Lipids & metabolic liver disease
Composite C-reactive protein-triglyceride-glucose adiposity indices and incident cardiovascular-liver-metabolic multimorbidity: a prospective cohort study
Authors' conclusion
In middle-aged and older adults, most CTI-related adiposity indices were significantly associated with the newly identified surrogate-defined CLMM phenotype, except for CTI-ABSI and CTI-WWI, which were not independently associated after full adjustment. Among them, CTI-BMI showed the strongest statistical association and the highest relative discrimination among the evaluated indices, although its absolute discrimination was modest.
Study context
- Population
- Middle-aged and older adults with full baseline records in China Health and Retirement Longitudinal Study (CHARLS)
- Participants
- 6,534 participants
- Exposure
- Nine CTI-derived adiposity indices and incident surrogate-defined CLM multimorbidity (CLMM) phenotype
- Outcome
- Surrogate-defined cardiovascular-liver-metabolic multimorbidity (CLMM) phenotype (CVD mainly self-reported physician diagnosis; MASLD inferred from lipid accumulation product)
- Follow-up
- approximately four-year follow-up
Methodological detailsChina Health and Retirement Longitudinal Study (CHARLS)
- China Health and Retirement Longitudinal Study (CHARLS)
Main finding
As reported in the abstract
Odds ratio
3.46
P < 0.001
CTI-BMI Q4
Odds ratio
2.37
P < 0.001
CTI-CVAI Q4
- Participants meeting CLMM phenotype criteria
- 406 (6.2%)
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Joint CTI and BMI categoriesLow CTI and high BMIvs Low CTI and low BMI | 2.49 (1.80–3.48) | |
| Joint CTI and BMI categoriesHigh CTI and high BMIvs Low CTI and low BMI | 2.53 (1.87–3.45) | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | AUC | P value |
|---|---|---|
| Discrimination of CTI-BMICTI-BMI vs BMI · IDI 0.02%, despite a positive NRI | 0.638 vs 0.638 | DeLong P = 0.924 |
- Discrimination of CTI-BMI — AUC of CTI-BMI (highest among indices; modest)
- 0.638 (95% CI 0.611-0.664)
- Discrimination of CTI-BMI — AUC of fully adjusted baseline model before vs after adding CTI-BMI
- 0.617 to 0.627
- Discrimination of CTI-BMI — net reclassification improvement (NRI) on adding CTI-BMI
- 28.63% (95% CI 18.63-38.64%)
- Discrimination of CTI-BMI — integrated discrimination improvement (IDI) on adding CTI-BMI
- 0.03% (95% CI 0.01-0.06%)
Joint CTI and BMI categories
- No statistically significant multiplicative or additive interaction
Effect modification of CTI-BMI association
- Stronger associations in men, current-smokers and current-drinkers
- all P for interaction <0.001
Sensitivity analyses
- CTI-BMI remained significantly associated after additional adjustment for baseline cardiovascular-liver-metabolic (CLM) component status, with reduced effect estimate
Original publication
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