The association between C-reactive protein-triglyceride glucose index and the risk of new-onset stroke in middle-aged and elderly individuals: A Retrospective Cohort Study

Objective The impact of the triglyceride-glucose (TyG) index on stroke incidence has been investigated in numerous studies. However, the relationship between the C-reactive protein-triglyceride-glucose (CTI) index, which is a new marker of insulin resistance and inflammation, and stroke is unclear. Methods We analysed data from 7,295 participants in the China Health and Retirement Longitudinal Study (CHARLS). The association of the CTI index with incident stroke was assessed using something called 'logistic regression'. Potential nonlinearity was explored using restricted cubic splines (RCS), and the stability of the results was evaluated through subgroup analyses. Furthermore, we compared the predictive performance of the CTI and TyG indices by calculating their respective areas under the receiver operating characteristic (ROC) curve. Results During the follow-up period, 456 participants experienced a stroke. After adjusting for confounding factors (Model 3), higher and progressively increasing CTI indices in the Q2 (OR = 1.48, 95% CI 1.08–2.05) and Q3 (OR = 1.75, 95% CI 1.27–2.43) groups were associated with an increased risk of new-onset stroke. Although the OR for Q4 was elevated, it was not statistically significant (OR = 1.32, 95% CI 0.92–1.92). RCS analysis revealed a U-shaped relationship between CTI index and stroke risk. ROC analysis revealed that the CTI index had an area under the curve (AUC) of 0.607 (95% confidence interval: 0.403–0.726), whereas the TyG index had an AUC of 0.553 (95% confidence interval: 0.713–0.373). This finding suggests that the CTI index is a more reliable indicator of stroke risk than the TyG index. Conclusions Overall, this study demonstrates that the CTI index is an independent risk factor for new-onset stroke. Our findings suggest that the most cost-effective approach to stroke prevention is to implement interventions targeting individuals whose CTI index begins to rise from moderate levels.