The combined effects of cardiometabolic index and high-sensitivity C-reactive protein on the risk of new onset stroke in a Chinese national prospective longitudinal cohort study
Abstract Background The Cardiometabolic Index (CMI) represents a novel anthropometric measurement, which combines characteristics of adiposity and lipids. Since obesity, lipid metabolism, and inflammation may collectively facilitate the occurrence of stroke, we hypothesize that a combination of elev...
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BMC
2025-01-01
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| Series: | Lipids in Health and Disease |
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| Online Access: | https://doi.org/10.1186/s12944-025-02430-y |
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| author | Fangfang Li Yu He Ali Yang Mingrong Xia Weizhou Zang Jiewen Zhang |
| author_facet | Fangfang Li Yu He Ali Yang Mingrong Xia Weizhou Zang Jiewen Zhang |
| author_sort | Fangfang Li |
| collection | DOAJ |
| description | Abstract Background The Cardiometabolic Index (CMI) represents a novel anthropometric measurement, which combines characteristics of adiposity and lipids. Since obesity, lipid metabolism, and inflammation may collectively facilitate the occurrence of stroke, we hypothesize that a combination of elevated levels of the CMI and high-sensitivity C-reactive protein (hs-CRP) increases the risk of future stroke among middle-aged and older Chinese adults. Methods This study included 8,973 participants aged 45 years or older from the China Longitudinal Study on Health and Retirement (CHARLS), who were stroke-free and underwent baseline evaluations between 2011 and 2012, with followed-up at 2013, 2015 and 2018. The exposures were CMI and hs-CRP, with CMI calculated using the formula [waist circumference (cm)/height (cm)] × [triglycerides (mmol/L)/HDL-C (mmol/L)]. The primary outcome was the occurrence of new-onset stroke events. Cox proportional hazards models and restricted cubic spline (RCS) analyses were conducted to examine the associations between CMI, hs-CRP, and their combined effects on stroke risk. Sensitivity analysis was further implemented to verify the robustness of the results. Results A total of 629 participants (7.01%) suffered new-onset stroke during follow-up. The risk for stroke increased with each elevating quartile of baseline CMI levels, with adjusted HRs and 95% CIs being 1.27 (0.98–1.66), 1.41 (1.08–1.83), and 1.46 (1.09–1.96) for Q2, Q3, and Q4, respectively. Moreover, participants with levels of hs-CRP ≥ 2 mg/L also had significantly higher stroke incidence compared to those with CRP levels < 2 mg/L (adjusted HR 1.24, 95% CI 1.05–1.47, p = 0.012). Specifically, those concurrently with the highest CMI quartile and levels of hs-CRP ≥ 2 mg/L had the highest risk of stroke (adjusted HR 1.90, 95% CI 1.32–2.74). The subsequent sensitivity analyses yielded consistent results, further corroborating the initial findings. Conclusions The combination of CMI and hs-CRP exhibited a significant association with stroke risk among middle-aged and older Chinese adults, highlighting the importance of joint assessments of these biomarkers for refining risk stratification and enhancing primary prevention strategies for stroke. |
| format | Article |
| id | doaj-art-17318f9134db4f90aca743bcf4c4bfd0 |
| institution | Kabale University |
| issn | 1476-511X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | Lipids in Health and Disease |
| spelling | doaj-art-17318f9134db4f90aca743bcf4c4bfd02025-01-12T12:37:55ZengBMCLipids in Health and Disease1476-511X2025-01-0124111110.1186/s12944-025-02430-yThe combined effects of cardiometabolic index and high-sensitivity C-reactive protein on the risk of new onset stroke in a Chinese national prospective longitudinal cohort studyFangfang Li0Yu He1Ali Yang2Mingrong Xia3Weizhou Zang4Jiewen Zhang5Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou University People’s HospitalDepartment of Neurology, Henan Provincial People’s Hospital, Zhengzhou University People’s HospitalDepartment of Neurology, Henan Provincial People’s Hospital, Zhengzhou University People’s HospitalDepartment of Neurology, Henan Provincial People’s