Association between C-reactive protein-triglyceride glucose index and risk of sarcopenia in older adults: findings from CHARLS and NHANES

Yan Chen; Tianchong Huang; Jiayin Wang; Changsheng Guo; Jing Gao; Xiaodong Feng

doi:10.1016/j.exger.2025.113003

Association between C-reactive protein-triglyceride glucose index and risk of sarcopenia in older adults: findings from CHARLS and NHANES

Exp Gerontol. 2026 Jan:213:113003. doi: 10.1016/j.exger.2025.113003. Epub 2025 Dec 17.

Authors

Yan Chen¹, Tianchong Huang¹, Jiayin Wang¹, Changsheng Guo², Jing Gao³, Xiaodong Feng⁴

Affiliations

¹ Rehabilitation Center, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, 450000, China.
² Department of graduate, Heilongjiang University of Chinese Medicine, Haerbin, Heilongjiang, 150040, China.
³ Rehabilitation Center, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, 450000, China. Electronic address: gaojing_9303@163.com.
⁴ Rehabilitation Center, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, 450000, China. Electronic address: fxd0502@163.com.

PMID: 41419119
DOI: 10.1016/j.exger.2025.113003

Abstract

Background: Insulin resistance (IR) and inflammation are two crucial risk factors of sarcopenia. C-reactive protein-triglyceride glucose index (CTI) has been proposed to be a novel biomarker reflecting IR and inflammation. However, association between CTI and sarcopenia risk remains unclear.

Aim: To explore the association between CTI and sarcopenia risk.

Methods: Data were obtained from Nutrition Examination Survey (NHANES) 2001-2010 and China Health and Retirement Longitudinal Study (CHARLS) 2011-2015. NHANES was used for cross-sectional analysis, and weighted logistic regression analysis was conducted to explore association between CTI and sarcopenia. CHARLS was used for longitudinal analysis, and the primary endpoint was the first occurrence of sarcopenia over follow-up. Logistic regression analysis and Cox proportional hazard analysis were conducted to explore the relationship between CTI and the risk of sarcopenia. Restricted cubic spline (RCS) analysis was performed to investigate the non-linear association between CTI and sarcopenia risk, and receiver operating characteristics (ROC) curves and the area under the ROC curve (AUC) were utilized to assess the predictive capability of CTI on the risk of sarcopenia.

Results: A total of 11,286 Americans and 1478 Chinese aged ≥60 years were included in this study. Logistic and Cox regression analysis revealed the cross-sectional (OR: 1.52, 95 %CI: 1.15-1.99, P = 0.004) and longitudinal (HR: 1.35, 95 %CI: 1.10-1.65, P = 0.004) correlation between CTI and sarcopenia risk after adjusting the covariates. For the two databases, non-linear association between CTI and sarcopenia risk was observed (P for non-linear <0.001). Additionally, compared to CRP and the TyG index, CTI exhibited the best predictive capability for sarcopenia risk, with the highest AUC (CHARLS: 0.730, NHANES: 0.722).

Conclusion: There exist both the cross-sectional and longitudinal association between CTI level and sarcopenia risk in older adults, and it is crucial to monitor CTI in the prevention and treatment of sarcopenia.

Keywords: CHARLS; CTI; NHANES; Predictive capability; Sarcopenia.

MeSH terms

Aged
Biomarkers / blood
Blood Glucose* / analysis
Blood Glucose* / metabolism
C-Reactive Protein* / analysis
C-Reactive Protein* / metabolism
China / epidemiology
Cross-Sectional Studies
Female
Humans
Insulin Resistance
Longitudinal Studies
Male
Middle Aged
Nutrition Surveys
ROC Curve
Risk Factors
Sarcopenia* / blood
Sarcopenia* / diagnosis
Sarcopenia* / epidemiology
United States / epidemiology

Substances

C-Reactive Protein
Biomarkers
Blood Glucose