The Journal of International Medical Research · Nov 9, 2026
Association of the C-reactive protein-triglyceride-glucose index with incident sarcopenia in Chinese middle-aged and older adults: A prospective cohort study
By Xiao QL, Liu JF, Huang L et al.
BackgroundSarcopenia is a progressive skeletal muscle disorder associated with metabolic dysfunction and chronic inflammation. The C-reactive protein-triglyceride-glucose index integrates inflammatory and metabolic status; however, its longitudinal association with sarcopenia remains unclear.MethodsThis prospective cohort study used data from the China Health and Retirement Longitudinal Study. Participants aged ≥45 years without sarcopenia at baseline in 2011 were followed up until 2015. The C-reactive protein-triglyceride-glucose index was calculated based on serum C-reactive protein, triglyceride, and fasting plasma glucose levels. Incident sarcopenia was defined according to the 2019 Asian Working Group for Sarcopenia criteria. Multivariable logistic regression was performed to assess the association between the baseline C-reactive protein-triglyceride-glucose index and incident sarcopenia. Restricted cubic splines assessed dose-response relationships, while subgroup and E-value analyses evaluated the robustness of the analyses.ResultsDuring 4 years of follow-up, 1071 participants developed sarcopenia. A higher baseline C-reactive protein-triglyceride-glucose index was associated with lower odds of incident sarcopenia (fully adjusted odds ratio per unit increase = 0.89, 95% confidence interval: 0.79-0.98). The association remained significant after excluding participants with diabetes or those on antidiabetic medications. Participants in the highest C-reactive protein-triglyceride-glucose index quartile had 29% lower odds than those in the lowest quartile (odds ratio = 0.71, 95% confidence interval: 0.55-0.92; p for trend = 0.002). Restricted cubic spline analysis revealed an overall association between the C-reactive protein-triglyceride-glucose index and incident sarcopenia, with no statistically significant evidence of nonlinearity.ConclusionsA higher baseline C-reactive protein-triglyceride-glucose index was associated with lower odds of incident sarcopenia in this Chinese cohort. This association persisted after excluding participants with diabetes or those on antidiabetic medication. Given the modest effect size and limited discriminatory performance, the present findings do not support the use of the C-reactive protein-triglyceride-glucose index as a standalone clinical biomarker and should be considered hypothesis-generating. Further longitudinal and mechanistic studies are warranted.