CTI-related composite adiposity indices and future cardiovascular disease risk among middle-aged and older Chinese adults

Figures

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  Figure 1. Flowchart of participant selection in the CHARLS cohort.

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  Figure 2. Kaplan–Meier curves for incident CVD according to tertiles of CTI-related composite indices. Kaplan–Meier curves showing cumulative hazard according to tertiles of CTI-related composite indices (A–D). Group differences were assessed using the log-rank test. Since incident CVD was identified at discrete CHARLS follow-up waves, the step pattern reflects wave-based outcome ascertainment rather than continuous event recording. Numbers at risk are shown below each panel. Abbreviations: CTI, C-reactive protein-triglyceride-glucose index; BMI, body mass index; BRI, body roundness index; WHtR, waist-to-height ratio; WWI, weight-adjusted waist index; CVD, cardiovascular disease.

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  Figure 3. Restricted cubic spline analyses of the associations between CTI-related composite indices and incident cardiovascular disease. Restricted cubic spline analyses showing the dose–response relationships between CTI-related composite indices and incident CVD risk after further adjustment for hypertension status. (A) CTI-BMI; (B) CTI-BRI; (C) CTI-WHtR; (D) CTI-WWI. Red solid lines indicate adjusted hazard ratios, and shaded areas represent 95% confidence intervals. Histograms at the bottom of each panel show the distribution of each index. The vertical dashed lines indicate the identified points used in the exploratory two-piecewise Cox regression analyses and were also used as reference points for HR estimation in the RCS plots. These identified points should be interpreted as exploratory rather than definitive clinical thresholds. Abbreviations: HR, hazard ratio; CI, confidence interval; CTI, C-reactive protein-triglyceride-glucose index; BMI, body mass index; BRI, body roundness index; WHtR, waist-to-height ratio; WWI, weight-adjusted waist index; CVD, cardiovascular disease.

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  Figure 4. Predictive performance of CTI-related composite indices for incident cardiovascular disease. Comparison of the predictive performance of CTI-related composite indices for incident CVD (A) Time-dependent receiver operating characteristic (ROC) curves at 4 years for CTI-BMI, CTI-BRI, CTI-WHtR, CTI-WWI, and CTI alone. The area under the curve (AUC) for each index is displayed in the corresponding panel (B) Time-dependent concordance index (C-index) curves over follow-up. Abbreviations: ROC, receiver operating characteristic; AUC, area under the curve; C-index, concordance index; CTI, C-reactive protein-triglyceride-glucose index; BMI, body mass index; BRI, body roundness index; WHtR, waist-to-height ratio; WWI, weight-adjusted waist index; CVD, cardiovascular disease.

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  Figure 5. Incremental predictive value of CTI-WHtR beyond the baseline model for incident cardiovascular disease. Incremental predictive performance of CTI-WHtR for incident CVD beyond the baseline model. (A) Time-dependent ROC curves at 4 years comparing Model 1 and Model 2. Model 1 represents the baseline model constructed from conventional risk factors, and Model 2 represents the baseline model plus CTI-WHtR. The addition of CTI-WHtR improved the AUC from 59.6 to 60.8%. (B) Time-dependent C-index curves for Model 1 and Model 2 during follow-up. Model 2 consistently showed slightly better discriminative ability than Model 1. Abbreviations: CTI-WHtR, C-reactive protein-triglyceride-glucose index × waist-to-height ratio; ROC, receiver operating characteristic; AUC, area under the curve; C-index, concordance index; CVD, cardiovascular disease.