C-reactive protein-triglyceride-glucose index is associated with cardiovascular disease in people living with HIV

The C-reactive protein-triglyceride-glucose index (CTI) has emerged as a novel biomarker to assess metabolic-inflammatory disorders. However, the relationship between CTI and cardiovascular disease (CVD) in people living with HIV (PLWH) remains unexplored. This cross-sectional study enrolled 505 PLWH who initiated antiretroviral therapy (ART) at Beijing Ditan Hospital between January 2016 and December 2020. Multivariate logistic regression models were constructed to assess the relationship between CTI and CVD prevalence, adjusting for potential confounding factors. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive performance of CTI for CVD, with the area under the curve (AUC) serving as the primary metric. Furthermore, restricted cubic spline (RCS) analysis was performed to explore the dose–response relationship between CTI and CVD. After adjusting for potential confounders, higher CTI was significantly associated with an increased prevalence of CVD. Each standard deviation (SD) increase in CTI was associated with a 189.0% higher prevalence of CVD (odds ratio [OR] = 2.890, 95% confidence interval [CI] = 1.805–4.598, P < 0.001). CTI yielded satisfactory discriminative performance for CVD (AUC = 0.763), with comparable predictive ability to the triglyceride-glucose (TyG) index (AUC = 0.731) and markedly better performance than C-reactive protein (AUC = 0.581). Subgroup and interaction analysis indicated that the association between CTI and CVD remained consistent across subgroups stratified by gender, smoking, drinking, hyperlipidemia, hypertension, and diabetes mellitus, with some variations observed across age groups and body mass index categories. RCS analysis showed a significantly higher prevalence of CVD when CTI values exceeded 8.9. As a novel composite biomarker integrating metabolic and inflammatory signatures, CTI is independently associated with CVD prevalence in PLWH. Incorporating CTI monitoring into routine clinical practice may improve the accuracy of CVD stratification and facilitate the development of personalized preventive and therapeutic strategies for this high-risk population.