Association of Remnant Cholesterol Inflammation Index with Cardiovascular Risks and All-Cause Mortality in Individuals with Diabetes or Prediabetes.

IF 8.5 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolism Journal Pub Date : 2025-10-02 DOI:10.4093/dmj.2025.0305

Qi-Lin Ma, Lei-Lei Du, Jia Peng

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引用次数: 0

Abstract

Background: Remnant cholesterol (RC) and low-grade inflammation are established contributors to cardiovascular disease (CVD) risks in diabetes. However, their combined prognostic impact remains unclear in dysglycemia. We evaluated the remnant cholesterol inflammation index (RCII), integrating RC and high-sensitivity C-reactive protein (hsCRP), for predicting mortality and CVD risks in diabetes/prediabetes.

Methods: This study included 2206 United States adults with diabetes/prediabetes from National Health and Nutrition Examination Survey 2015-2018. RCII was calculated as [RC (mg/dL)×hsCRP (mg/L)]/10. All-cause mortality was tracked via National Death Index until 2019; CVD risk was assessed cross-sectionally. Cox proportional hazard regression determined the hazard ratio (HR) and 95% confidence intervals (CIs) of RCII for all-cause mortality. Logistic regression models estimated the odds ratio (OR) and 95% CIs of RCII for CVD risks.

Results: For CVD risks, Q4 vs. Q1 demonstrated increased odds (OR, 2.32; 95% CI, 1.23 to 4.37), though per-standard deviation (SD) increments were non-significant (OR, 1.15; 95% CI, 0.98 to 1.35; P=0.083). During a median of 38 months follow-up, higher RCII quartiles showed graded associations with all-cause mortality (Q4 vs. Q1: HR, 2.45; 95% CI, 1.08 to 5.58; per 1-SD increase: HR, 1.21; 95% CI, 1.08 to 1.35). Restricted cubic splines confirmed dose-dependent relationships for CVD risks and all-cause mortality (all P=0.005 for overall). Subgroup analyses revealed consistent mortality associations but sex-specific CVD interactions (P=0.047 for interaction).

Conclusion: Our study found the RCII as a biomarker for predicting all-cause mortality and CVD risks in individuals with prediabetes or diabetes, highlighting the synergistic effects of RC and low-grade inflammation on adverse outcomes in this population and may facilitate early identification of individuals at heightened risk for CVD.

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残余胆固醇炎症指数与糖尿病或前驱糖尿病患者心血管风险和全因死亡率的关系

背景：残余胆固醇（RC）和低度炎症是糖尿病患者心血管疾病（CVD）风险的确定因素。然而，它们对血糖异常的综合预后影响尚不清楚。我们评估了残余胆固醇炎症指数（RCII），整合RC和高敏c反应蛋白（hsCRP），用于预测糖尿病/前驱糖尿病患者的死亡率和心血管疾病风险。方法：本研究纳入了2015-2018年国家健康与营养调查中2206名患有糖尿病/前驱糖尿病的美国成年人。RCII计算为[RC （mg/dL）×hsCRP (mg/L)]/10。通过国家死亡指数追踪全因死亡率，直到2019年；横截面评估心血管疾病风险。Cox比例风险回归确定了RCII对全因死亡率的风险比（HR）和95%置信区间（CIs）。Logistic回归模型估计了RCII与CVD风险的比值比（OR）和95% ci。结果：对于心血管疾病风险，Q4与Q1的比值增加（OR, 2.32; 95% CI， 1.23至4.37），尽管每标准偏差（SD）增量无显著性（OR, 1.15; 95% CI， 0.98至1.35；P=0.083）。在中位38个月的随访期间，较高的RCII四分位数与全因死亡率呈分级相关（Q4 vs Q1: HR, 2.45; 95% CI, 1.08 - 5.58；每1-SD增加：HR， 1.21; 95% CI, 1.08 - 1.35）。限制性三次样条曲线证实了心血管疾病风险和全因死亡率之间的剂量依赖关系（总体P=0.005）。亚组分析显示死亡率与性别特异性CVD相互作用一致（相互作用P=0.047）。结论：我们的研究发现RCII是预测糖尿病前期或糖尿病患者全因死亡率和心血管疾病风险的生物标志物，突出了RC和低级别炎症对该人群不良结局的协同作用，并可能有助于早期识别心血管疾病高风险个体。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes & Metabolism Journal Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

10.40

自引率

6.80%

发文量

审稿时长

52 weeks

期刊介绍： The aims of the Diabetes & Metabolism Journal are to contribute to the cure of and education about diabetes mellitus, and the advancement of diabetology through the sharing of scientific information on the latest developments in diabetology among members of the Korean Diabetes Association and other international societies. The Journal publishes articles on basic and clinical studies, focusing on areas such as metabolism, epidemiology, pathogenesis, complications, and treatments relevant to diabetes mellitus. It also publishes articles covering obesity and cardiovascular disease. Articles on translational research and timely issues including ubiquitous care or new technology in the management of diabetes and metabolic disorders are welcome. In addition, genome research, meta-analysis, and randomized controlled studies are welcome for publication. The editorial board invites articles from international research or clinical study groups. Publication is determined by the editors and peer reviewers, who are experts in their specific fields of diabetology.