Integrating inflammation, insulin resistance, and visceral adiposity: the C-reactive protein–triglyceride–glucose-Chinese visceral adiposity (CTI–Chinese visceral adiposity index (CVAI)) index is associated with cardiovascular disease risk across cardiovascular-kidney-metabolic (CKM) stages 0–3 in a nationwide prospective cohort
Authors' conclusion
CTI-CVAI is independently and linearly associated with incident CVD risk in Chinese adults with CKM stage 0-3. As a low-cost, accessible biomarker integrating three key pathological pathways, it optimizes early CVD risk stratification and reclassification, providing a promising tool for targeted CVD prevention in CKM high-risk populations.
Study context
- Population
- Chinese adults aged ≥45 years with CKM stages 0–3, China Health and Retirement Longitudinal Study
- Participants
- 6,728 adults
- Exposure
- Higher vs lower CTI-CVAI
- Outcome
- Incident CVD
- Follow-up
- Median 9 years
Methodological detailsnationwide, China Health and Retirement Longitudinal Study (CHARLS) 2011-2020
- Nationwide
- CHARLS 2011-2020
Main finding
As reported in the abstract
Hazard ratio (95% CI)P value
Per 1-SD CTI-CVAI increment
1.32(1.26–1.39)
P < 0.001Q4vs Q1
2.07(1.77–2.42)
P < 0.001- Overall cardiovascular disease (CVD) incidence
- 23.83%
- Linear, dose-dependent association of CTI-CVAI with CVD risk
- P < 0.001
- Restricted cubic spline: linear association
- P for non-linearity > 0.05
Observational data: associations, not effects.
Further findings
Risk reclassification vs single biomarkers
- NRI
- 0.0566, P < 0.001
Subgroup and sensitivity analyses
- Association stable across most subgroups; all sensitivity analyses robust
Original publication
Integrating inflammation, insulin resistance, and visceral adiposity: the C-reactive protein–triglyceride–glucose-Chinese visceral adiposity (CTI–CVAI) index is associated with cardiovascular disease risk across CKM stages 0–3 in a nationwide prospective cohort. Cardiovasc Diabetol. Published 12 June 2026. doi:10.
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