Remnant cholesterol inflammatory index and its association with all-cause and cause-specific mortality in middle-aged and elderly populations: evidence from US and Chinese national population surveys

作者：Yifei Wang, Lei Bi, Qing Li, Qiuyu Wang, Tingting Lv, Ping Zhang · 发表于：Lipids in Health and Disease · 年份：2025 · DOI：10.1186/s12944-025-02580-z · 被引用次数：36 · 研究领域：Inflammatory Biomarkers in Disease Prognosis、Nutritional Studies and Diet、Diabetes, Cardiovascular Risks, and Lipoproteins

BACKGROUND: The remnant cholesterol inflammatory index (RCII) is a novel metric that combines remnant cholesterol and high-sensitivity C-reactive protein, reflecting the metabolic and inflammatory risk. This study investigates the association between RCII and long-term risks of all-cause and cause-specific mortality in middle-aged and elderly populations in the US and China. METHOD: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) and the China Health and Retirement Longitudinal Study (CHARLS), including 7,565 and 12,932 participants aged 45 years and older, respectively. The participants were categorized into quartiles based on natural log-transformed RCII (lnRCII) values. Kaplan-Meier survival analysis, Cox proportional hazards models, restricted cubic splines (RCS) and mediation analysis were used to examine the relationship between lnRCII and mortality outcomes, adjusting for potential covariates. RESULT: The mean age of the participants was 59.90 ± 10.44 years (NHANES) and 58.64 ± 9.78 years (CHARLS), with 53.28% and 52.50% female, respectively. Kaplan-Meier survival analysis showed that higher lnRCII quartiles (≥ 0.79 in NHANES, ≥ -0.13 in CHARLS) were significantly associated with increased all-cause mortality risk (p < 0.001). Each standard deviation (SD) increase in lnRCII corresponded to a higher risk of all-cause mortality, and the hazard ratios (HRs) and 95% confidence interval (CI) were 1.29 (95% CI: 1.21-1.36) in NHANES and 1.2...