Cardiovascular

Association of advanced lung cancer inflammation index with hypertension in obstructive sleep apnea.

Lin M, Yang Y, et al. • Medicine • 2026

PubMed 42736731 DOI 10.1097/MD.0000000000050538
TL;DR

This study suggests a significant association between ALI and hypertension in individuals with OSA, highlighting the potential relevance of inflammation and nutritional status in hypertension.

Key Findings

Results

Each unit increase in Log ALI was associated with significantly higher odds of hypertension in OSA patients.

  • OR = 1.44, 95% CI: 1.25–1.66, P < .001
  • Logistic regression models were adjusted for confounders
  • Analysis was conducted on data from 12,049 participants across four NHANES cycles
  • OSA was identified using questionnaire-based sleep-related information
Results

Participants in the highest ALI quartile had significantly greater odds of hypertension compared to those in the lowest quartile.

  • OR = 1.70, 95% CI: 1.40–2.07, P < .001 for the fourth versus first quartile
  • Quartile analysis was used to assess dose-response patterns across ALI levels
  • This finding was consistent with the continuous association observed per unit increase in Log ALI
Results

Restricted cubic spline (RCS) analysis revealed a nonlinear association between ALI and hypertension in OSA patients.

  • RCS analyses were conducted to evaluate potential nonlinear relationships between ALI and hypertension
  • The nonlinear relationship was identified in addition to the linear associations found in logistic regression
  • This suggests the relationship between ALI and hypertension does not follow a simple linear pattern across the full range of ALI values
Methods

The study population consisted of 12,049 participants drawn from four National Health and Nutrition Examination Survey (NHANES) cycles.

  • OSA status was determined through questionnaire-based sleep-related information rather than polysomnography
  • The Advanced Lung Cancer Inflammation Index (ALI) integrates markers of both inflammation and nutritional status
  • Logistic regression models were adjusted for confounders to isolate the association between ALI and hypertension
Discussion

The study identifies ALI as a potentially relevant marker linking inflammation and nutritional status to hypertension risk in OSA patients.

  • The ALI integrates markers of inflammation and nutritional status, making it a composite measure
  • The authors highlight 'the potential relevance of inflammation and nutritional status in hypertension'
  • The relationship between OSA and hypertension has been well established prior to this study
  • This study adds ALI as a measurable factor associated with hypertension within the OSA population

What This Means

This research suggests that a measure called the Advanced Lung Cancer Inflammation Index (ALI) — which combines information about a person's inflammation levels and nutritional status — is linked to higher rates of high blood pressure (hypertension) in people who have obstructive sleep apnea (OSA). Using data from over 12,000 Americans surveyed across multiple years, the researchers found that people with OSA who had higher ALI scores were significantly more likely to also have hypertension. Specifically, those in the top quarter of ALI scores were 70% more likely to have hypertension compared to those in the bottom quarter. The analysis also revealed that this relationship is not perfectly straightforward — the connection between ALI and hypertension follows a curved (nonlinear) pattern, meaning the risk does not simply increase at the same rate across all ALI levels. This was confirmed using a statistical technique called restricted cubic spline analysis. This research suggests that inflammation and nutritional status, as captured together by the ALI, may play a meaningful role in understanding why some people with sleep apnea develop high blood pressure while others do not. This could eventually help identify OSA patients at higher cardiovascular risk, though the study's reliance on self-reported sleep questionnaires rather than formal sleep testing is an important limitation to keep in mind.

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Citation

Lin M, Yang Y, Li Z, Lv T, Pan Y, Li S, et al.. (2026). Association of advanced lung cancer inflammation index with hypertension in obstructive sleep apnea.. Medicine. https://doi.org/10.1097/MD.0000000000050538