Among 3,488 participants, 42.7% were diagnosed with non-alcoholic fatty liver disease ().
is positively correlated with the prevalence of NAFLD (odds ratio 1.94) and liver fibrosis (odds ratio 1.38).
The significant correlation between CTI and NAFLD/liver fibrosis was consistent across various subgroups.
CTI demonstrates a higher accuracy for identifying NAFLD (area under the curve 0.756) and liver fibrosis (area under the curve 0.702) compared to triglyceride glucose index and high-sensitivity C-reactive protein alone.
Simplified
BACKGROUND: The novel serum high-sensitivity C-reactive protein-triglyceride glucose index () has been recognized as an optimal parameter encompassing both insulin resistance (IR) and inflammation, which are potential mechanisms contributing to non-alcoholic fatty liver disease (). This study aims to examine the correlation between CTI and NAFLD/liver fibrosis in American adults.
METHODS: This is a cross-sectional study utilizing data from NHANES during the period from 2017 to 2020. The composite CTI was calculated through the formula: 0.412×Ln [(high-sensitivity C-reactive protein(hs-CRP)] + Ln(triglycerides × fasting plasma glucose/2). To explore the correlation between CTI and NAFLD/liver fibrosis, multivariate logistic regression analyses, subgroup analyses, restricted cubic spline (RCS) regression, and receiver operating characteristic (ROC) analysis were employed.
RESULTS: Among 3,488 participants, 42.7% (n = 1,488) were diagnosed as NAFLD, while 9.4% (n = 329) exhibited liver fibrosis. Logistic regression and RCS regression analyses demonstrated a significant positive linear correlation between CTI and the prevalence of NAFLD (OR = 1.94, 95% CI: 1.70, 2.22) as well as liver fibrosis (OR = 1.38, 95% CI: 1.14, 1.67), even after being adjusted for potential confounding variables. Furthermore, a significant correlation between CTI and the prevalence of NAFLD/liver fibrosis was observed across various subgroups. ROC analysis revealed that CTI can serve as a more robust identify for the prevalence of NAFLD (AUC = 0.756) and liver fibrosis (AUC = 0.702) compared to triglyceride glucose index (TyG) and hs-CRP alone.
CONCLUSION: Elevated levels of CTI are directly associated with significant liver fibrosis and the presence of NAFLD, indicating its potential utility as a biomarker for liver fibrosis and NAFLD.
Key numbers
1.94
Increased Odds of
Odds ratio for prevalence with elevated
1.38
Increased Odds of Liver Fibrosis
Odds ratio for liver fibrosis prevalence with elevated
0.756
Diagnostic Accuracy for
Area under the curve (AUC) for in diagnosis
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Declarations. Ethics approval and consent to participate: The study was approved by the National Centre for Health Statistics Research Ethics Review Board, and every participant signed informed consent. The written informed consent of all subjects was obtained following the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Clinical trial number: Not applicable.
