ArticleBMC cardiovascular disorders2026
The triglyceride-glucose index and C-reactive protein-triglyceride-glucose index as surrogate markers of vascular stiffness in prediabetes: a cross-sectional study.
Article in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPrediabetes accelerates arterial stiffening, yet the optimal metabolic biomarker for vascular assessment remains undetermined. This study investigated the associations of the homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride-glucose (TyG) index, and C-reactive protein-triglyceride-glucose index (CTI) with arterial stiffness in a prediabetic population.
methodsThis cross-sectional study enrolled 2,008 prediabetic adults. Arterial stiffness was defined by brachial-ankle pulse wave velocity (baPWV). Multivariable logistic regression, restricted cubic spline (RCS) modeling, and ROC curve analyses were employed to evaluate and compare the discriminatory performance of HOMA-IR, TyG, and CTI.
resultsAll three indices were independently associated with arterial stiffness. Fully adjusted odds ratios (ORs) per one-unit increment were 1.12 (1.04-1.21) for HOMA-IR, 1.49 (1.24-1.80) for TyG, and 1.52 (1.25-1.85) for CTI. Comparing the highest to the lowest quartiles, the ORs for arterial stiffness were 1.84 ( 1.31-2.59) for HOMA-IR, 2.02 (1.44-2.82) for TyG, and 1.72 (1.23-2.39) for CTI, respectively. RCS analysis revealed a nonlinear relationship for HOMA-IR, whereas TyG and CTI exhibited linear dose-response patterns. ROC analyses based on adjusted prediction models showed that CTI had the numerically highest discriminatory performance (AUC = 0.790), followed closely by TyG (AUC = 0.784), whereas HOMA-IR showed lower discrimination (AUC = 0.737). Pairwise DeLong tests showed that CTI provided a modest but statistically significant improvement over TyG (P = 0.041), while both CTI and TyG significantly outperformed HOMA-IR (both P < 0.001). Findings remained robust across subgroup and sensitivity analyses.
conclusionsHOMA-IR, TyG, and CTI are independent risk indicators for arterial stiffness in prediabetes. Notably, TyG and CTI exhibit stronger associations and superior discriminatory utility compared to HOMA-IR. These simple, accessible metabolic indices-particularly TyG and CTI-serve as robust practical surrogate markers for identifying prevalent arterial stiffness in individuals with prediabetes.
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