Jan 2026· Mediators of Inflammation· Vol 2026· 0 citations· 38 references
Medicine
TL;DR
Findings indicate a significant association between CTI and COPD, suggesting its potential role as a biomarker for the prevention and treatment of COPD.
Abstract
Background The C‐reactive protein (CRP)‐triglyceride glucose index (CTI) is a new composite biomarker used to assess inflammation and insulin resistance (IR) severity. Inflammation and IR play important roles in chronic obstructive pulmonary disease (COPD). However, the impact of CTI on COPD remains unknown. Methods To explore the association between CTI and the prevalence of COPD, a total of 8682 participants from the China Health and Retirement Longitudinal Study (CHARLS) and 8986 participants from the US National Health and Nutrition Examination Survey (NHANES) were included. We used logistic multivariate regression to evaluate the association between CTI and COPD. In addition, smooth curve fitting analyzed dose–response relationships, while subgroup analyses explored effect heterogeneity. Results We found a positive correlation between CTI and the risk of COPD after adjusting for all covariates in the NHANES database (OR = 1.34, 95% confidence interval [CI]: 1.18–1.53), which is consistent with the findings obtained from Cox regression analysis in the CHARLS database (HR = 1.16, 95% CI: 1.07–1.26), with consistent dose–response trends confirmed by restricted cubic spline (RCS) analyses. Subgroup analyses confirmed consistency across most strata, with a significant interaction detected with cardiovascular disease (CVD). Sensitivity analyses further confirmed the robustness of associations. Conclusions These findings indicate a significant association between CTI and COPD, suggesting its potential role as a biomarker for the prevention and treatment of COPD.
Chronic obstructive pulmonary disease (COPD) is a leading cause of global mortality and has been linked to systemic inflammation and insulin resistance. The C-reactive protein–triglyceride–glucose index (CTI), a composite biomarker integrating inflammatory and metabolic components, may reflect these intertwined pathways. However, its association with COPD in the general population remains unclear. In this cross-sectional study, we analyzed data from 3442 adults aged ≥20 years participating in the National Health and Nutrition Examination Survey 2015 to 2018. Weighted multivariable logistic regression models were used to assess the association between CTI and self-reported COPD. Dose–response relationships were evaluated using restricted cubic splines. Subgroup and interaction analyses were performed across demographic and socioeconomic factors. Receiver operating characteristic (ROC) curves were constructed to compare the discriminatory ability of CTI with individual biomarkers. Mean CTI levels were higher among participants with COPD compared to those without COPD (9.29 vs 8.95; P < .001). After adjustment for potential confounders, participants in the highest CTI quartile had a modestly increased likelihood of COPD compared with those in the lowest quartile (odds ratio = 1.04, 95% confidence interval: 1.02–1.07). A linear dose–response association was observed (P for nonlinearity = .319). A statistically significant interaction by sex was identified, with a stronger association observed in males. In ROC curve analysis, CTI demonstrated slightly higher discriminatory ability (area under the ROC curve = 0.630) than individual biomarkers, although overall predictive performance remained limited. In this nationally representative cross-sectional analysis, higher CTI levels were independently associated with COPD prevalence, with a modest effect size. While CTI showed slightly improved discriminatory performance compared with single biomarkers, its overall predictive capacity was limited. Prospective studies are warranted to clarify its potential role in COPD risk assessment.
