Evaluation of the predictive value of C-reactive protein-albumin-lymphocyte (CALLY) index for disability and severity...

Multiple sclerosis (MS) is a demyelinating disease in which chronic inflammation is predominant in nerve tissue, characterized by neurodegeneration and variable neurological impairment, as well as immune system-induced damage. MS, which is particularly common in young adults, causes significant disability and drastically reduces the quality of life. We aimed to determine the predictive value of integrating serum albumin, lymphocyte, and C-reactive protein (CALLY index) for assessing the disability status of MS patients, as determined by the EDSS (Expanded Disability Status Scale).

This retrospective study included 290 patients with MS and a 290-member healthy control group matched for BMI (body mass index), gender, and age.

The MS group had significantly higher neutrophil count and NLR, whereas it had significantly lower CALLY index, albumin, and lymphocyte count. The CALLY index demonstrated a significant negative (inverse) correlation with the EDSS, EDSS severity, disease duration, BMI, and NLR in Spearman's correlation analysis. The multivariable logistic regression analysis demonstrated that the CALLY index and disease duration were independent predictors of MS severity (the EDSS ≤3.5 vs. ≥4). The Receiver Operating Characteristic (ROC) analysis for the CALLY index with a cut-off level of 0.71 predicted the EDSS severity with a specificity of 72.1%; and a sensitivity of 67.3% (the area under curve analysis was 0.719, p < 0.001).

The CALLY index is a reliable, robust, inexpensive, and simple biomarker for predicting the disability and severity of MS patient), with implications for both inflammation and immunonutrition.