The association between sarcopenia and C-reactive protein-triglyceride glucose index (CTI) in Chinese older adults remains unclear. This study aims to explore this association based on nationwide survey data. This longitudinal study utilized data from the China Health and Retirement Longitudinal Study (CHARLS). We included participants aged ≥45 years with complete baseline (2011) and follow-up (2015) data. The CTI was calculated as 0.412 × Ln (C-reactive protein) + Ln (Triglyceride × Fasting plasma glucose)/2. Sarcopenia was defined per the 2019 Asian Working Group for Sarcopenia criteria, incorporating muscle strength, appendicular skeletal muscle mass (estimated via a validated equation), and physical performance. After exclusions, 5741 participants were included. Multivariable logistic regression models were employed to assess associations between CTI (as continuous variable and quartiles) and incident sarcopenia, with progressive adjustment for demographic, behavioral, and clinical covariates. Propensity score matching, inverse probability weighting, restricted cubic splines, and subgroup analyses were conducted to validate robustness. Results: This longitudinal study of 5741 participants (mean age: 57.26 years; 53.9% female) conducted over four years found that the incidence of sarcopenia was 13.7%. Higher CTI levels were found to be inversely correlated with sarcopenia risk, with an unadjusted odds ratio (OR) of 0.643 (95% confidence interval (CI): 0.559–0.738) and a fully adjusted OR of 0.732 (95% CI: 0.615–0.869). Quartile analysis revealed a progressive reduction in risk from Q1 to Q4 (Q4 OR = 0.618, 95% CI: 0.469–0.811). Propensity score matching and inverse probability weighting confirmed the robustness of these results (OR ≈ 0.58–0.59). Restricted cubic splines indicated a non-linear association (P for non-linearity = 0.011). Subgroup analyses identified effect modifications by sex, marital status and arthritis. Sensitivity analyses excluding confounders confirmed the inverse relationship. The area under the ROC curve for prediction was 0.831. This study has identified a U-shaped association between CTI and sarcopenia risk in middle-aged and older adults. Both low and high CTI levels were found to be detrimental. This association is particularly apparent in women and older adults, highlighting the need for further research into the underlying mechanisms. • A study on the association between CTI index and the incidence of sarcopenia in elderly chinese population. • High CTI levels are significantly associated with increased sarcopenia risk. • CTI may as a cost-effective biomarker for early sarcopenia screening.
Wei et al. (Sun,) studied this question.
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