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Publication Name
World Journal of Diabetes
ISSN
1948-9358
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study
Copyright: ©Author(s) 2026.
World J Diabetes. Jul 15, 2026; 17(7): 120647
Published online Jul 15, 2026. doi: 10.4239/wjd.120647
Table 1 Patient demographics and baseline characteristics stratified by C-reactive protein-triglyceride-glucose index quartiles
Characteristic
CTI quartiles
P value
Overall, n = 7413Q1, n = 1854Q2, n = 1853Q3, n = 1853Q4, n = 1853
Age (year)50.0 ± 10.947.2 ± 11.950.6 ± 10.651.4 ± 10.350.9 ± 10.0< 0.001
Sex < 0.001
    Men4157 (56.1)632 (34.1)940 (50.7)1159 (62.5)1426 (77.0)
    Women3256 (43.9)1222 (65.9)913 (49.3)694 (37.5)427 (23.0)
University degree or above (n = 578)293 (50.7)83 (57.2)85 (49.4)57 (46.0)68 (49.6)0.426
Current smoking (n = 3579)617 (17.2)87 (8.57)151 (15.9)166 (19.2)213 (28.6)< 0.001
Current drinking (n = 3579)614 (17.2)114 (11.2)146 (15.3)174 (20.1)180 (24.1)< 0.001
Regular exercise (n = 3579)1815 (50.7)516 (50.8)517 (54.3)436 (50.3)346 (46.4)0.014
SBP (mmHg)124 ± 16.7118 ± 15.5123 ± 16.3126 ± 16.3129 ± 16.5< 0.001
DBP (mmHg)75.7 ± 11.570.8 ± 10.474.5 ± 11.377.2 ± 11.080.2 ± 11.3< 0.001
BMI (kg/m2)24.6 ± 3.3422.4 ± 2.8324.1 ± 2.9525.3 ± 2.9326.6 ± 3.16< 0.001
WC (cm)84.1 ± 10.276.5 ± 8.6982.5 ± 9.1386.7 ± 8.5890.7 ± 8.64< 0.001
HC (cm)94.3 ± 5.9391.4 ± 5.2593.8 ± 5.6295.3 ± 5.4696.7 ± 6.01< 0.001
WHR0.90 (0.84, 0.94)0.83 (0.79, 0.88)0.88 (0.83, 0.92)0.91 (0.87, 0.95)0.94 (0.90, 0.97)< 0.001
BRI3.67 (2.94, 4.41)2.82 (2.31, 3.48)3.51 (2.88, 4.12)3.94 (3.36, 4.52)4.32 (3.71, 4.97)< 0.001
ALT (U/L)26.5 ± 23.119.5 ± 24.122.7 ± 14.828.3 ± 24.635.5 ± 23.9< 0.001
AST (U/L)25.0 ± 17.522.4 ± 16.523.4 ± 9.3225.9 ± 23.728.2 ± 16.8< 0.001
TBIL (μmol/L)13.2 ± 5.0113.7 ± 5.3413.4 ± 4.7813.0 ± 4.8912.7 ± 4.97< 0.001
DBIL (μmol/L)3.83 ± 1.644.18 ± 1.743.92 ± 1.523.77 ± 1.733.45 ± 1.46< 0.001
TP (g/L)72.6 ± 4.4771.5 ± 4.3072.0 ± 4.2272.9 ± 4.2474.0 ± 4.70< 0.001
ALB (g/dL)4.61 ± 0.284.57 ± 0.274.59 ± 0.284.62 ± 0.284.68 ± 0.28< 0.001
BUN (mmol/L)5.07 ± 1.364.94 ± 1.305.06 ± 1.395.09 ± 1.375.19 ± 1.35< 0.001
PLT (109/L)219 (187, 255)216 (182, 252)220 (188, 256)221 (190, 260)220 (188, 254)< 0.001
Cr (mg/dL)0.78 ± 0.260.72 ± 0.170.77 ± 0.290.81 ± 0.340.82 ± 0.19< 0.001
eGFR (mL/minute/1.73 m2)104 ± 21.0108 ± 20.7104 ± 21.0102 ± 19.6104 ± 22.0< 0.001
UA (μmol/L)342 ± 87.9296 ± 72.8329 ± 80.0359 ± 85.1386 ± 86.4< 0.001
FPG (mmol/L) 5.58 ± 1.445.04 ± 0.575.27 ± 0.675.50 ± 1.016.50 ± 2.30< 0.001
HbA1c (%)5.88 ± 0.835.57 ± 0.405.72 ± 0.465.89 ± 0.676.35 ± 1.26< 0.001
TCHO (mmol/L) 5.18 ± 1.044.82 ± 0.945.09 ± 0.955.25 ± 0.945.56 ± 1.18< 0.001
TG (mmol/L) 1.48 (1.00, 2.28)0.81 (0.66, 1.01)1.22 (1.00, 1.50)1.75 (1.44, 2.13)3.11 (2.36, 4.41)< 0.001
