Prognostic stratification with composite insulin resistance–inflammation biomarkers in patients with chronic kidney disease and coronary artery disease across glycemic statuses

作者：Zixiang Ye, Enmin Xie, C Song, R U I Zhang, Haoyu Wang, Chao Wu, Kefei Dou · 发表于：Cardiovascular Diabetology · 年份：2026 · DOI：10.1186/s12933-026-03108-0 · 被引用次数：4 · 研究领域：Adipokines, Inflammation, and Metabolic Diseases、Inflammatory Biomarkers in Disease Prognosis、Chronic Kidney Disease and Diabetes

BACKGROUND: Patients with chronic kidney disease (CKD) and coronary artery diseases (CAD) have a poor long-term prognosis. Although insulin resistance (IR) and systemic inflammation are well-established drivers of cardiovascular risk, the prognostic value of their composite assessment across the glycemic spectrum in patients with CKD and CAD remains undetermined. This study aimed to evaluate the prognostic utility of composite IR-inflammation biomarkers for predicting mortality in patients with CKD and CAD stratified by glycemic status. METHODS: 1353 patients with CKD and CAD were enrolled from National Health and Nutrition Examination Survey (NHANES) data (1999-2018). Composite biomarkers (TyG-hsCRP, TyG-CRP, and C-reactive Protein-Triglyceride Glucose Index [CTI]) were calculated. Patients were categorized by glycemic status (normoglycemia, prediabetes, diabetes) based on WHO/IEC criteria. The endpoint was all-cause and cardiovascular disease (CVD) death. Statistical analyses included Cox regression, Nelson-Aalen cumulative hazard plots with Log-rank test, restricted cubic splines, ROC curves, and reclassification metrics, adjusted for demographics, comorbidities, and treatments. Subgroup and sensitivity analyses ensured robustness. RESULTS: Over a median follow-up of 63-months, 744 all-cause and 323 CVD deaths occurred. Adjusted models showed elevated composite indices linked to higher mortality (e.g., CTI HR 1.43 [95% CI 1.24-1.65] for all-cause; HR 1.32 [1.06-1.64] for C...