Background Emerging research has associated non-conventional lipid indices with hypertension risk; however, the joint contribution of these lipid metrics and inflammatory biomarkers to hypertension susceptibility remains unclear. Using a nationally representative cohort, we aimed to examine the independent associations of non-conventional lipid indices and their inflammatory composites with incident hypertension. Methods We included 6891 participants from the China Health and Retirement Longitudinal Study (2011–2020). We used multivariable Cox proportional hazards regression to assess the association between baseline and cumulative non-conventional lipid-inflammatory parameters and incident hypertension. We used restricted cubic spline modelling to characterise dose-response relationships. We evaluated receiver operating characteristic curves, net reclassification improvement, and integrated discrimination improvement as secondary conditional analyses. Results Over a median follow-up of 7.79 years, 2532 incident hypertension cases occurred. Higher tertiles of non-conventional lipid indices were associated with progressively increased hypertension risk. In the primary model, elevated baseline and cumulative non-conventional lipid metrics were associated with a higher risk of hypertension across all composite indices. The lipoprotein combine index-C-reactive protein showed the largest effect size (hazard ratio = 1.59; 95% confidence interval = 1.44–1.75). Composite indices demonstrated modest incremental discrimination over individual measures (area under the curve range = 0.55–0.58). Conclusions Non-conventional lipid indices are independently associated with incident hypertension among middle-aged and older Chinese adults. Composite lipid-inflammatory markers provide modest incremental prognostic information beyond conventional lipids, though their standalone discriminatory performance is weak.
Mengjie Zhao, Miaoran Wang, Zirong Li et al.· Journal of Global Health· 0 citations
Background: Cardiovascular disease (CVD) is the leading cause of mortality worldwide. The C-reactive protein–triglyceride–glucose (CTI) index captures metabolic inflammation and insulin resistance, while obesity indices reflect adiposity-related cardiometabolic risk. However, the predictive value of combining CTI with obesity indices for CVD remains unclear. Objectives: To examine the prognostic utility of CTI combined with established and novel obesity indicators for CVD, and to benchmark their predictive efficacy. Design: Nationally representative prospective cohort study. Methods: Using data from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative prospective cohort, 7847 adults aged 45 years and above without baseline CVD were enrolled. CTI was calculated from C-reactive protein, fasting blood glucose, and triglycerides (TG); each obesity index was combined with CTI to form composite parameters (CTI-body mass index (CTI-BMI), CTI-waist circumference (CTI-WC), CTI-waist-to-height ratio (CTI-WHtR), CTI-body roundness index (CTI-BRI), CTI-weight-adjusted waist index (CTI-WWI), CTI-Chinese visceral adiposity index (CTI-CVAI), CTI-a body shape index (CTI-ABSI)). We employed Cox proportional hazard models, restricted cubic spline analyses, Kaplan–Meier survival plots, ROC curve evaluations, and weighted quantile sum (WQS) regression to examine the links and prognostic utility of each metric with incident CVD across baseline and cumulative exposure tiers. Results: Over a 9-year follow-up period, 1938 new-onset CVD cases were documented. Following multivariable adjustment, each CTI-obesity composite metric showed a significant positive link to CVD risk (p < 0.05). Moreover, all CTI‑obesity composite parameters showed stronger associations with CVD than CTI alone. CTI‑CVAI demonstrated the relatively best predictive accuracy among the evaluated indices, though absolute discriminatory ability remained modest (baseline area under the ROC curve (AUC): 0.596; cumulative AUC: 0.600). Trajectory clustering found that, versus the well-managed group, the poorly managed subgroup had 21%–71% higher CVD risk (max 71% for CTI-WC). WQS regression indicated that CRP and obesity indices (especially CVAI) were the major contributors in the mixed exposure; cumulative exposure WQS analysis showed that cumulative TG and cumulative obesity parameters contributed the most. Conclusion: CTI combined with obesity indices, particularly CTI-CVAI, was associated with modestly improved predictive ability for CVD risk compared with CTI alone. This parameter may offer incremental information for CVD risk stratification by integrating metabolic inflammation and visceral fat markers.
Mengjie Zhao, Xujie Wang, Xuexue Zhang et al.· Therapeutic Advances in Endo...· 0 citations