C-reactive protein–triglyceride–glucose index and advanced cardiovascular-kidney-metabolic syndrome in middle-aged and older adults: A cross-population study
Ming Wu, Qing Zhou, Wenwu Zhou, Xiaolong Ma, Anxing Hou, Fei Chen, Cong Nie, Jiahao PanBackground
Cardiovascular–kidney–metabolic (CKM) syndrome integrates metabolic risk, kidney dysfunction and cardiovascular disease. The C-reactive protein–triglyceride–glucose index (CTI) combines inflammatory, lipid and glycaemic measures, but its association with advanced CKM across populations remains unclear.
Methods
Cross-sectional analyses included adults aged ≥45 years from NHANES 2001–2010 and the 2011 and 2015 CHARLS waves. NHANES included 6290 participants from five consecutive two-year cycles with positive fasting-subsample weights. CHARLS included 19,347 observations from 13,867 participants; models adjusted for survey wave, with standard errors clustered by participant. CTI was examined continuously, per cohort-specific SD, by quartiles and with three-knot restricted cubic splines. Analyses included core and expanded models, sensitivity analyses and comparisons of concurrent discrimination.
Results
Core-model odds ratios per one-unit higher CTI were 1.76 (95% CI, 1.57–1.98) in NHANES and 2.90 (2.72–3.10) in CHARLS, attenuating to 1.50 (1.30–1.72) and 1.37 (1.26–1.49), respectively, after expanded adjustment. Sensitivity estimates remained positive. Overall spline associations were significant; non-linearity was absent in NHANES (P = 0.384) but present in CHARLS (P = 0.0039).
Conclusions
Higher CTI was cross-sectionally associated with prevalent advanced CKM. Shared measurement domains and contemporaneous assessment limit causal and prospective interpretation, and the clinical value of CTI remains uncertain.