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
Authors' conclusion
Prespecified 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.
Study context
- Population
- Middle-aged and older adults free of diabetes, heart disease and stroke at baseline, China and EnglandChinese 303 · English 255
- Participants
- 6,498 vs 2,455
- Exposure
- Per 1-SD increase and quartiles of CTI-waist circumference (CTI-WC) and CTI-waist-to-height ratio (CTI-WHtR)
- Chinesen = 6,498
- Englishn = 2,455
- Outcome
- Incident CMM: at least two of diabetes, heart disease and stroke during follow-up; death before CMM as competing event
- Follow-up
- Median 7.00 (China) and 9.58 (England) years
Methodological detailstwo cohorts (China and England), competing-risk (Fine-Gray) analysis
- Two cohorts (China and England)
- Competing-risk (Fine-Gray) analysis
Main finding
As reported in the abstract
Incident CMM (≥2 of diabetes, heart disease, stroke), death as competing event · median follow-up 7.00 and 9.58 years
Chinese
303
events
English
255
events
Subdistribution hazard ratio (95% CI)
CTI-WC, per 1-SD increase (Chinese cohort)
1.59(1.44–1.75)
CTI-WHtR, per 1-SD increase (Chinese cohort)
1.59(1.44–1.76)
CTI-WC, per 1-SD increment (English cohort)significant
1.18(1.03–1.35)
Each row per its own increment, as printed
Observational data: associations, not effects.
Further findings
Prediction of cardiometabolic multimorbidity (CMM), Chinese cohort · 7-year
- AUC CTI-WC (highest)
- 0.693
- AUC CTI-WHtR
- 0.692
- CTI-WC showed the largest reclassification improvement
Calibration and sensitivity analyses
- Supported model stability
Original publication
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. Cardiovasc Diabetol. Published 10 June 2026. doi:10.
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