The C-reactive protein-triglyceride glucose index (CTI) predicts mortality in cardiovascular-kidney-metabolic syndrome: a dual-cohort study with machine learning validation

CTI, a novel inflammatory metabolic biomarker, reliably predicts all-cause and cardiovascular mortality in CKM syndrome, with consistent validation across NHANES and CHARLS. The NHANES-derived RSF model (AUC > 0.86) combines high accuracy and clinical utility, and is supported by stable external validation in CHARLS and sensitivity analyses. SHAP-based mechanistic insights further enable personalized risk assessments.