Diabetes research and clinical practice · 2026
The association between the C-reactive protein-triglyceride-glucose index and all-cause and cardiovascular mortality in patients with diabetic foot: A retrospective cohort study.
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Cui Xuecan, Zheng Liran, Ding Min, Chang Bai, Zhang Chunmei, Ma Hairong, Xu Wenyan, Wang Shuai, Wang Meijun
Аннотация
AIMS: The C-reactive protein-triglyceride-glucose index (CTI) is a novel biomarker of insulin resistance and inflammation. This study aimed to investigate the association between baseline CTI and all-cause and cardiovascular (CVD) mortality in patients with diabetic foot (DF), providing a scientific basis for clarifying this relationship in clinical practice.
METHODS: A total of 827 inpatients meeting inclusion criteria were enrolled from a tertiary hospital DF department in Tianjin (2020-2021), with median follow-up of 47 months. Outcomes included all-cause and CVD mortality. Multivariable Cox regression, restricted cubic splines (RCS), Kaplan-Meier analysis, and ROC curves were used to evaluate associations and predictive performance.
RESULTS: During follow-up, 325 all-cause deaths occurred, including 158 CVD deaths. Fully adjusted models showed that high CTI was associated with 57% higher all-cause mortality (HR = 1.57, 95% CI:1.24-2.00) and 50% higher CVD mortality (HR = 1.50, 95% CI:1.06-2.11). RCS indicated nonlinear associations (P < 0.05), and ROC supported CTI's predictive accuracy for mortality.
CONCLUSIONS: A higher CTI level was independently associated with an increased risk of all-cause and cardiovascular mortality in patients with diabetic foot. The CTI may serve as a promising and easily accessible risk stratification tool, though its clinical utility requires validation in prospective studies.
METHODS: A total of 827 inpatients meeting inclusion criteria were enrolled from a tertiary hospital DF department in Tianjin (2020-2021), with median follow-up of 47 months. Outcomes included all-cause and CVD mortality. Multivariable Cox regression, restricted cubic splines (RCS), Kaplan-Meier analysis, and ROC curves were used to evaluate associations and predictive performance.
RESULTS: During follow-up, 325 all-cause deaths occurred, including 158 CVD deaths. Fully adjusted models showed that high CTI was associated with 57% higher all-cause mortality (HR = 1.57, 95% CI:1.24-2.00) and 50% higher CVD mortality (HR = 1.50, 95% CI:1.06-2.11). RCS indicated nonlinear associations (P < 0.05), and ROC supported CTI's predictive accuracy for mortality.
CONCLUSIONS: A higher CTI level was independently associated with an increased risk of all-cause and cardiovascular mortality in patients with diabetic foot. The CTI may serve as a promising and easily accessible risk stratification tool, though its clinical utility requires validation in prospective studies.