C-reactive protein-triglyceride glucose index and fatty liver disease associated with metabolic dysfunction in U.S. adults: a cross-sectional study based on NHANES

Background C-reactive protein-triglyceride glucose index (CTI) has been identified as a novel inflammatory marker for comprehensive assessment of the severity of inflammation and insulin resistance, but the role of CTI in Metabolic dysfunction-associated steatotic liver disease(MASLD) is still unclear. This study aims to explore the relationship between CTI level and MASLD. To determine its potential as a predictive marker of steatosis and fibrosis stages. Methods This is a study based on the 2017-2020 NHANES survey data of 15,560 participants. Multivariate regression analysis was performed on the data to explore the linear relationship between CTI and its quartile and hepatic steatosis and liver fibrosis, and the linear or nonlinear association between CTI and MALSD was visualize using restricted cubic splines. Subgroup analysis was performed to determine the consistency of this association across different population groups. The receiver operating characteristic curve(ROC) was established to determine Cutoff values and the area under the curve was calculated to compare the diagnostic efficacy of different measures, and the clinical decision curve was plotted. Result A total of 3,816 U.S. adults over the age of 18 were recruited,adjusted multiple logistic regression analysis showed a significant positive correlation between CTI index and MASLD (OR: 2.13 95%CI:1.68, 2.70), and a significant positive correlation between CTI index and liver fibrosis (OR:1.60 95%CI:1.15, 2.23), compared with the lowest quartile of CTI (Q1), the risk of hepatic steatosis increased in Q2, Q3 and Q4 participants, and the risk of hepatic fibrosis also increased successively. In the subgroup analysis, the association between CTI index and various variables remained consistent. ROC-AUC shows that CTI as a composite index is better than other single index in clinical diagnosis. Conclusions The CTI index is positively correlated with the prevalence of MASLD. Our study emphasizes the importance of the CTI index as a new marker of MASLD, so that it can play a role in early diagnosis, treatment, and monitoring prognosis.