C-reactive protein–triglyceride glucose index predicts mortality in cardiovascular-kidney-metabolic syndrome stage 0–3: a prospective cohort study
Qianliang Ying, Fan He, Lei Wu, Qucheng Wei, Jian Xu
Abstract
BACKGROUND: Cardiovascular-kidney-metabolic (CKM) syndrome is defined by the interplay of metabolic risk factors, chronic kidney disease, and cardiovascular disease. The C-reactive protein-triglyceride glucose index (CTI) is a composite biomarker that reflects both inflammation and insulin resistance, but whether it is associated with mortality in persons with early-stage CKM syndrome is unknown. METHODS: We analyzed data from the National Health and Nutrition Examination Survey from 1999 to 2010. We used multivariable Cox proportional-hazards models to assess the association between the CTI score and the risk of all-cause mortality and cardiovascular disease (CVD) mortality, with vital status ascertained through Linkage to the National Death Index through December 31, 2019. RESULTS: Among 10,718 participants, a total of 1783 deaths (491 from CVD) occurred during a mean follow-up of 14.0 years. In fully adjusted models, a higher CTI score was associated with a greater risk of all-cause mortality (HR per unit increase, 1.56; 95% CI, 1.36 to 1.78) and of CVD mortality (HR per unit increase, 2.03; 95% CI, 1.49 to 2.77). The association with all-cause mortality was stronger among participants under the age of 60 than among those over 60 years old (P < 0.001 for interaction). CONCLUSION: Our study found that in patients with early-stage CKM syndrome, a higher CTI was independently associated with an increased risk of all-cause mortality and CVD mortality. This association was more significant in younger participants.