Combined effects of high sensitivity C-reactive protein and triglyceride–glucose index on risk of cardiovascular disease among middle-aged and older Chinese: Evidence from the China Health and Retirement Longitudinal Study |
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| Institution: | 1. The First Affiliated Hospital of Kangda College of Nanjing Medical University, The Affiliated Lianyungang Hospital of Xuzhou Medical University, The First People''s Hospital of Lianyungang, Lianyungang, Jiangsu, 222000, China;2. Department of Chronic Non-Communicable Disease Control, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu, 214023, China;3. Department of Acute Infectious Disease Control and Immunization Program, Wuzhong Center for Disease Control and Prevention, Suzhou, Jiangsu, 215000, China;4. Department of Health Promotion and Chronic Non-Communicable Disease Control, Wuzhong Center for Disease Control and Prevention, Suzhou, Jiangsu, 215000, China;5. Public Health Research Center and Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University, Wuxi, Jiangsu, 214122, China;1. Federal University of Santa Catarina (UFSC), Postgraduate Program in Nutrition, Brazil;2. School of Public Health, University of São Paulo (USP), Postgraduate Program in Nutrition in Public Health, Brazil;3. Federal University of Paraná (UFPR), Departamento de Nutrição, Brazil;4. Federal University of Rio de Janeiro (UFRJ), Institute of Studies on Collective Health, Brazil;5. Federal University of Grande Dourados (UFGD), School of Health Sciences, Brazil;1. College of Medicine, Southwest Jiaotong University, Chengdu, China;2. Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People''s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, China;3. Medical Research Center, The Third People''s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, Sichuan, China;4. School of Chemistry and Life Sciences, Suzhou University of Science and Technology, Suzhou, Jiangsu, China;1. Human Nutrition & Exercise Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK;2. Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia;3. School of Life Sciences, The University of Nottingham, Nottingham, UK;4. School of Population Health, Curtin University, Perth, Australia;1. Experimental and Clinical Biomedical Sciences Mario Serio Department, University of Florence, Italy;2. Diabetes Unit, Azienda Sanitaria Città di Torino, Turin, Italy;3. Diabetes Unit, ASL TO4, Chivasso (Turin), Italy;4. Coordinator Working Group Vaccines and Immunization Policies, Italian Scientific Society of Hygiene, Preventive Medicine and Public Health (SItI), Italy;5. Diabetes Research Institute, IRCCS San Raffaele Hospital, Milan, Italy;6. Interdisciplinary Department of Medicine, Aldo Moro, University of Bari, Italy;1. Department of Pharmacotherapy, College of Pharmacy. University of Utah, Salt Lake City, UT, USA;2. Department of Pharmacy Practice, College of Pharmacy. Mercer University, Atlanta, GA, USA;1. Faculdade Israelita de Ciências da Saúde Albert Einstein, Rua Comendador Elias Jafet, 755, São Paulo, SP, 05653-000, Brazil;2. Hospital Israelita Albert Einstein, Av. Brasil, 1085, São Paulo, SP, 01431-000, Brazil;3. Heart Institute (InCor), University of São Paulo Medical School Hospital, Av. Dr. Enéas Carvalho de Aguiar, 44, São Paulo, SP, 05403-900, Brazil |
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| Abstract: | Background and aimsHigh sensitivity C-reactive protein (hsCRP) and triglyceride glucose (TyG) index were proved to be independent risk factors of cardiovascular disease (CVD). However, individual hsCRP or TyG index might not provide sufficient predictive value on CVD risk. The current study aimed to evaluate the cumulative effect of hsCRP and TyG index on CVD risk prospectively.Methods and resultsA total of 9626 participants were enrolled in the analysis. The TyG index was calculated as ln(triglyceride mg/dL] × fasting glucose mg/dL]/2). The primary outcome was new-onset CVD events (cardiac events or stroke), and the secondary outcomes were new-onset cardiac events and stroke, separately. Participants were divided into 4 groups through the median of hsCRP and TyG index. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using multivariable Cox proportion hazard models. From 2013 to 2018, 1730 participants experienced CVD (570 stroke and 1306 cardiac events). Linear associations were found between hsCRP, TyG index, hsCRP/TyG ratio and CVD (all p < 0.05). Compared to participants with low hsCRP/low TyG index, multivariable adjusted HRs (95% CIs) for those with high hsCRP/high TyG index were 1.17 (1.03–1.37) for CVD. No interaction of hsCRP and TyG index was found on CVD (p-interaction ≥0.05). Furthermore, adding hsCRP and TyG index simultaneously to conventional risk model improved risk reclassification for CVD, stroke and cardiac events (all p < 0.05).ConclusionThe present study suggested combination of hsCRP and TyG index might better improved the ability for risk stratification of CVD among middle-aged and older Chinese. |
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| Keywords: | High sensitivity C-Reactive protein Triglyceride glucose index Cumulative effect Cardiovascular disease Risk stratification |
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