Age-related associations between the CALLY index and advanced cardiovascular-kidney-metabolic (CKM) syndrome: Insights from NHANES population data.

A higher log-transformed CALLY index was associated with a lower likelihood of advanced CKM syndrome.

• Odds ratio per unit increase in log-transformed CALLY index: 0.90 (95% CI: 0.86–0.95)
• Analysis used multivariable logistic regression with data from 11,866 adults aged 20 years and older
• Data were drawn from 9 NHANES cycles spanning 2001–2018
• CKM syndrome stages 3 and 4 were classified as 'advanced CKM'

Individuals in the top tertile of the CALLY index had significantly lower odds of advanced CKM compared to those in the bottom tertile.

• Odds ratio for top vs. bottom tertile: 0.79 (95% CI: 0.67–0.93)
• This represents a 21% lower odds of advanced CKM in the top tertile
• The CALLY index was calculated as (albumin × lymphocyte count) ÷ C-reactive protein, then log-transformed

A threshold effect in the association between CALLY index and advanced CKM was observed specifically in individuals under 60 years of age.

• Protective effects of the CALLY index increased below a CALLY value of 455 units in individuals under 60 years
• Smoothing splines were used to identify this non-linear threshold relationship
• Subgroup analyses by age and other variables were performed to detect this age-dependent pattern
• The threshold effect was not described as present in individuals aged 60 years and older

The study population included 11,866 adults across 9 NHANES survey cycles from 2001 to 2018.

• Participants were aged 20 years and older
• CKM syndrome was categorized into stages 0 to 4, with stages 3 and 4 designated as advanced
• Multivariable logistic regression and smoothing splines were used as the primary analytical methods

The CALLY index integrates C-reactive protein, albumin, and lymphocyte count as a composite marker of systemic inflammation, nutrition, and immune status.

• CALLY index formula: (albumin × lymphocyte count) ÷ C-reactive protein
• The index was log-transformed prior to analysis
• The authors note that no prior studies had explored the CALLY index in the context of CKM syndrome
• CKM syndrome represents co-occurrence of cardiovascular disease, chronic kidney disease, and metabolic syndrome