HDL-C (mmol/L) 1.31 ± 0.301.50 ± 0.311.36 ± 0.281.25 ± 0.231.12 ± 0.23< 0.001
LDL-C (mmol/L) 2.91 ± 0.832.74 ± 0.773.01 ± 0.783.09 ± 0.792.81 ± 0.93< 0.001
hs-CRP (mg/L)1.35 (0.71, 2.33)0.59 (0.30, 0.98)1.16 (0.75, 1.83)1.80 (1.12, 2.74)2.32 (1.50, 3.44)< 0.001
CTI8.90 ± 0.907.80 ± 0.428.59 ± 0.179.16 ± 0.1610.1 ± 0.58< 0.001
TyG8.83 ± 0.738.09 ± 0.358.55 ± 0.318.95 ± 0.309.73 ± 0.62< 0.001
HOMA-IR2.03 (1.36, 3.02)1.50 (1.05, 2.09)1.83 (1.27, 2.61)2.23 (1.54, 3.12)2.97 (2.00, 4.29)< 0.001
FINS (μIU/mL)8.60 (5.90, 12.2)6.76 (4.84, 9.39)8.00 (5.50, 11.1)9.38 (6.53, 13.0)11.3 (7.73, 14.8)< 0.001
FIB-41.23 ± 0.641.25 ± 0.811.26 ± 0.601.23 ± 0.571.19 ± 0.550.006
NFS-2.21 ± 1.14-2.34 ± 1.10-2.22 ± 1.14-2.22 ± 1.12-2.05 ± 1.19< 0.001
APRI0.26 (0.20, 0.34)0.25 (0.19, 0.31)0.25 (0.20, 0.32)0.26 (0.21, 0.34)0.29 (0.22, 0.39)< 0.001
DM931 (12.6)59 (3.18)122 (6.58)203 (11.0)547 (29.5)< 0.001
Pre-DM3549 (47.9)642 (34.6)888 (47.9)1058 (57.1)961 (51.9)< 0.001
NGR2933 (39.6)1153 (62.2)843 (45.5)592 (31.9)345 (18.6)< 0.001
Hypertriglyceridemia3043 (41.0)39 (2.10)254 (13.7)999 (53.9)1751 (94.5)< 0.001
Low HDL-C1911 (25.8)248 (13.4)370 (20.0)511 (27.6)782 (42.2)< 0.001
Hypertension343 (4.63)48 (2.59)98 (5.29)101 (5.45)96 (5.18)< 0.001
MASLD4050 (54.6)354 (19.1)817 (44.1)1259 (67.9)1620 (87.4)< 0.001
Use of antihypertensive medication (n = 851)319 (37.5)47 (26.7)87 (40.7)95 (44.0)90 (36.7)0.004
Use of antidiabetic medication (n = 851)134 (15.7)47 (26.7)87 (40.7)95 (44.0)90 (36.7)< 0.001
Use of lipid-lowering medications (n = 851)79 (9.28)24 (13.6)16 (7.48)14 (6.48)25 (10.2)0.07
Data are presented as mean ± SD, median (interquartile range), or n (%). SBP: Systolic blood pressure; DBP: Diastolic blood pressure; BMI: Body mass index; WC: Waist circumference; HC: Hip circumference; WHR: Waist to hip ratio; BRI: Body roundness index; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; TBIL: Total bilirubin; DBIL: Direct bilirubin; TP: Total protein; ALB: Albumin; BUN: Blood urea nitrogen; PLT: Platelet count; Cr: Serum creatinine; eGFR: Estimated glomerular filtration rate; UA: Uric acid; FPG: Fasting plasma glucose; HbA1c: Glycated haemoglobin; TCHO: Total cholesterol; TG: Triglycerides; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; hs-CRP: High-sensitivity C-reactive protein; CTI: C-reactive protein-triglyceride-glucose index; TyG: Triglyceride-glucose index; HOMA-IR: Homeostatic model assessment of insulin resistance; FINS: Fasting insulin; FIB-4: Fibrosis-4 index; NFS: Non-alcoholic fatty liver disease fibrosis score; APRI: Aspartate aminotransferase to platelet ratio index; DM: Diabetes mellitus; Pre-DM: Prediabetes mellitus; NGR: Normal glucose regulation; MASLD: Metabolic dysfunction-associated steatotic liver disease.
