Zhang Jialin, Lin Yanhua, Zeng Jingyan, Luo Guihu, Liao Pan, Chen Qianyun, Zhong Han, Liang Simei, Zhou Cailiu, Yang Bin, Li Xing
Department of Rheumatology and Immunology, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde), Foshan, China.
Department of Rheumatology and Immunology, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630, China.
BMC Rheumatol. 2025 Apr 22;9(1):47. doi: 10.1186/s41927-025-00499-7.
The C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index is a novel biomarker reflecting inflammation, nutrition, and immune status, and its potential clinical significance and prognostic role in patients with rheumatoid arthritis (RA) has not been reported.
The objective of this study was to investigate whether CALLY is associated with all-cause mortality in RA patients.
The characteristics of 1101 RA patients and 18,047 non-RA individuals were collected from the National Health and Nutrition Examination Survey (NHANES) database between 1999 and 2010. The CALLY index is calculated as albumin × lymphocyte count / (CRP × 10). Multivariable Cox regression models were used to assess the association between the CALLY index and all-cause mortality in RA patients. Restricted cubic spline (RCS) analysis was applied to evaluate potential linear or nonlinear relationships between the CALLY index and mortality. Kaplan-Meier survival curves were used to assess survival probabilities across different CALLY levels in RA patients.The final analysis was conducted on July 10, 2024.
Multivariable logistic regression analysis indicated that a low CALLY index was significantly associated with RA patients when compared to non-RA individuals, with an odds ratio (OR) of 0.74 (95% CI: 0.65-0.83). Cox regression models revealed that RA patients with a higher CALLY index showed a decreased risk of all-cause mortality, with a hazard ratio (HR) of 0.62 (95% CI: 0.51-0.77). RCS analysis demonstrated a L-shaped relationship between the CALLY index and survival outcomes of RA patients. Segmented regression identified an optimal cutoff value for the CALLY index at 12.79, where values below this threshold were inversely correlated with all-cause mortality risk. Subgroup analysis suggested a synergistic interaction between a high Log-CALLY index, male, and age below 60 years. Kaplan-Meier survival curve analysis showed significantly higher survival rates in the high CALLY group compared to the low CALLY group (P = 0.0012).
The CALLY index is a valuable biomarker for evaluating the prognosis of patients with RA, and a lower CALLY index indicates an increased long-term mortality risk in RA patients, which suggests the importance of comprehensive assessment for inflammatory status and immune function.
Not applicable.
C反应蛋白（CRP）-白蛋白-淋巴细胞（CALLY）指数是一种反映炎症、营养和免疫状态的新型生物标志物，其在类风湿关节炎（RA）患者中的潜在临床意义和预后作用尚未见报道。
本研究旨在探讨CALLY是否与RA患者的全因死亡率相关。
从1999年至2010年的美国国家健康与营养检查调查（NHANES）数据库中收集了1101例RA患者和18047例非RA个体的特征。CALLY指数的计算方法为白蛋白×淋巴细胞计数/（CRP×10）。采用多变量Cox回归模型评估CALLY指数与RA患者全因死亡率之间的关联。应用受限立方样条（RCS）分析评估CALLY指数与死亡率之间潜在的线性或非线性关系。采用Kaplan-Meier生存曲线评估RA患者不同CALLY水平下的生存概率。最终分析于2024年7月10日进行。
多变量逻辑回归分析表明，与非RA个体相比，低CALLY指数与RA患者显著相关，比值比（OR）为0.74（95%CI：0.65-0.83）。Cox回归模型显示，CALLY指数较高的RA患者全因死亡风险降低，风险比（HR）为0.62（95%CI：0.51-0.77）。RCS分析显示CALLY指数与RA患者的生存结局呈L形关系。分段回归确定CALLY指数的最佳截断值为12.79，低于该阈值的值与全因死亡风险呈负相关。亚组分析表明，高Log-CALLY指数、男性和年龄低于60岁之间存在协同相互作用。Kaplan-Meier生存曲线分析显示，高CALLY组的生存率显著高于低CALLY组（P = 0.0012）。
CALLY指数是评估RA患者预后的有价值生物标志物，较低的CALLY指数表明RA患者长期死亡风险增加，这提示全面评估炎症状态和免疫功能的重要性。
不适用。
