- 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
- Association Between C-Reactive Protein-Triglyceride Glucose Index and All-Cause Mortality and Exacerbation in Adult Asthma: NHANES, 1999-2010 and 2015-2018.
BibTeX
@misc{deng2026creactive,
title = {{C-Reactive Protein-Triglyceride-Glucose Index, Inflammatory-Metabolic Burden, and Prevalent Stroke in U.S. Adults: NHANES 1999-2010}},
author = {Q. Deng and Z. Yin},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.07.26362446},
url = {https://www.medrxiv.org/content/10.64898/2026.09.07.26362446v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - C-Reactive Protein-Triglyceride-Glucose Index, Inflammatory-Metabolic Burden, and Prevalent Stroke in U.S. Adults: NHANES 1999-2010
AU - Q. Deng
AU - Z. Yin
PY - 2026
DA - 2026/09/07
PB - medRxiv
DO - 10.64898/2026.09.07.26362446
UR - https://www.medrxiv.org/content/10.64898/2026.09.07.26362446v1
AB - BackgroundThe C-reactive protein-triglyceride-glucose index (CTI) integrates inflammatory and metabolic markers, but recent studies have already linked CTI to stroke and cardiovascular outcomes. Whether CTI provides information beyond established risk factors in the U.S. general population remains uncertain. MethodsWe analyzed 11,809 adults from NHANES 1999-2010 with fasting laboratory, stroke, covariate, and survey-design data. Stroke was defined by self-reported physician diagnosis. Survey-weighted logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). We evaluated restricted cubic splines, exploratory subgroup interactions, and sensitivity to excluding CRP >10 mg/L. CTI was compared with TyG and its component biomarkers, and incremental value was quantified using weighted C-statistics, integrated discrimination improvement, and continuous net reclassification improvement. ResultsAmong 11,809 participants, 411 reported stroke. CTI was associated with prevalent stroke before cardiometabolic adjustment (unadjusted OR = 2.05, 95% CI: 1.74-2.42; demographically adjusted OR = 1.57, 95% CI: 1.31-1.89; both P < 0.001), but the fully adjusted association was attenuated (OR = 1.22, 95% CI: 0.98-1.53; P = 0.080). There was no evidence of non-linearity, and subgroup interaction tests, including the CTI-by-age interaction, were not statistically significant. Adding CTI to traditional covariates minimally changed discrimination (weighted C-statistic, 0.846 to 0.847). ConclusionsCTI reflects an inflammatory-metabolic burden phenotype, but its association with prevalent stroke was largely accounted for by traditional risk factors, and it provided negligible incremental discrimination in this cross-sectional analysis.
ER -