Full Size Table
Table 2 Logistic regression analyses the association between C-reactive protein-triglyceride-glucose index and metabolic dysfunction-associated steatotic liver disease
Characteristic
Model 1
Model 2
Model 3
OR (95%CI)
P value
OR (95%CI)
P value
OR (95%CI)
P value
MASLD
CTI (per 1 unit)5.26 (4.83-5.73)< 0.0015.12 (4.49-5.85)< 0.0012.74 (1.79-4.20)< 0.001
CTI quartile
    Q1Ref./Ref./Ref./
    Q23.34 (2.88-3.88)< 0.0013.40 (2.72-4.24)< 0.0012.59 (1.55-4.32)< 0.001
    Q38.98 (7.73-10.5)< 0.0018.07 (6.42-10.15)< 0.0013.34 (1.85-6.05)< 0.001
    Q429.50 (24.70-35.30)< 0.00126.40 (19.90-34.90)< 0.0015.09 (2.24-11.54)< 0.001
P for trend< 0.001< 0.001< 0.001
ORs were estimated using the following models: Model 1: Unadjusted for any covariates; Model 2: Additionally adjusted for age, sex, current smoking, current drinking, regular exercise; Model 3: Model 2 + additionally adjusted for systolic blood pressure, diastolic blood pressure, hip circumference, aspartate aminotransferase, total protein, total bilirubin, direct bilirubin, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, platelet count, albumin, glycated haemoglobin, estimated glomerular filtration rate, blood urea nitrogen, hypertension, hypertriglyceridemia, low HDL-C. CTI: C-reactive protein-triglyceride-glucose index; MASLD: Metabolic dysfunction-associated steatotic liver disease.
