Can one composite index capture both inflammatory and metabolic cardiovascular risk in type 2 diabetes?

Table 1 Comparison of composite cardiovascular risk biomarkers in type 2 diabetes mellitus

Feature	CRP-FCP product	TyG index	HOMA-IR	Multi-marker panels
Formula	CRP × FCP	ln(TG × FG/2)	FG × insulin/22.5	Various combinations
Primary pathophysiological domain	Inflammation + endogenous insulin secretory status	Lipotoxic-metabolic insulin resistance	Insulin resistance	Multiple biological axes
Inflammatory component	Yes (CRP)	No	No	Variable
Requires insulin assay	No	No	Yes	Variable
Prospective evidence in T2DM	Limited (DD2 categorical only)	Relatively extensive	Moderate, heterogeneous	Emerging
Reported predictive performance (AUC)	Modest (0.550-0.558)	Moderate (0.60-0.70)	Variable (0.55-0.65)	Potentially higher (0.65-0.80)
Ethnic diversity of evidence	European + East Asian	Broad, including multi-ethnic cohorts (PURE)	Broad, heterogeneous	Predominantly Western
Practical cost and feasibility	Low	Low	Moderate	Moderate to high

CRP: C-reactive protein; FCP: Fasting C-peptide; TyG: Triglyceride-glucose; HOMA-IR: Homeostasis model assessment of insulin resistance; TG: Triglycerides; FG: Fasting glucose; AUC: Area under the curve; T2DM: Type 2 diabetes mellitus.