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
High 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 cumul...
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| Veröffentlicht in: | Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2023-06, Vol.33 (6), p.1245-1253 |
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| container_title | Nutrition, metabolism, and cardiovascular diseases |
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| creator | Feng, Guijuan Yang, Man Xu, Lingkai Liu, Yaqi Yu, Jia Zang, Yuhan Shen, Suwen Zheng, Xiaowei |
| description | High 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.
A 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 |
| doi_str_mv | 10.1016/j.numecd.2023.04.001 |
| format | Article |
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A 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).
The 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.
•A large prospective study on 9626 middle-aged and older Chinese.•First study to prospectively evaluate the cumulative effect of hsCRP and TyG index on CVD risk among middle-aged and older Chinese.•Combination of hsCRP and TyG index might better improved the ability for risk stratification of CVD among middle-aged and older Chinese.</description><identifier>ISSN: 0939-4753</identifier><identifier>EISSN: 1590-3729</identifier><identifier>DOI: 10.1016/j.numecd.2023.04.001</identifier><identifier>PMID: 37095018</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Aged ; Biomarkers ; Blood Glucose - metabolism ; C-Reactive Protein ; Cardiovascular disease ; Cardiovascular Diseases - diagnosis ; Cardiovascular Diseases - epidemiology ; China ; China - epidemiology ; Cumulative effect ; East Asian People ; Glucose ; High sensitivity C-Reactive protein ; Humans ; Longitudinal Studies ; metabolism ; Middle Aged ; nutrition ; Retirement ; risk ; Risk Assessment ; Risk Factors ; Risk stratification ; stroke ; Stroke - diagnosis ; Stroke - epidemiology ; taxonomic revisions ; triacylglycerols ; Triglyceride glucose index ; Triglycerides</subject><ispartof>Nutrition, metabolism, and cardiovascular diseases, 2023-06, Vol.33 (6), p.1245-1253</ispartof><rights>2023 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University</rights><rights>Copyright © 2023 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c395t-530f117591405b89fb740d246a2cab33b7e7d39cbc7f17d327755555617b27143</citedby><cites>FETCH-LOGICAL-c395t-530f117591405b89fb740d246a2cab33b7e7d39cbc7f17d327755555617b27143</cites><orcidid>0000-0003-4174-6290</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.numecd.2023.04.001$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3541,27915,27916,45986</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37095018$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Feng, Guijuan</creatorcontrib><creatorcontrib>Yang, Man</creatorcontrib><creatorcontrib>Xu, Lingkai</creatorcontrib><creatorcontrib>Liu, Yaqi</creatorcontrib><creatorcontrib>Yu, Jia</creatorcontrib><creatorcontrib>Zang, Yuhan</creatorcontrib><creatorcontrib>Shen, Suwen</creatorcontrib><creatorcontrib>Zheng, Xiaowei</creatorcontrib><title>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</title><title>Nutrition, metabolism, and cardiovascular diseases</title><addtitle>Nutr Metab Cardiovasc Dis</addtitle><description>High 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.
A 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).
The 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.
•A large prospective study on 9626 middle-aged and older Chinese.•First study to prospectively evaluate the cumulative effect of hsCRP and TyG index on CVD risk among middle-aged and older Chinese.•Combination of hsCRP and TyG index might better improved the ability for risk stratification of CVD among middle-aged and older Chinese.</description><subject>Aged</subject><subject>Biomarkers</subject><subject>Blood Glucose - metabolism</subject><subject>C-Reactive Protein</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular Diseases - diagnosis</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>China</subject><subject>China - epidemiology</subject><subject>Cumulative effect</subject><subject>East Asian People</subject><subject>Glucose</subject><subject>High sensitivity C-Reactive protein</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>metabolism</subject><subject>Middle Aged</subject><subject>nutrition</subject><subject>Retirement</subject><subject>risk</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Risk stratification</subject><subject>stroke</subject><subject>Stroke - diagnosis</subject><subject>Stroke - epidemiology</subject><subject>taxonomic revisions</subject><subject>triacylglycerols</subject><subject>Triglyceride glucose