Hospital, Zhengzhou University People’s HospitalDepartment of Neurology, Henan Provincial People’s Hospital, Zhengzhou University People’s HospitalDepartment of Neurology, Henan Provincial People’s Hospital, Zhengzhou University People’s HospitalAbstract Background The Cardiometabolic Index (CMI) represents a novel anthropometric measurement, which combines characteristics of adiposity and lipids. Since obesity, lipid metabolism, and inflammation may collectively facilitate the occurrence of stroke, we hypothesize that a combination of elevated levels of the CMI and high-sensitivity C-reactive protein (hs-CRP) increases the risk of future stroke among middle-aged and older Chinese adults. Methods This study included 8,973 participants aged 45 years or older from the China Longitudinal Study on Health and Retirement (CHARLS), who were stroke-free and underwent baseline evaluations between 2011 and 2012, with followed-up at 2013, 2015 and 2018. The exposures were CMI and hs-CRP, with CMI calculated using the formula [waist circumference (cm)/height (cm)] × [triglycerides (mmol/L)/HDL-C (mmol/L)]. The primary outcome was the occurrence of new-onset stroke events. Cox proportional hazards models and restricted cubic spline (RCS) analyses were conducted to examine the associations between CMI, hs-CRP, and their combined effects on stroke risk. Sensitivity analysis was further implemented to verify the robustness of the results. Results A total of 629 participants (7.01%) suffered new-onset stroke during follow-up. The risk for stroke increased with each elevating quartile of baseline CMI levels, with adjusted HRs and 95% CIs being 1.27 (0.98–1.66), 1.41 (1.08–1.83), and 1.46 (1.09–1.96) for Q2, Q3, and Q4, respectively. Moreover, participants with levels of hs-CRP ≥ 2 mg/L also had significantly higher stroke incidence compared to those with CRP levels < 2 mg/L (adjusted HR 1.24, 95% CI 1.05–1.47, p = 0.012). Specifically, those concurrently with the highest CMI quartile and levels of hs-CRP ≥ 2 mg/L had the highest risk of stroke (adjusted HR 1.90, 95% CI 1.32–2.74). The subsequent sensitivity analyses yielded consistent results, further corroborating the initial findings. Conclusions The combination of CMI and hs-CRP exhibited a significant association with stroke risk among middle-aged and older Chinese adults, highlighting the importance of joint assessments of these biomarkers for refining risk stratification and enhancing primary prevention strategies for stroke.https://doi.org/10.1186/s12944-025-02430-yCardiometabolic indexhs-CRPStrokeCHARLS |
| spellingShingle | Fangfang Li Yu He Ali Yang Mingrong Xia Weizhou Zang Jiewen Zhang The combined effects of cardiometabolic index and high-sensitivity C-reactive protein on the risk of new onset stroke in a Chinese national prospective longitudinal cohort study Lipids in Health and Disease Cardiometabolic index hs-CRP Stroke CHARLS |
| title | The combined effects of cardiometabolic index and high-sensitivity C-reactive protein on the risk of new onset stroke in a Chinese national prospective longitudinal cohort study |
| title_full | The combined effects of cardiometabolic index and high-sensitivity C-reactive protein on the risk of new onset stroke in a Chinese national prospective longitudinal cohort study |
| title_fullStr | The combined effects of cardiometabolic index and high-sensitivity C-reactive protein on the risk of new onset stroke in a Chinese national prospective longitudinal cohort study |
| title_full_unstemmed | The combined effects of cardiometabolic index and high-sensitivity C-reactive protein on the risk of new onset stroke in a Chinese national prospective longitudinal cohort study |
| title_short | The combined effects of cardiometabolic index and high-sensitivity C-reactive protein on the risk of new onset stroke in a Chinese national prospective longitudinal cohort study |
| title_sort | combined effects of cardiometabolic index and high sensitivity c reactive protein on the risk of new onset stroke in a chinese national prospective longitudinal cohort study |
| topic | Cardiometabolic index hs-CRP Stroke CHARLS |
| url | https://doi.org/10.1186/s12944-025-02430-y |
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