{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:03:58Z","timestamp":1781071438146,"version":"3.54.1"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Arthritis encompasses heterogeneous joint and rheumatic conditions and is associated with increased cardiovascular disease (CVD) risk. The C-reactive protein\u2013triglyceride\u2013glucose index (CTI) integrates inflammatory and metabolic burden, but its association with CVD among adults with arthritis remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from the China Health and Retirement Longitudinal Study (CHARLS) and an independent hospital-based cross-sectional replication cohort were analyzed. In the CHARLS, baseline CTI was assessed in 2,894 adults with self-reported physician-diagnosed arthritis or rheumatism. Cumulative CTI exposure (cumCTI) and exploratory two-time-point CTI level-change patterns were evaluated in 1,394 participants using Wave 3 in 2015 as the time origin. Cox regression, restricted cubic spline, subgroup, sensitivity, and exploratory predictive performance analyses were performed for incident CVD. In the hospital-based cohort, 7,960 participants were analyzed using logistic regression and spline analyses for prevalent CVD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the CHARLS, 771 incident CVD events occurred in the baseline CTI analysis, and 300 occurred in the repeated-measures analyses. In fully adjusted models, baseline CTI was associated with incident CVD [hazard ratio (HR) = 1.251, 95% confidence interval (CI): 1.083\u20131.446,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002], with the highest risk in Q4 versus Q1 (HR\u00a0=\u00a01.587, 95% CI: 1.257\u20132.003;\n                      <jats:italic>p<\/jats:italic>\n                      for trend &amp;lt; 0.001). cumCTI was also associated with incident CVD (HR\u00a0=\u00a01.118, 95% CI: 1.025\u20131.220,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.012), with higher risk in Q4 versus Q1 (HR\u00a0=\u00a01.504, 95% CI: 1.038\u20132.179;\n                      <jats:italic>p<\/jats:italic>\n                      for trend = 0.012). Compared with Cluster 1, both Cluster 2 and Cluster 3 were associated with higher CVD risk. In the hospital-based cross-sectional replication cohort, baseline CTI was associated with prevalent CVD recorded in hospital medical records. Exploratory predictive analyses showed modest discrimination for CTI [area under the curve (AUC) = 0.556, 95% CI: 0.529\u20130.583], and adding CTI to the basic model changed Harrell\u2019s C-index from 0.615 to 0.618.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Higher CTI-related inflammatory-metabolic burden was associated with increased CVD risk in middle-aged and older adults with arthritis. CTI may provide complementary information for recognizing inflammatory-metabolic cardiovascular vulnerability in adults with arthritis, but its incremental predictive value was modest and requires further validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1854928","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T05:40:04Z","timestamp":1781070004000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between the C-reactive protein\u2013triglyceride\u2013glucose index and incident cardiovascular disease in middle-aged and older adults with arthritis: a nationwide prospective cohort study with hospital-based cross-sectional replication"],"prefix":"10.3389","volume":"17","author":[{"given":"Feng","family":"Luo","sequence":"first","affiliation":[{"name":"Guizhou University of Traditional Chinese Medicine","place":["Guiyang, 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