Peng Sun, Chunlei Ma, Zi-Qi Sang et al.· Medicine· 0 citations
Cardiovascular disease (CVD) remains a leading global cause of mortality, with metabolic and inflammatory dysregulation playing pivotal roles. The C-reactive protein-triglyceride glucose index (CTI), a novel biomarker integrating inflammation (CRP) and insulin resistance (triglyceride-glucose index), has shown promise in predicting adverse outcomes, but its associations with CVD and mortality in the general population remain unclear. The aim of this study is to explore the association of the C-reactive protein-triglyceride glucose index with cardiovascular disease and mortality. This study analyzed data from 8720 adults in the National Health and Nutrition Examination Survey (NHANES) 2001–2010. CTI was calculated as CTI 0.412 × ln(CRP [mg/L]) + [ln(TG [mg/dL] × FPG [mg/dL])]/2. Multivariable logistic regression examined the association between CTI tertiles (T1–T3) and CVD, and Cox regression assessed the relationship between CTI tertiles and cardiovascular and all-cause mortality, with adjustment for demographic, lifestyle, and clinical factors. Higher CTI tertiles were correlated with worse metabolic profiles and higher prevalence of hypertension and diabetes (P < .001). After full adjustment, the highest CTI tertile (T3) was associated with increased CVD risk (odds ratio = 1.50, 95% confidence interval [CI]: 1.18–1.92, P = .004), cardiovascular mortality (hazard ratio = 1.54, 95% CI: 1.06–2.25, P = .024), and all-cause mortality (hazard ratio = 1.53, 95% CI: 1.29–1.89, P < .001). Restricted cubic spline analysis revealed a nonlinear relationship between CTI and cardiovascular mortality, as well as all-cause mortality. Higher CTI is associated with prevalent CVD and independently predicts increased cardiovascular and all-cause mortality.
Zhenze Yu, Zihan Zhao, Mingzhuang Sun et al.· Medicine· 0 citations
BACKGROUND
The association between the C-reactive protein-triglyceride-glucose (CTI) index and prevalent asthma was examined in two national cohorts.
METHODS
This cross-sectional study included 6809 participants from NHANES and 9148 from CHARLS. Multivariable logistic regression and restricted cubic spline models were used to assess associations between CTI and prevalent asthma. Receiver operating characteristic curves, continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to compare CTI with CRP or TyG alone.
RESULTS
Higher CTI was associated with greater odds of prevalent asthma in both cohorts. In fully adjusted models, the odds ratio was 1.34 (95% CI, 1.11-1.51) in NHANES and 1.14 (95% CI, 1.05-1.23) in CHARLS. Participants in the highest CTI quartile had higher odds of asthma than those in the lowest quartile in both cohorts. There was no evidence of non-linearity in NHANES, whereas a non-linear association was observed in CHARLS. CTI yielded slightly higher AUCs than CRP or TyG alone, while the continuous NRI and IDI estimates were positive and statistically significant.
CONCLUSION
Higher CTI was positively associated with prevalent asthma in both cohorts, although association patterns differed. These findings should be considered exploratory and hypothesis-generating and warrant prospective evaluation using objective asthma assessment.
Wenxuan Zhang, Liya Li, Shuting Du et al.· Respiratory Medicine· 0 citations
Depression is a prevalent and underrecognized comorbidity in chronic obstructive pulmonary disease (COPD) that worsens outcomes. The C-reactive protein–albumin–lymphocyte (CALLY) index, a composite immune-nutritional biomarker, has demonstrated prognostic value in various chronic conditions, but its prospective association with incident depression in COPD remains unexplored.
This prospective cohort study included 40,200 UK Biobank participants with baseline COPD. Cox proportional hazards regression was used to estimate the association between the CALLY index and incident depression, with progressive adjustment across five models. Restricted cubic spline (RCS) curves and two-segment Cox regression was applied to characterize non-linear associations and identify inflection points. Subgroup and sensitivity analyses were conducted to assess robustness.
During a mean follow-up of 13.1 ± 2.8 years, 2,059 incident depression events occurred. In the fully adjusted model, each one-standard deviation (SD) increment in ln-CALLY was associated with a 7% lower risk of depression (HR = 0.93, 95% CI: 0.88–0.97,
P
= 0.002). The highest quartile exhibited an 18% risk reduction vs. the lowest (HR = 0.82, 95% CI: 0.72–0.95,
P
= 0.007). RCS analysis revealed a significant L-shaped relationship (
P
for non-linearity = 0.022). Threshold effect analysis identified an inflection point at CALLY = 17.75; below this threshold, each one-unit increase was associated with a 5% risk reduction (HR = 0.95, 95% CI: 0.90–0.99,
P
= 0.037), whereas above the threshold the association was non-significant. A nominally significant age interaction was observed (
P
= 0.017), though this did not survive Bonferroni correction for multiple testing (adjusted threshold
P
< 0.007). Sensitivity analyses including Fine-Gray competing risk models yielded consistent results.
