Joint association of high-sensitivity C-reactive protein and cumulative atherogenic index of plasma with cardiovascular disease risk in CKM syndrome stages 0-3: a prospective cohort study.

BACKGROUND

Although high-sensitivity C-reactive protein (hs-CRP) and cumulative atherogenic index of plasma (CumAIP) are recognized risk markers for cardiovascular disease (CVD), their association with CVD incidence-and specifically their combined effect-in individuals with Cardiovascular-Kidney-Metabolic (CKM) syndrome is far less understood.

METHODS

This study analyzed 3,028 participants at CKM stages 0-3 from the China Health and Retirement Longitudinal Study. Kaplan‑Meier survival curves and Cox proportional hazards models were used to investigate the associations of CumAIP and hs-CRP levels with the risk of CVD in this population, as well as to evaluate their combined effect on CVD incidence.

RESULTS

During the 5-year follow-up period (2015-2020), 495 participants developed CVD. Both hs-CRP and CumAIP were associated with CVD risk. After progressively adjusting for all covariates, compared with the low-hs-CRP group, the high-hs-CRP group exhibited a 36.6% increased risk of CVD (HR = 1.366, 95%CI: 1.133 ~ 1.648); compared with the low-CumAIP group, the high-CumAIP group showed a 40.8% increased risk (HR = 1.408, 95%CI: 1.158 ~ 1.711). The combination of high hs-CRP and high CumAIP was associated with a higher risk of developing CVD. Compared to individuals with both low hs-CRP and low CumAIP, those with high levels of both biomarkers had a 1.834-fold higher risk (95%CI: 1.408-2.389). Subgroup analysis indicated that the combined association of hs-CRP and CumAIP was more pronounced in males.

CONCLUSION

This study suggests that elevated hs-CRP and CumAIP are jointly associated with CVD incidence, and their combination exhibits a joint effect among middle-aged and older adults with stage 0-3 CKM syndrome.