Lipids & metabolic liver disease
Associations of the combined C-reactive protein-triglyceride glucose index and frailty index in different dimensions with incident stroke among individuals with stages 0–3 cardiovascular-kidney-metabolic syndrome
Authors' conclusion
Persistently high CTI-FI is associated with increased stroke risk. CTI-FI, especially cuCTI-FI and traCTI-FI, are potent predictors of stroke. Long-term surveillance of CTI-FI alterations and maintenance of its low levels is clinically important for early stroke detection and prevention in patients with stages 0-3 CKM syndrome.
Study context
- Population
- Individuals with cardiovascular kidney metabolic (CKM) syndrome stages 0–3, China Health and Retirement Longitudinal Study; mean age 57.94 years, 53.45% female
- Participants
- 5,293 individuals
- Exposure
- Higher vs lower CTI and FI (CTI-FI) dimensions
- Outcome
- Incident stroke
- Follow-up
- nearly 9-year follow-up
Methodological detailsChina Health and Retirement Longitudinal Study, five waves, K-means clustering
- China Health and Retirement Longitudinal Study, five waves
- K-means clustering
Main finding
As reported in the abstract
Fully adjusted HR (95% CI)
Baseline CTI-FI Q4vs Baseline CTI-FI Q1
2.36(1.76–3.15)
cuCTI-FI Q3vs cuCTI-FI Q1
4.75(2.73–8.27)
traCTI-FI Cluster 3vs traCTI-FI Cluster 1
6.24(3.72–10.46)
- Stroke events
- 540 (10.20%)
- Increase in stroke risk per 1-unit increase in baseline CTI-FI
- 61%
- Increase in stroke risk per 1-unit increase in cumulative CTI-FI (cuCTI-FI)
- 41%
Observational data: associations, not effects.
Further findings
Nonlinear association (restricted cubic spline (RCS)) with stroke incidence
- Baseline CTI-FI: significant positive nonlinear association
- Poverall < 0.001, Pnonlinear = 0.049
- cuCTI: significant positive nonlinear association
- Poverall < 0.001, Pnonlinear = 0.047
Prediction of stroke (ROC, DeLong test)
- cuCTI-FI performed significantly better than baseline CTI-FI
- P < 0.001
- Trajectories of CTI-FI (traCTI-FI) performed significantly better than baseline CTI-FI
- P = 0.022
- Baseline CTI-FI, cuCTI-FI and traCTI-FI performed better than CTI and frailty index (FI)
Original publication
Associations of the combined C-reactive protein-triglyceride glucose index and frailty index in different dimensions with incident stroke among individuals with stages 0–3 cardiovascular-kidney-metabolic syndrome. Cardiovasc Diabetol. Published 26 May 2026. doi:10.
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