Association of CALLY index and CLR with COPD risk in middle-aged and older Americans: evidence from NHANES 2017–2020

BackgroundChronic obstructive pulmonary disease (COPD) is marked by restrictions on airflow, leading to a gradual and irreversible reduction in lung function. This study assessed the predictive value of hematological inflammatory biomarkers, specifically the C-reactive protein-albumin-lymphocyte (CA...

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Main Authors: Jiaji Zhou, Wenyi Du, Hanzhou Huang, Yongqi Chen, Leyan Chen, Mingfeng Zheng
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1535415/full
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author Jiaji Zhou
Jiaji Zhou
Wenyi Du
Hanzhou Huang
Hanzhou Huang
Yongqi Chen
Yongqi Chen
Leyan Chen
Leyan Chen
Mingfeng Zheng
Mingfeng Zheng
author_facet Jiaji Zhou
Jiaji Zhou
Wenyi Du
Hanzhou Huang
Hanzhou Huang
Yongqi Chen
Yongqi Chen
Leyan Chen
Leyan Chen
Mingfeng Zheng
Mingfeng Zheng
author_sort Jiaji Zhou
collection DOAJ
description BackgroundChronic obstructive pulmonary disease (COPD) is marked by restrictions on airflow, leading to a gradual and irreversible reduction in lung function. This study assessed the predictive value of hematological inflammatory biomarkers, specifically the C-reactive protein-albumin-lymphocyte (CALLY) index and the C-reactive protein to lymphocyte ratio (CLR), for determining COPD risk in United States adults aged 40 and above.MethodsData were sourced from the National Health and Nutrition Examination Survey (NHANES) covering the period from 2017 to March 2020. The relationship between inflammatory markers, including the CALLY index, CLR, and their components, and COPD was assessed using multivariate logistic regression. Subgroup analyses explored the relationship between the CALLY index, CLR, and COPD, while restricted cubic spline (RCS) analyses evaluated potential non-linearity. The predictive performance of these biomarkers for COPD risk was assessed using receiver operating characteristic (ROC) curve analysis.ResultsAfter controlling for confounders, for every one-unit increase in the CALLY index (converted to natural logarithm), the prevalence of COPD decreased by 19% (OR = 0.81, 95% CI: 0.71–0.92, P = 0.001). Conversely, for every one-unit increase in the CLR (converted to natural logarithm), the prevalence of COPD increased by 23% (OR = 1.23, 95% CI: 1.08–1.40, P < 0.001). The linear negative correlation between the CALLY index and COPD was demonstrated by using RCS curves, while the CLR exhibited a positive association. After being fully adjusted, both the CALLY index and the CLR yielded an adjusted area under the curve (AUC) of 0.831 for predicting the risk of COPD, demonstrating excellent predictive capability.ConclusionThe study identifies a linear negative relationship between the CALLY index and COPD, unaffected by potential confounders. A higher CLR is linked to an elevated risk of COPD development. Both the CALLY index and CLR were superior in predicting the risk of developing COPD. Our findings emphasize that the CALLY index and CLR may be a new inflammatory early warning biomarker for COPD.
