Pan-immune-inflammation value and sleep disturbances in rheumatoid arthritis: A population-based NHANES study

The present study sought to assess the individual and synergistic effects of pan-immunoinflammatory value (PIV) and trouble sleeping on rheumatoid arthritis (RA). We used data from the National Health and Nutrition Examination Survey from 2005 to 2020. PIV was computed as: (neutrophil count × platelet count × monocyte count) /lymphocyte count. Trouble sleeping was assessed using a single self-reported question (National Health and Nutrition Examination Survey item SLQ050), while RA case ascertainment relied on self-reported diagnosis by a physician. The associations between PIV and sleep-related RA susceptibility were interrogated through multivariable logistic regression models, with restricted cubic splines deployed to unmask potential nonlinear relationships. Effect modification was further evaluated via stratified analyses across demographic and clinical subgroups. The analytical cohort comprised 27,398 participants (2032 RA cases). In fully adjusted models, elevated PIV demonstrated a 14.9% increased RA risk in the highest versus lowest PIV quartile (Q4 vs Q1) (OR = 1.149, 95% CI:1.007-1.312), while trouble sleeping independently conferred 59.8% higher odds (OR = 1.598, 95% CI:1.449-1.761). Interaction analysis revealed that the association between PIV and RA was modulated by trouble sleeping. This study explores the association between elevated PIV, trouble sleeping, and RA. However, due to the cross-sectional nature of the data, causality cannot be inferred. The findings suggest a correlation between PIV and trouble sleeping with RA risk, but further longitudinal studies are required to establish causal relationships.