Full Size Table
Table 3 Logistic regression analyses the association between C-reactive protein-triglyceride-glucose index and metabolic dysfunction-associated steatotic liver disease in different glycemic status
Characteristic
Model 1
Model 2
Model 3
OR (95%CI)
P value
OR (95%CI)
P value
OR (95%CI)
P value
NGR (n = 2933)
CTI (per 1 unit)5.24 (4.56-6.05)< 0.0014.53 (3.63-5.66)< 0.0013.07 (2.19-4.31)< 0.001
CTI quartile
    Q1Ref./Ref./Ref./
    Q23.72 (3.00-4.63)< 0.0013.84 (2.75-5.35)< 0.0012.62 (1.81-3.81)< 0.001
    Q310.00 (7.96-12.70)< 0.0017.76 (5.42-11.11)< 0.0013.40 (2.17-5.33)< 0.001
    Q423.60 (17.40-32.40)< 0.00115.41 (9.35-25.39)< 0.0015.15 (2.53-10.49)< 0.001
P for trend/< 0.001/< 0.001/< 0.001
Pre-DM (n = 3549)
CTI (per 1 unit)5.00 (4.40-5.70)< 0.0015.17 (4.24-6.30)< 0.0013.26 (1.70-6.23)< 0.001
CTI quartile
    Q1Ref./Ref./Ref./
    Q22.60 (2.09-3.25)< 0.0012.65 (1.92-3.65)< 0.0011.77 (0.83-3.78)< 0.001
    Q36.65 (5.35-8.31)< 0.0016.20 (4.49-8.58)< 0.0013.41 (1.47-7.93)< 0.001
    Q423.20 (17.80-30.60)< 0.00125.20 (16.50-38.50)< 0.0015.57 (1.58-19.68)< 0.001
P for trend/< 0.001/< 0.001/0.002
DM (n = 931)
CTI (per 1 unit)3.12 (2.52-3.92)< 0.0013.33 (2.34-4.75)< 0.0011.58 (0.65-3.84)0.307
CTI quartile
    Q1Ref./Ref./Ref./
    Q22.10 (1.12-3.99)0.0223.84 (1.42-10.38)< 0.0012.52 (0.62-10.24)0.196
    Q33.92 (2.16-7.26)< 0.00111.41 (4.22-30.86)< 0.0012.64 (0.62-11.20)0.190
    Q412.30 (6.89-22.30)< 0.00118.09 (7.12-45.95)< 0.0012.55 (0.47-13.98)0.280
P for trend/< 0.001/< 0.001/0.382
Odds ratios were estimated using the following models: Model 1: Unadjusted for any covariates; Model 2: Additionally adjusted for age, sex, current smoking, current drinking, regular exercise; Model 3: Model 2 + additionally adjusted for systolic blood pressure, diastolic blood pressure, hip circumference, aspartate aminotransferase, total protein, total bilirubin, direct bilirubin, total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, platelet count, albumin, glycated haemoglobin, estimated glomerular filtration rate, blood urea nitrogen, hypertension, hypertriglyceridemia, low HDL-C. NGR: Normal glucose regulation; CTI: C-reactive protein-triglyceride-glucose index; Pre-DM: Prediabetes mellitus; DM: Diabetes mellitus.
Full Size Table
Table 4 Receiver operating characteristic analysis of biomarkers and risk scores for metabolic dysfunction-associated steatotic liver disease prediction
AUC
95%CI
Cut off value
Sensitivity
Specificity
P value for difference in AUC
Total
CTI0.8080.798-0.8178.9080.6980.769Ref.
TyG0.8020.792-0.8128.6660.7580.697< 0.001
hs-CRP0.6620.649-0.6741.2050.6620.597< 0.001
FIB-40.5290.516-0.5431.4030.7330.326< 0.001
NFS0.5410.528-0.554-1.9720.4370.630< 0.001
APRI0.5870.574-0.6000.2490.6080.517< 0.001
ALT0.7480.737-0.75919.5000.7250.646< 0.001
AST0.6330.620-0.64622.5000.5850.608< 0.001
Anthropometric indices10.8740.866-0.882/0.7910.788< 0.001
Anthropometric indices1 + CTI0.8800.872-0.887/0.8470.746< 0.001
Conventional risk factors20.8210.812-0.831/0.8400.646< 0.001
Conventional risk factors2 + CTI0.8240.814-0.833/0.8380.652< 0.001
1Anthropometric indices: Body mass index, waist circumference, hip circumference, waist to hip ratio, body roundness index.
2Conventional risk factors: Age, sex, current smoking, current drinking, regular exercise, body mass index, waist circumference, hip circumference, waist to hip ratio, body roundness index, aspartate aminotransferase, alanine aminotransferase, total cholesterol, triglycerides, high-density lipoprotein cholesterol, fasting plasma glucose, systolic blood pressure.
AUC: Area under the curve; CTI: C-reactive protein-triglyceride-glucose index; TyG: Triglyceride-glucose index; hs-CRP: High-sensitivity C-reactive protein; FIB-4: Fibrosis-4 index; NFS: Non-alcoholic fatty liver disease fibrosis score; APRI: Aspartate aminotransferase to platelet ratio index; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase.
