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. 2025 Apr 1:16:1511319.
doi: 10.3389/fendo.2025.1511319. eCollection 2025.

The comprehensive effects of high-sensitivity C-reactive protein and triglyceride glucose index on cardiometabolic multimorbidity

Bingen Wan #  1 , Silin Wang #  1 , Sheng Hu #  1 , Weiqing Han  1 , Shengyu Qiu  1 , Lingxiao Zhu  1 , Liancheng Ruan  1 , Yiping Wei  1 , Jianjun Xu  1
Affiliations

The comprehensive effects of high-sensitivity C-reactive protein and triglyceride glucose index on cardiometabolic multimorbidity

Bingen Wan et al. Front Endocrinol (Lausanne). .

Abstract

Background: The triglyceride-glucose index (TyG index) is one of the surrogate markers of insulin resistance, and high-sensitivity C-reactive protein (hsCRP) reflects systemic inflammation. Existing studies suggest that insulin resistance or systemic inflammation may be indicative of cardiometabolic disease, but few of the existing studies have combined the TyG index and inflammation levels before assessing cardiometabolic multimorbidity. Our study data came from the China Health and Retirement Longitudinal Study (CHARLS). Participants in this data were followed for 9 years, and we used these data to conduct a long-term analysis to assess the combined effects of the TyG index and hsCRP on cardiometabolic multimorbidity in Chinese adults over 45 years of age.

Purpose: To study the combined effect of TyG index and hsCRP on cardiometabolic multimorbidity in middle-aged as well as elderly Chinese.

Method: The study data came from the China Health and Retirement Longitudinal Study (CHARLS), which included a total of 4,483 middle-aged and elderly participants who did not have cardiovascular metabolic diseases at baseline, which was from CHARLS 2011, and the last survey was in 2020. A total of five cardiometabolic diseases were considered in this study: diabetes, hypertension, hyperlipidemia, heart disease and stroke. A person was defined as having cardiometabolic multimorbidity when he/she had two or more cardiometabolic diseases at the same time. TyG index (median as cut-off) and hsCRP (1mg/L as cut-off) were each divided into two groups and combined into four groups (Group L-L: TyG index<median & hsCRP<1mg/L; Group H-L: TyG index>=median & hsCRP<1mg/L; Group L-H: TyG index<median & hsCRP>=1mg/L; Group H-H: TyG index>=median & hsCRP>=1mg/L). Multiple regression equations were fitted to analyse the combined influence of TyG index and hsCRP on cardiometabolic multimorbidity.

Results: TyG index increases the risk of CMM events independently of hsCRP, as does the reverse. When the TyG index is elevated and hsCRP is also elevated, this condition significantly increases the danger of cardiometabolic multimorbidity in middle-aged and elderly Chinese.

Conclusion: High levels of TyG index and hsCRP can enhance the danger of cardiometabolic multimorbidity in Chinese middle-aged and elderly people, and the joint use of hsCRP and TyG index assessment may be a better way to achieve primary prevention of cardiometabolic multimorbidity in Chinese middle-aged and elderly people.

Keywords: cardiometabolic multimorbidity (CMM); high-sensitivity C-reactive protein (hsCRP); inflammation; insulin resistance (IR); triglyceride glucose index (TyG index).

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Researcher inclusion flowchart.
Figure 2
Figure 2
K-M plots of cardiometabolic multimorbidity at different TyG index and hsCRP levels. TyG, triglyceride-glucose index; hsCRP, high-sensitivity C-reactive protein.
Figure 3
Figure 3
Age affects the association of TyG index and hsCRP levels with CMM occurrence.CMM, Cardiometabolic Multimorbidity; TyG-index, triglyceride-glucose index; hsCRP, high-sensitivity C-reactive protein; HR hazard ratio, CI confidence interval. Number of participants: 45–59 years (n=2903); 60–69 years (n=1090); 70 ~ years (n=490). Dots and lines represent the HR and 95% CI.
See this image and copyright information in PMC

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