ArticleCardiovascular diabetology2026
The predictive value of C-reactive protein-triglycerides-glucose index-waist-to-height ratio for stroke: a nationwide cohort study.
Article in Cardiovascular diabetology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Association between C-reactive protein-triglyceride glucose related indices and all-cause and cardiovascular mortality in individuals with cardiovascular-kidney-metabolic syndrome.Cardiovascular diabetology · 2026Article
- Composite C-reactive protein-triglyceride-glucose-adiposity indices and incident cardiovascular disease in the CHARLS cohort: a prospective cohort study.Cardiovascular diabetology · 2026Article
- Predictive value of cholesterol, high-density lipoprotein, and glucose index-obesity-derived index for stroke: a cohort study.Lipids in health and disease · 2026Article
- Metabolic status modifies the predictive value of the C-reactive protein-triglyceride-glucose Index-waist-to-height ratio for major adverse cardiovascular and cerebrovascular events: a prospective cohort study from the China Health and Retirement Longitudinal Study (CHARLS).Cardiovascular diabetology · 2026Article
- Association of C-reactive protein-triglycerides-glucose index-waist to height ratio and cardiometabolic multimorbidity in middle-aged and older adults: a nationwide cohort study.Cardiovascular diabetology · 2026Article
- Association of CTI and its obesity-related derivatives with incident depression among middle-aged and older adults across CKM stages 0-4: a nationwide prospective cohort study and external clinical validation.Frontiers in endocrinology · 2026Article
- Association of the C-reactive protein-triglyceride-glucose index with the risk of incident cardiovascular disease in rectal cancer survivors.Frontiers in cardiovascular medicine · 2026Article
- From traditional to novel: a national cohort study on the predictive value of C-reactive protein-triglyceride-glucose-obesity composite parameters for cardiovascular disease.Therapeutic advances in endocrinology and metabolism · 2026Article
- CTI-related composite adiposity indices and future cardiovascular disease risk among middle-aged and older Chinese adults.Frontiers in nutrition · 2026Article
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4 authors.
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Abstract
backgroundCombining biomarkers and anthropometric indicators is a common way to improve predictive efficacy. Yet the effect of the C-reactive protein-triglycerides-glucose index (CTI) and its derivatives on stroke is unknown. This study aims to explore their association with stroke and compare their predictive value.
methodsA total of 10,070 participants from the China Health and Retirement Longitudinal Study (CHARLS) were included. Covariate selection was performed using the Boruta algorithm and complementary methods. The predictive performance of various indicators was compared via metrics including area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) to determine the optimal predictive indicator. Subsequently, Cox proportional hazards models, trajectory pattern analysis, restricted cubic spline (RCS) analysis, Kaplan-Meier curves were used to investigate its association with stroke.
resultsFrom 2011 to 2020, 950 participants (9.43%) experienced an incident stroke during follow-up. CTI derivatives outperformed standalone CTI in prediction, with CTI-waist-to-height ratio (CTI-WHtR) exhibiting the strongest association with stroke risk. In the fully adjusted model, each one-unit increase in CTI-WHtR linked to a 73% higher risk of stroke [odds ratio (OR) = 1.73, 95% confidence interval (CI) 1.45-2.07], and participants in the highest quartile of CTI-WHtR had more than double the risk compared with those in the lowest quartile (OR = 2.20, 95% CI 1.71-2.83). There were three distinct trajectories of CTI-WHtR over time. Compared with Cluster 1 (low value rising), Cluster 2 (stable high value) was associated with a 69% higher risk of stroke (OR = 1.69, 95% CI 1.34-2.13), and Cluster 3 (moderate value rising) with a 26% higher risk (OR = 1.26, 95% CI 1.06-1.52). A clear dose-response relationship was observed between CTI-WHtR and stroke risk, with risk increasing sharply when CTI-WHtR exceeded 2.52.
conclusionThe consistent positive linear association between CTI-WHtR and stroke risk highlights its potential utility as a clinical and public health indicator. Monitoring and maintaining optimal CTI-WHtR levels may aid in identification of individuals at elevated stroke risk. Graphical Abstract.
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