Full Size Table
Table 5 Receiver operating characteristic curve analysis of biomarkers and risk scores for metabolic dysfunction-associated steatotic liver disease prediction in different glycemic status
AUC
95%CI
Cut off value
Sensitivity
Specificity
P for difference in AUC
NGR (n = 2933)
    CTI0.7920.776-0.8098.5960.7300.723Ref.
    TyG0.7870.771-0.8048.4650.7720.662< 0.001
    hs-CRP0.6500.630-0.6701.2050.5980.635< 0.001
    FIB-40.5230.502-0.5441.1740.6710.379< 0.001
    NFS0.5090.487-0.530-2.4180.4570.576< 0.001
    APRI0.5900.570-0.6110.2550.5650.578< 0.001
    ALT0.7410.723-0.76019.5000.6950.686< 0.001
    AST0.6380.618-0.65822.5000.5560.655< 0.001
    Anthropometric indices10.8870.875-0.899/0.8250.795< 0.001
    Anthropometric indices1 + CTI0.8910.880-0.903/0.8480.778< 0.001
    Conventional risk factors20.8320.818-0.847/0.8090.710< 0.001
    Conventional risk factors2 + CTI0.8340.820-0.849/0.8270.697< 0.001
Pre-DM (n = 3549)
    CTI0.7830.767-0.7988.9080.7150.711Ref.
    TyG0.7720.756-0.7888.7190.7370.677< 0.001
    hs-CRP0.6500.631-0.6691.2050.6870.560< 0.001
    FIB-40.5960.576-0.6151.4030.7290.409< 0.001
    NFS0.5420.523-0.562-1.7560.7280.337< 0.001
    APRI0.5610.542-0.5810.2440.6370.452< 0.001
    ALT0.7330.716-0.75021.5000.6660.687< 0.001
    AST0.6080.589-0.62723.5000.5380.616< 0.001
    Anthropometric indices10.8530.840-0.865/0.7220.82< 0.001
    Anthropometric indices1 + CTI0.8590.847-0.871/0.7240.829< 0.001
    Conventional risk factors20.7830.767-0.798/0.7400.680< 0.001
Conventional risk factors2 + CTI0.7860.770-0.801/0.7440.682< 0.001
DM (n = 931)
    CTI0.7490.712-0.7869.4560.6680.707Ref.
    TyG0.7500.713-0.7879.0700.7630.606< 0.001
    hs-CRP0.6150.571-0.6581.3950.6430.551< 0.001
    FIB-40.6270.583-0.6711.5680.7450.470< 0.001
    NFS0.6160.572-0.661-0.8820.5280.667< 0.001
    APRI0.5730.529-0.6170.2710.5540.576< 0.001
    ALT0.7380.700-0.77521.5000.6680.702< 0.001
    AST0.6370.596-0.67826.5000.3640.864< 0.001
    Anthropometric indices10.7900.755-0.824/0.7010.722< 0.001
    Anthropometric indices1 + CTI0.8010.767-0.835/0.7990.646< 0.001
    Conventional risk factors20.7400.702-0.778/0.7000.657< 0.001
    Conventional risk factors2 + CTI0.7440.706-0.782/0.6960.662< 0.001
1Anthropometric indices: Body mass index, waist circumference, hip circumference, waist to hip ratio, body roundness index.
2Conventional risk factors: Age, sex, current smoking, current drinking, regular exercise, body mass index, waist circumference, hip circumference, waist to hip ratio, body roundness index, aspartate aminotransferase, alanine aminotransferase, total cholesterol, triglycerides, high-density lipoprotein cholesterol, fasting plasma glucose, systolic blood pressure.
NGR: Normal glucose regulation; Pre-DM: Prediabetes mellitus; DM: Diabetes mellitus AUC: Area under the curve; CTI: C-reactive protein-triglyceride-glucose index; TyG: Triglyceride-glucose index; hs-CRP: High-sensitivity C-reactive protein; FIB-4: Fibrosis-4 index; NFS: Non-alcoholic fatty liver disease fibrosis score; APRI: Aspartate aminotransferase to platelet ratio index; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase.
Full Size Table
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