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spelling doaj-art-db65a00fd1914f7f9b927696f39e83b72025-08-20T03:10:34ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-04-011210.3389/fmed.2025.15354151535415Association of CALLY index and CLR with COPD risk in middle-aged and older Americans: evidence from NHANES 2017–2020Jiaji Zhou0Jiaji Zhou1Wenyi Du2Hanzhou Huang3Hanzhou Huang4Yongqi Chen5Yongqi Chen6Leyan Chen7Leyan Chen8Mingfeng Zheng9Mingfeng Zheng10Department of Thoracic Surgery, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, ChinaWuxi Medical Center, Affiliated With Nanjing Medical University, Wuxi, ChinaDepartment of General Surgery, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, ChinaDepartment of Thoracic Surgery, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, ChinaWuxi Medical Center, Affiliated With Nanjing Medical University, Wuxi, ChinaDepartment of Thoracic Surgery, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, ChinaWuxi Medical Center, Affiliated With Nanjing Medical University, Wuxi, ChinaDepartment of Thoracic Surgery, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, ChinaWuxi Medical Center, Affiliated With Nanjing Medical University, Wuxi, ChinaDepartment of Thoracic Surgery, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, ChinaWuxi Medical Center, Affiliated With Nanjing Medical University, Wuxi, ChinaBackgroundChronic obstructive pulmonary disease (COPD) is marked by restrictions on airflow, leading to a gradual and irreversible reduction in lung function. This study assessed the predictive value of hematological inflammatory biomarkers, specifically the C-reactive protein-albumin-lymphocyte (CALLY) index and the C-reactive protein to lymphocyte ratio (CLR), for determining COPD risk in United States adults aged 40 and above.MethodsData were sourced from the National Health and Nutrition Examination Survey (NHANES) covering the period from 2017 to March 2020. The relationship between inflammatory markers, including the CALLY index, CLR, and their components, and COPD was assessed using multivariate logistic regression. Subgroup analyses explored the relationship between the CALLY index, CLR, and COPD, while restricted cubic spline (RCS) analyses evaluated potential non-linearity. The predictive performance of these biomarkers for COPD risk was assessed using receiver operating characteristic (ROC) curve analysis.ResultsAfter controlling for confounders, for every one-unit increase in the CALLY index (converted to natural logarithm), the prevalence of COPD decreased by 19% (OR = 0.81, 95% CI: 0.71–0.92, P = 0.001). Conversely, for every one-unit increase in the CLR (converted to natural logarithm), the prevalence of COPD increased by 23% (OR = 1.23, 95% CI: 1.08–1.40, P < 0.001). The linear negative correlation between the CALLY index and COPD was demonstrated by using RCS curves, while the CLR exhibited a positive association. After being fully adjusted, both the CALLY index and the CLR yielded an adjusted area under the curve (AUC) of 0.831 for predicting the risk of COPD, demonstrating excellent predictive capability.ConclusionThe study identifies a linear negative relationship between the CALLY index and COPD, unaffected by potential confounders. A higher CLR is linked to an elevated risk of COPD development. Both the CALLY index and CLR were superior in predicting the risk of developing COPD. Our findings emphasize that the CALLY index and CLR may be a new inflammatory early warning biomarker for COPD.https://www.frontiersin.org/articles/10.3389/fmed.2025.1535415/fullinflammation indicatorschronic obstructive pulmonary diseaseNHANESCALLY indexCLR
spellingShingle Jiaji Zhou
Jiaji Zhou
Wenyi Du
Hanzhou Huang
Hanzhou Huang
Yongqi Chen
Yongqi Chen
Leyan Chen
Leyan Chen
Mingfeng Zheng
Mingfeng Zheng
Association of CALLY index and CLR with COPD risk in middle-aged and older Americans: evidence from NHANES 2017–2020
Frontiers in Medicine
inflammation indicators
chronic obstructive pulmonary disease
NHANES
CALLY index
CLR
title Association of CALLY index and CLR with COPD risk in middle-aged and older Americans: evidence from NHANES 2017–2020
title_full Association of CALLY index and CLR with COPD risk in middle-aged and older Americans: evidence from NHANES 2017–2020
title_fullStr Association of CALLY index and CLR with COPD risk in middle-aged and older Americans: evidence from NHANES 2017–2020
title_full_unstemmed Association of CALLY index and CLR with COPD risk in middle-aged and older Americans: evidence from NHANES 2017–2020
title_short Association of CALLY index and CLR with COPD risk in middle-aged and older Americans: evidence from NHANES 2017–2020
title_sort association of cally index and clr with copd risk in middle aged and older americans evidence from nhanes 2017 2020
topic inflammation indicators
chronic obstructive pulmonary disease
NHANES
CALLY index
CLR
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1535415/full
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