Change in C-reactive protein-triglyceride glucose index and risk of stroke among middle-aged and older adults free of diabetes: A national cohort study

BACKGROUND AND AIM: Previous evidence on C-reactive protein-triglyceride glucose index (CTI) was limited by a single measurement, evidence regarding the longitudinal role of CTI was lack. This study was aimed to investigate the association of changes in CTI with the risk of stroke in non-diabetic adults. METHODS AND RESULTS: A total of 5973 participants free of diabetes were enrolled from the China Health and Retirement Longitudinal Study (CHARLS). Participants were divided into 4 group according to the high (≥8.72) and low (<8.72) levels of CTI at baseline and wave 3 as stable low, remitted, elevated, and stable high. During a median follow-up of 3.50 years, 310 cases (5.19 %) stroke occurred. Compared to the stable low group, a significant higher risk of stroke was only observed in the stable high group (hazard ratio [HR], 1.76; 95 % confidence interval [CI], 1.34-2.30), rather than the remitted (HR, 1.35; 95 % CI, 0.91-1.99) or elevated (HR, 1.09; 95 % CI, 0.78-1.54) group. The addition of changes in CTI to a conventional risk model had an incremental effect on the predictive value for stroke (P < 0.05). Mediation analyses showed that the association between stable high CTI and stroke was partially mediated by hypertension (19.36 %) and dyslipidemia (8.92 %). CONCLUSIONS: Only stable high CTI was associated with an increased higher risk of stroke in non-diabetic adults. Monitoring longitudinal levels of CTI may provide new insights for the prevention and management of stroke.