Lipids & metabolic liver disease
Association of the C-reactive protein–triglyceride–glucose index with metabolic dysfunction-associated steatotic liver disease and long-term all-cause and cardiovascular mortality: evidence from two nationwide prospective cohort studies
Authors' conclusion
CTI is a robust metabolic-inflammatory marker associated with MASLD and long-term all-cause and cardiovascular mortality across diverse populations. The strong mediating role of diabetes underscores the central importance of glycaemic dysfunction in cardiometabolic risk. As a readily obtainable index, CTI may aid in cardiometabolic risk stratification among individuals with MASLD.
Study context
- Population
- Participants of National Health and Nutrition Examination Survey (NHANES) (US) and China Health and Retirement Longitudinal Study (CHARLS) (China); mortality analyses among participants with MASLD
- Exposure
- Higher vs lower CTI
- Outcome
- Cardiovascular and all-cause mortality among participants with MASLD
Methodological detailstwo nationally representative cohorts (US and China), multi-stage investigation, external validation in CHARLS, causal mediation analyses, sensitivity analyses
- Two nationally representative cohorts (US and China)
- Multi-stage investigation
- External validation in CHARLS
- Causal mediation analyses
- Sensitivity analyses
Main finding
As reported in the abstract
Cardiovascular death, HR per unit CTI
1.57
95% CI 1.24–1.99
All-cause death, HR per unit CTI
1.47
95% CI 1.28–1.69
Threshold effect: mortality risk rising sharply once CTI exceeded approximately
5.6
Observational data: associations, not effects.
Further findings
CTI and presence of MASLD (cross-sectional)
- Higher CTI strongly and nonlinearly associated with MASLD in both cohorts
Mediation of CTI–mortality association
- Diabetes accounted for a substantial proportion; BMI played a minimal mediating role
Original publication
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