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Background <p>This study examined the association between the C-reactive protein–albumin–lymphocyte (CALLY) index and prevalent diabetes in a cross-sectional NHANES sample. CALLY integrates inflammatory, immune, and nutritional components, but its relationship with diabetes prevalence has not been well characterized.</p> Methods <p>Data from 38,722 participants in the NHANES survey (1999–2010) were analyzed. The CALLY index was constructed as a mathematical algorithm that integrates parameters representing inflammation, immunity, and nutritional status. The analytical approach incorporated a hierarchical modeling strategy with progressive complexity utilizing logistic regression to control for potential confounding variables. Restricted cubic spline (RCS) analysis was used to identify non-linear relationships between the CALLY index and diabetes prevalence.</p> Results <p>Computational analysis revealed that higher CALLY levels were significantly associated with lower diabetes prevalence, with participants in the highest CALLY quartile having 28% lower odds of prevalent diabetes (OR 0.72, 95% CI 0.62–0.84) compared to those in the lowest quartile after adjusting for multiple covariates. Similar inverse patterns were observed across several demographic subgroups, although the strength of association varied between strata. The RCS analysis identified an inverse non-linear relationship with an inflection point at 29.613, beyond which the inverse association attenuated. This inflection point may be useful for describing the observed non-linear pattern in this dataset, but should not be interpreted as a clinically actionable cutoff.</p> Conclusion <p>Higher CALLY index levels were significantly associated with lower diabetes prevalence in this cross-sectional analysis. The CALLY index may be a useful composite research indicator for characterizing diabetes-related metabolic status at the population level, but its predictive and clinical value require prospective validation.</p>

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Association between the CALLY index as an integrated nutritional biomarker and diabetes prevalence in the NHANES population study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月20日

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  • Jinxiang Peng,
  • Bo Yin,
  • Jianjun Xiang,
  • Ling Lin,
  • Hai Huang,
  • Feng Wu

摘要

Background

This study examined the association between the C-reactive protein–albumin–lymphocyte (CALLY) index and prevalent diabetes in a cross-sectional NHANES sample. CALLY integrates inflammatory, immune, and nutritional components, but its relationship with diabetes prevalence has not been well characterized.

Methods

Data from 38,722 participants in the NHANES survey (1999–2010) were analyzed. The CALLY index was constructed as a mathematical algorithm that integrates parameters representing inflammation, immunity, and nutritional status. The analytical approach incorporated a hierarchical modeling strategy with progressive complexity utilizing logistic regression to control for potential confounding variables. Restricted cubic spline (RCS) analysis was used to identify non-linear relationships between the CALLY index and diabetes prevalence.

Results

Computational analysis revealed that higher CALLY levels were significantly associated with lower diabetes prevalence, with participants in the highest CALLY quartile having 28% lower odds of prevalent diabetes (OR 0.72, 95% CI 0.62–0.84) compared to those in the lowest quartile after adjusting for multiple covariates. Similar inverse patterns were observed across several demographic subgroups, although the strength of association varied between strata. The RCS analysis identified an inverse non-linear relationship with an inflection point at 29.613, beyond which the inverse association attenuated. This inflection point may be useful for describing the observed non-linear pattern in this dataset, but should not be interpreted as a clinically actionable cutoff.

Conclusion

Higher CALLY index levels were significantly associated with lower diabetes prevalence in this cross-sectional analysis. The CALLY index may be a useful composite research indicator for characterizing diabetes-related metabolic status at the population level, but its predictive and clinical value require prospective validation.