Association of C-reactive protein-triglyceride-glucose index with all-cause and cardiovascular mortality in postmenopausal women.

Introduction: Although the C-reactive protein-triglyceride-glucose index (CTI) is associated with various adverse outcomes, its relationship with mortality in postmenopausal women remains unclear. Material and methods: We analysed data on 5,582 postmenopausal women from the National Health and Nutrition Examination Survey 2001-2010, with mortality follow-up continuing until the end of 2019. C-reactive protein-triglyceride-glucose index was calculated as 0.412 × ln [C-reactive protein (mg/l)] + ln [triglycerides (mg/dl) × fasting plasma glucose (mg/dl))/2]. The Cox proportional hazards model assessed the risk of mortality across CTI levels. We assessed potential nonlinearity with spline analyses and conducted sensitivity analyses. Results: The mean age of participants was 65.1 ±11.2 years and a mean CTI of 4.2 ±0.6 recorded at baseline. Over a median follow-up of 141 months (~ 11.8 years), 1,846 (33.1%) deaths occurred, including 582 (10.4%) cardiovascular disease (CVD) deaths. An association was observed between increasing CTI values and greater mortality risk in this population. Non-linear analysis identified a CTI threshold at 4.16. Below this value, no significant association with all-cause mortality was found (hazard ratio - HR 0.87, 95% CI: 0.74-1.03); above it, each 1-unit CTI increase raised all-cause mortality risk by 68% (HR 1.68, 95% CI: 1.47-1.92; Conclusions: Elevated CTI remains independently associated with an increased risk of both all-cause and CVD mortality in postmenopausal women.