Association between C-reactive protein-triglyceride-glucose index and the risk of cardiovascular-kidney-metabolic syndrome progression: insights from the China Health and Retirement Longitudinal Study.

BACKGROUND AND AIM: This study aimed to investigate the association between the baseline and cumulative C-reactive protein-triglyceride-glucose index (CTI) with the progression of cardiovascular-kidney-metabolic (CKM) syndrome.

METHODS AND

RESULTS

Data were derived from 7280 participants in the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2020. Logistic regression models assessed the link between CTI and advanced CKM stages, while Cox proportional hazards models evaluated the association between baseline and cumulative CTI with incident major adverse cardiovascular events (MACEs). At baseline, individuals in the higher CTI quartiles (Q2-Q4) had significantly increased odds of being in advanced CKM stages compared to those in the lowest quartile (Q1) (P for trend <0.001). During a median follow-up of 9.0 years, 1322 participants (21.1%) across CKM Stages 0-3 experienced MACEs. Each one standard deviation (SD) increase in CTI was associated with a higher risk of MACEs [adjusted HR (95% CI): 1.113 (1.037, 1.195)]. Each one SD increase in cumulative CTI was also associated with a higher risk of MACEs [adjusted HR (95% CI): 1.030 (1.006, 1.054)]. CTI provides incremental prognostic value for MACEs beyond its individual components (C-reactive protein alone, triglyceride-glucose index alone, and their combination).

CONCLUSIONS

Elevated CTI was independently associated with more advanced stages of CKM syndrome and predicted a higher risk of cardiovascular events among individuals without pre-existing cardiovascular disease. These findings suggest that CTI may serve as a valuable biomarker for early risk stratification and targeted intervention in CKM management.