Evidence map›Paper›PMID 42271373›Full record

ArticleCardiovascular diabetology2026

Association of the C-reactive protein-triglyceride-glucose (CTI) index and its central obesity-modified derivatives with incident cardiometabolic multimorbidity: results from two prospective cohorts in China and England.

Chuhui Yue, Xinyu Wang, Yaona Li, Sujun Yuan, Zhu Wang, Hongli Liu, Huiyu Yang

Abstract read
In one paragraph

Article in Cardiovascular diabetology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Chuhui YueDepartment of Cardiology, The Second Hospital of Shanxi Medical University (Affiliated Hospital of Shanxi Medical University), Taiyuan, 030001, Shanxi Province, China.
Xinyu WangDepartment of Cardiology, The Second Hospital of Shanxi Medical University (Affiliated Hospital of Shanxi Medical University), Taiyuan, 030001, Shanxi Province, China.
Yaona LiDepartment of Cardiology, The First Hospital of Shanxi Medical University (Affiliated Hospital of Shanxi Medical University), Taiyuan, 030001, Shanxi Province, China.
Sujun YuanDepartment of Cardiology, The Second Hospital of Shanxi Medical University (Affiliated Hospital of Shanxi Medical University), Taiyuan, 030001, Shanxi Province, China.
Zhu WangDepartment of Cardiology, The Second Hospital of Shanxi Medical University (Affiliated Hospital of Shanxi Medical University), Taiyuan, 030001, Shanxi Province, China.
Hongli LiuDepartment of Cardiology, The Second Hospital of Shanxi Medical University (Affiliated Hospital of Shanxi Medical University), Taiyuan, 030001, Shanxi Province, China.
Huiyu YangDepartment of Cardiology, The Second Hospital of Shanxi Medical University (Affiliated Hospital of Shanxi Medical University), Taiyuan, 030001, Shanxi Province, China. yanghuiyu2010@126.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCentral obesity exacerbates cardiometabolic multimorbidity (CMM) susceptibility through insulin resistance and inflammation. We investigated the longitudinal association of C-reactive protein-triglyceride-glucose (CTI)-related indices-which integrate these mechanisms with abdominal obesity measurements-with incident CMM in middle-aged and older adults.

methodsThis study included 6,498 participants from the China Health and Retirement Longitudinal Study and 2,455 from the English Longitudinal Study of Ageing, all free of diabetes, heart disease, and stroke at baseline. Incident CMM was defined as the occurrence of at least two of these diseases during follow-up. CTI-waist circumference (CTI-WC) and CTI-waist-to-height ratio (CTI-WHtR) were prespecified as principal exposures, with CTI, triglyceride-glucose index (TyG), and corresponding obesity-related derivatives as comparators. Death before CMM was treated as a competing event. Associations and prediction were assessed using Fine-Gray models, cumulative incidence functions, restricted cubic splines, time-dependent area under the curve, C-statistic, net reclassification improvement, integrated discrimination improvement, and calibration metrics.

resultsDuring median follow-up periods of 7.00 and 9.58 years, 303 and 255 participants developed incident CMM in the Chinese and English cohorts, respectively. In the Chinese cohort, each 1-standard deviation increase in CTI-WC and CTI-WHtR was associated with higher CMM risk (CTI-WC: subdistribution HR = 1.59, 95% CI 1.44-1.75; CTI-WHtR: subdistribution HR = 1.59, 95% CI 1.44-1.76), and the highest quartile had approximately fourfold higher risk than the lowest quartile. In the English cohort, associations were weaker but directionally consistent, with CTI-WC remaining significant per 1-standard deviation increment (1.18, 1.03-1.35). In the Chinese cohort, CTI-WC and CTI-WHtR yielded the highest 7-year area under the curve values (0.693 and 0.692), and CTI-WC showed the largest reclassification improvement. Calibration and sensitivity analyses supported model stability.

conclusionsPrespecified CTI-WC and CTI-WHtR were associated with incident CMM after accounting for competing mortality. Integrating inflammatory-metabolic burden with central adiposity may improve CMM risk stratification, especially in the Chinese cohort.

Indexed as

Blood GlucoseCardiovascular DiseasesC-Reactive ProteinObesity, AbdominalTriglyceridesAgedBiomarkersCardiometabolic Risk FactorsChinaEnglandFemaleHumansIncidenceMaleMiddle AgedMultimorbidityBiomarkersBlood GlucoseC-Reactive ProteinTriglyceridesAbdominal obesityCardiometabolic multimorbidityCHARLSCTI-related indicesELSA

Identifiers

PMID42271373
PMCPMC13479450

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.