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Associations of C-reactive protein-albumin-lymphocyte (CALLY) index with cardiorenal syndrome: Insights from a
Zhehao Xu1, Jiao Tang2, Xin Chen2
1Department of General Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China.
Insights
The CALLY index, a novel immune-nutritional score, is inversely associated with cardiorenal syndrome (CRS) risk. Lower CALLY index values predict higher CRS likelihood, suggesting its clinical utility for risk assessment.
Area of Science:
- Cardiology
- Nephrology
- Immunology
- Nutritional Science
Background:
- Cardiorenal syndrome (CRS) involves complex immune imbalance and inflammation.
- The C-reactive protein-Albumin-lymphocyte (CALLY) index is a new immune-nutritional score.
- The predictive value of the CALLY index for CRS requires investigation.
Purpose of the Study:
- To evaluate the predictive value of the CALLY index for cardiorenal syndrome (CRS).
- To assess the association between the CALLY index and CRS risk in a large population.
- To compare the predictive performance of the CALLY index against traditional inflammatory markers.
Main Methods:
- Analysis of 27,978 participants from the National Health and Nutrition Examination Survey (NHANES) (1999-2010).
- Calculation of the CALLY index: (Albumin/Lymphocyte)/(CRP * 10^4).
- Definition of CRS as coexisting cardiovascular disease and chronic kidney disease (eGFR <60 mL/min/1.73 m^2).
- Multivariate weighted logistic regression and ROC curve analysis were used.
Main Results:
- The prevalence of CRS was 1.22% in the study population.
- A significant inverse relationship was found between the CALLY index and CRS risk (OR=0.95, P<0.001).
- Higher CALLY index quartiles showed progressively reduced CRS risk (P for trend <0.001).
- The CALLY index demonstrated superior predictive performance (AUC=0.672) compared to other inflammatory markers.
Conclusions:
- The CALLY index is significantly and independently associated with a reduced risk of cardiorenal syndrome.
- The CALLY index outperforms traditional inflammatory markers in predicting CRS.
- The CALLY index shows potential as a valuable clinical tool for identifying individuals at risk for CRS.
Background:
Cardiorenal syndrome (CRS) is a complex condition characterized by the interplay of immune imbalance and inflammation. The C-reactive protein-Albumin-lymphocyte (CALLY) CALLY index serves as a new immune-nutritional scoring system, but its predictive value for CRS remains to be established.
Methods:
In this study, we analyzed data from 27,978 participants in National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010. The CALLY index was calculated as the ratio of albumin to lymphocyte, divided by C-reactive protein (CRP) multiplied by 104. CRS was defined by the coexistence of cardiovascular disease and chronic kidney disease (eGFR <60 mL/min/1.73 m2). Multivariate weighted logistic regression models were employed to determine the odds ratio and 95 % confidence interval for the association between the CALLY index and CRS. Receiver operating characteristic (ROC) curves and restricted cubic spline (RCS) curves were used to assess the predictive efficacy and nonlinear relationship, respectively.
Results:
The prevalence of CRS in the study population was 1.22 %. Our findings revealed a significant inverse relationship between the CALLY index and CRS risk, with lower CALLY index values being associated with a higher likelihood of CRS (OR = 0.95, 95 % CI = 0.94-0.96, P < 0.001). Participants in higher quartiles of the CALLY index showed a progressively reduced risk of CRS (P for trend <0.001). Moreover, the CALLY index demonstrated superior predictive performance compared to other inflammatory indicators, such as systemic immune-inflammation index (SII), neutrophil/high-density lipoprotein ratio (NHR), lymphocyte/high-density lipoprotein ratio (LHR), monocyte/high-density lipoprotein ratio (MHR), and platelet/high-density lipoprotein ratio (PHR) (AUC = 0.672, 95 % CI = 0.643-0.701).
Conclusions:
This study underscores the significant negative correlation between the CALLY index and the risk of cardiorenal syndrome. The CALLY index emerges as a robust and independent predictor of CRS, outperforming traditional inflammatory markers. This finding highlights the potential utility of the CALLY index as a clinical tool for identifying individuals at risk for CRS.
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