Composite C-reactive protein–triglyceride–glucose–adiposity indices and incident cardiovascular disease in the China Health and Retirement Longitudinal Study (CHARLS) cohort: a prospective cohort study
Authors' conclusion
CTI-derived adiposity indices were associated with incident CVD in middle-aged and older adults, with CTI-WHtR showing the most consistent overall performance among the evaluated indices. These findings support the epidemiological relevance of integrating metabolic-inflammatory burden with adiposity-related phenotypes in cardiovascular risk assessment.
Study context
- Population
- Adults aged ≥ 45 years without baseline cardiovascular disease (CVD), China Health and Retirement Longitudinal Study (CHARLS)
- Participants
- 6,161 adults
- Exposure
- Highest vs lowest quartile of CTI-derived adiposity indices
- Outcome
- Incident CVD
- Follow-up
- Median 9 years
Methodological detailsnationwide
- Nationwide
Main finding
As reported in the abstract
Incident CVD, fully adjusted, highest vs lowest quartile
Highest quartile vs Lowest quartileHazard ratio (95% CI)
CTI-WHtR
1.57(1.24–2.00)
CTI-BMI
1.55(1.23–1.97)
CTI-BRI
1.40(1.11–1.78)
CTI-WWI
1.37(1.08–1.74)
- Developed CVD (all participants)
- 1,503 (24.39%)
Observational data: associations, not effects.
Further findings
Dose-response (restricted cubic splines (RCS))
- Predominantly linear dose-response relationships
Discrimination (AUC)
- AUC, CTI-WWI (lowest of CTI-derived indices)
- 0.558
- AUC, CTI-WHtR (highest of CTI-derived indices)
- 0.573
- AUC, CTI
- 0.522
- Discrimination was modest
Reclassification
- All CTI-derived indices improved continuous NRI and IDI beyond the conventional risk factor model
Cumulative exposure and trajectories
- Higher cumulative exposure and higher trajectory clusters associated with increased CVD risk
Mediation
- Suggested interrelationships between metabolic-inflammatory dysregulation and adiposity in relation to CVD
Original publication
Composite C-reactive protein–triglyceride–glucose–adiposity indices and incident cardiovascular disease in the CHARLS cohort: a prospective cohort study. Cardiovasc Diabetol. Published 2 June 2026. doi:10.
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