The association between the C-reactive protein-triglyceride-glucose index and cardiovascular diseases: A cohort study using data from the China Health and Retirement Longitudinal Study 2011–2020

Abstract

Background Inflammation and insulin resistance (IR) are both risk factors for cardiovascular disease (CVD). The C-reactive protein-triglyceride-glucose index (CTI) is a novel biomarker that comprehensively assesses the severity of inflammation and IR. This study investigates the association between CTI and the risk of CVD. Methods Data from the China Health and Retirement Longitudinal Study (CHARLS) conducted between 2011 and 2020 were utilized, focusing on individuals aged 45 years and older. The CTI was calculated as 0.412 × Ln (C-reactive protein [CRP, mg/L]) + Ln (triglycerides [TG, mg/dL] × fasting blood glucose [FBG, mg/dL]/ 2). Self-reported CVD events were used as the primary outcome measure. Multivariable Cox regression, restricted cubic splines (RCS) analysis, and subgroup analyses were performed to examine the association between CTI and CVD risk. Results This study included 5,642 participants, with a CVD incidence rate of 23.70% (1,337 cases). After adjusting for covariates, each unit increase in the CTI was associated with an 11% increase in the risk of CVD (hazard ratio (HR) = 1.11, 95% confidence interval (CI) = 1.01–1.23). Similar results were observed when CTI was analyzed as a categorical variable (quartiles). RCS analyses revealed a nonlinear relationship between CTI and CVD risk. Subgroup analysis revealed no significant associations in certain subgroups, suggesting that the effect of the association may be heterogeneous. Conclusion Higher CTI (whether treated as a continuous or categorical variable) was significantly associated with an increased risk of CVD. A nonlinear relationship between CTI and CVD risk was observed.