index</subject><subject>Triglycerides</subject><issn>0939-4753</issn><issn>1590-3729</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUl2L1DAULaK44-o_EMmjL635aCdTHwQpqysMCH48hzS5bTOmyZqkg_Pmf_APir_EdGf1UQyEey8599zLySmKpwRXBJPti0PllhmUriimrMJ1hTG5V2xI0-KScdreLza4ZW1Z84ZdFI9iPGDMOGb1w-Iix7bBZLcpfnZ-7o0DjWAYQKWI_IAmM04ogosmmaNJJ9SVAaTKBaCb4BMYh6TTKAUz2pOCYDT8-v5jtIvyEZBxGr4h71Aw8cvKp2TQxh9lVIuVAWkTQWacnL0b0Wy0tlDKMe-wknqrIaBuyktFeImujpncKUBD8DNKE9w-SXQN0qbptuMDJBNgBpfQPjOatOiMsOhjTk6PiweDtBGe3MXL4vObq0_ddbl___Zd93pfKtY2qWwYHgjhTUtq3PS7duh5jTWtt5Iq2TPWc-CatapXfCA5o5w369kS3lNOanZZPD_zZoG-LhCTmE1UYK104Jco6I7VlJB8_wOKt5gTQnmG1meoCj7GAIO4CWaW4SQIFqsNxEGcbSBWGwhci2yD3PbsbsLSz6D_Nv359wx4dQZAluRoIIiozCqzzkqqJLQ3_57wG-FWyj0</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Feng, Guijuan</creator><creator>Yang, Man</creator><creator>Xu, Lingkai</creator><creator>Liu, Yaqi</creator><creator>Yu, Jia</creator><creator>Zang, Yuhan</creator><creator>Shen, Suwen</creator><creator>Zheng, Xiaowei</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7S9</scope><scope>L.6</scope><orcidid>https://orcid.org/0000-0003-4174-6290</orcidid></search><sort><creationdate>20230601</creationdate><title>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</title><author>Feng, Guijuan ; Yang, Man ; Xu, Lingkai ; Liu, Yaqi ; Yu, Jia ; Zang, Yuhan ; Shen, Suwen ; Zheng, Xiaowei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c395t-530f117591405b89fb740d246a2cab33b7e7d39cbc7f17d327755555617b27143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aged</topic><topic>Biomarkers</topic><topic>Blood Glucose - metabolism</topic><topic>C-Reactive Protein</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular Diseases - diagnosis</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>China</topic><topic>China - epidemiology</topic><topic>Cumulative effect</topic><topic>East Asian People</topic><topic>Glucose</topic><topic>High sensitivity C-Reactive protein</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>metabolism</topic><topic>Middle Aged</topic><topic>nutrition</topic><topic>Retirement</topic><topic>risk</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Risk stratification</topic><topic>stroke</topic><topic>Stroke - diagnosis</topic><topic>Stroke - epidemiology</topic><topic>taxonomic revisions</topic><topic>triacylglycerols</topic><topic>Triglyceride glucose index</topic><topic>Triglycerides</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Feng, Guijuan</creatorcontrib><creatorcontrib>Yang, Man</creatorcontrib><creatorcontrib>Xu, Lingkai</creatorcontrib><creatorcontrib>Liu, Yaqi</creatorcontrib><creatorcontrib>Yu, Jia</creatorcontrib><creatorcontrib>Zang, Yuhan</creatorcontrib><creatorcontrib>Shen, Suwen</creatorcontrib><creatorcontrib>Zheng, Xiaowei</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>AGRICOLA</collection><collection>AGRICOLA - Academic</collection><jtitle>Nutrition, metabolism, and cardiovascular diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Feng, Guijuan</au><au>Yang, Man</au><au>Xu, Lingkai</au><au>Liu, Yaqi</au><au>Yu, Jia</au><au>Zang, Yuhan</au><au>Shen, Suwen</au><au>Zheng, Xiaowei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>Nutrition, metabolism, and cardiovascular diseases</jtitle><addtitle>Nutr Metab Cardiovasc Dis</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>33</volume><issue>6</issue><spage>1245</spage><epage>1253</epage><pages>1245-1253</pages><issn>0939-4753</issn><eissn>1590-3729</eissn><abstract>High 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.
A 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).
The 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.
•A large prospective study on 9626 middle-aged and older Chinese.•First study to prospectively evaluate the cumulative effect of hsCRP and TyG index on CVD risk among middle-aged and older Chinese.•Combination of hsCRP and TyG index might better improved the ability for risk stratification of CVD among middle-aged and older Chinese.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>37095018</pmid><doi>10.1016/j.numecd.2023.04.001</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4174-6290</orcidid></addata></record> |
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| subjects | Aged Biomarkers Blood Glucose - metabolism C-Reactive Protein Cardiovascular disease Cardiovascular Diseases - diagnosis Cardiovascular Diseases - epidemiology China China - epidemiology Cumulative effect East Asian People Glucose High sensitivity C-Reactive protein Humans Longitudinal Studies metabolism Middle Aged nutrition Retirement risk Risk Assessment Risk Factors Risk stratification stroke Stroke - diagnosis Stroke - epidemiology taxonomic revisions triacylglycerols Triglyceride glucose index Triglycerides |
| title | 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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