In COPD patients, the CALLY index exhibits a significant L-shaped association with incident depression risk, characterized by a pronounced protective effect below the identified threshold and a risk plateau above it. These findings suggest that the CALLY index may serve as a clinically accessible tool for depression risk stratification, particularly in younger COPD patients, although the age-specific effect requires confirmation in future studies.
Yushan Shi, Xianhai Chen, Yan Wang· Frontiers in Medicine· 0 citations
Background The C‐reactive protein–albumin–lymphocyte (CALLY) index, a novel composite marker derived from lymphocyte count, serum albumin, and C‐reactive protein (CRP) levels, is commonly used to assess nutritional and inflammatory status. However, existing studies have not clarified the association between the CALLY index and prognosis in patients with chronic inflammatory airway diseases (CIADs). This study aims to elucidate the relationship between the CALLY index and the risks of all‐cause and cardiovascular mortality among CIAD patients in the United States. Methods This investigation included 4128 patients with CIAD from the National Health and Nutrition Examination Survey (NHANES, 1999–2010). The CALLY index was measured only at baseline. We employed weighted Cox proportional hazards regression models to assess the association between the CALLY index and risks of all‐cause and cardiovascular mortality across three progressively adjusted models. To evaluate potential nonlinear dose–response relationships, we applied restricted cubic spline (RCS) models. Additionally, subgroup analyses and sensitivity analyses were conducted to verify the robustness of our findings. Results Multivariable‐adjusted Model 3 demonstrated that, compared with the lowest quartile, the highest CALLY index quartile showed a significant inverse association with both all‐cause and cardiovascular mortality, with corresponding HRs of 0.36 (95% CI: 0.27–0.47) and 0.33 (95% CI: 0.21–0.51), respectively (both p < 0.05). Conclusions The CALLY index showed a significant inverse association with all‐cause and cardiovascular mortality among U.S. adults with CIAD, suggesting its potential value as a prognostic tool for risk stratification in this group.
Yuting Fan, Zhao Chen, Mingshan Xue et al.· Mediators of Inflammation· 0 citations
OBJECTIVE
This study aimed to explore the relationships between C-reactive protein-triglyceride-glucose index (CTI), a comprehensive indicator of the triglyceride-glucose (TyG) index and C-reactive protein (CRP), and the risk of overactive bladder (OAB).
METHODS
A total of 6014 participants from the U.S. National Health and Nutrition Examination Survey (NHANES) were included for cross-sectional study from 2005 -2010. The presence of OAB was defined as the Overactive Bladder Syndrome Symptom Score (OABSS) reaching 3 points or above. After taking into account the covariates, multivariable logistic regression was employed to examine the association between CTI and OAB, and a multiple imputation technique was applied. Restricted cubic spline (RCS) analyze was used to explore dose-response relationships and interaction effects, respectively.
RESULT
OAB and nocturia were associated with higher CTI levels and prevalence of hypertension, diabetes, and dyslipidemia. In fully adjusted models, the highest CTI quartile was significantly associated with increased risks of OAB (OR 1.26, 95% CI 1.13-1.40, p < 0.001), nocturia (OR 1.38, 95% CI 1.26-1.51, p < 0.001) with consistent validated by multiple imputation. The RCS analysis showed the risk of incident OAB rose progressively as CTI increased, with a clear linear pattern. We further found that body mass index (BMI) acts as an indirect mediator in the relationship between CTI and both OAB and nocturia via mediation analysis.
CONCLUSION
CTI is significantly associated with OAB and its nocturia subtypes, which is partially mediated by BMI. CTI own potential value for risk characterization and for identifying individuals with OAB.