Current insights and limitations of using the C-reactive protein–triglyceride glucose index (CTI) in cardiovascular diseases: A narrative mini-review

Abstract

The C-reactive protein–triglyceride glucose index (CTI) has recently emerged as an integrative biomarker capturing both inflammation and insulin resistance (IR). A growing body of evidence suggests that CTI is potentially associated with an elevated risk of cardiovascular disease (CVD). Nevertheless, the application of CTI in the context of CVD has not been comprehensively reviewed, and its potential limitations remain underexplored. In the narrative mini-review, we summarized evidence showing that higher CTI was consistently associated with an increased risk of CVD, including stroke. For instance, for each 1-unit increase in CTI, the hazard ratios (HRs) or odds ratios (ORs) for CVD ranged from 1.06 to 2.85, with a pooled effect estimate (eOR) of 1.30 (95% CI: 1.13–1.50). Similarly, each 1-unit increase in CTI or cumulative CTI (cuCTI) was associated with a 10–33% increased risk of self-reported stroke, with a pooled eOR of 1.20 (95% CI: 1.13–1.29). However, several knowledge gaps remain: (1) population-specific CTI formulas require development and validation across different demographic and clinical groups; (2) the predictive performance of CTI should, wherever feasible, be compared with that of its individual components; and (3) consistency between formula application and descriptive results must be ensured to allow meaningful comparisons. Show more