Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Diabetes. Jul 15, 2026; 17(7): 120422
Published online Jul 15, 2026. doi: 10.4239/wjd.120422
Published online Jul 15, 2026. doi: 10.4239/wjd.120422
Can one composite index capture both inflammatory and metabolic cardiovascular risk in type 2 diabetes?
Young-Hye Cho, Department of Family Medicine, Pusan National University School of Medi
Jung In Choi, Department of Family Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
Sang Yeoup Lee, Family Medicine and Biomedical Research Institute, Pusan National Uni
Sang Yeoup Lee, Department of Medical Education, Pusan National University School of Medi
Author contributions: Cho YH, Choi JI, and Lee SY wrote the paper; Cho YH and Choi JI collected the data; Lee SY revised the final version of the paper; and all authors thoroughly reviewed and endorsed the final manuscript.
AI contribution statement: We used an AI-based language tool (Claude by Anthropic) to help with English language editing and structural refinement of the manuscript. The authors formulated all scientific interpretations, the critical appraisal of the cited literature, and the scholarly conclusions. The AI tool participated only at the level of language expression, not in scientific reasoning or interpretation.
Supported by a 2025 research grant from Pusan National University Yangsan Hospital.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Sang Yeoup Lee, MD, Executive Vice President, Principal Investigator, Professor, Family Medicine and Biomedical Research Institute, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan 50612, South Korea.
Received: February 26, 2026
Revised: April 3, 2026
Accepted: May 19, 2026
Published online: July 15, 2026
Processing time: 133 Days and 8.7 Hours
Revised: April 3, 2026
Accepted: May 19, 2026
Published online: July 15, 2026
Processing time: 133 Days and 8.7 Hours
Core Tip
Core Tip: The product of C-reactive protein and fasting C-peptide represents a hypothesis-generating composite marker integrating inflammatory and metabolic cardiovascular risk in type 2 diabetes mellitus. By combining two biomarkers with distinct and individually limited predictive profiles, this approach aims to capture the adipose tissue-driven metaflammation axis underlying diabetic vascular disease. The multiplicative formulation preferentially reflects the high-C-reactive protein, high-fasting C-peptide phenotype, but its clinical value remains uncertain given modest discriminative performance, limited comparison with competing composite indices, and the need for prospective validation across diverse populations.