{
  "abstract": "Background: The C-reactive protein–albumin–lymphocyte (CALLY) index has shown prognostic value in various chronic conditions, but its prospective association with incident chronic obstructive pulmonary disease (COPD) and potential non-linear dose–response patterns remain unexplored.\n\nMethods: This prospective cohort study included 292,945 UK Biobank participants. Multivariable Cox proportional hazards regression was used to estimate the association between the natural-log-transformed CALLY (ln-CALLY) index and incident COPD. Restricted cubic spline (RCS) curves and two-segment Cox regression were applied to characterize non-linear associations and identify inflection points. Subgroup and sensitivity analyses were conducted to assess robustness.\n\nResults: During a mean follow-up of 13.6 years, 6618 incident COPD events occurred. Each one-unit increment in ln-CALLY was associated with a 17% lower risk of COPD in the fully adjusted model (HR = 0.83, 95% CI: 0.81–0.85, P < 0.001). The highest quartile exhibiting a 41% risk reduction versus the lowest (HR = 0.59, 95% CI: 0.54–0.64, P < 0.001). RCS analysis revealed a significant L-shaped relationship. Threshold effect analysis identified an inflection point at ln-CALLY = 7.00; below this threshold, each one-unit increase was associated with a 19% risk reduction (HR = 0.81, 95% CI: 0.78–0.83, P < 0.001), whereas above the threshold the association was non-significant. The inverse association was more pronounced in participants aged <65 years. Sensitivity analyses yielded consistent results.\n\nConclusion: The CALLY index exhibits a significant L-shaped association with incident COPD risk, characterized by a pronounced protective effect below ln-CALLY = 7.00 and a risk plateau above this threshold. These findings support the broader concept that immuno-nutritional status is a determinant of respiratory health.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Laboratory Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People’s Republic of China",
    "Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, People’s Republic of China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yushan Shi",
      "orcid": "0000-0003-3951-2751"
    },
    {
      "affs": [
        0
      ],
      "name": "Huihui Jiang",
      "orcid": "0009-0001-0999-0261"
    },
    {
      "affs": [
        0
      ],
      "name": "Shuangshuang Pu"
    },
    {
      "affs": [
        0
      ],
      "name": "Yaobei Liu"
    },
    {
      "affs": [
        1
      ],
      "name": "Yan Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Weifang Liu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/0ktn4e6djgbcz.bib",
  "cited_by": 0,
  "doi": "10.2147/copd.s640670",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13729764/",
  "id": "0ktn4e6djgbcz",
  "issns": [
    "1176-9106",
    "1178-2005"
  ],
  "landing_url": "https://doi.org/10.2147/copd.s640670",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2740|Chronic Obstructive Pulmonary Disease (COPD) Research"
    ]
  ],
  "openalex": "W7224364241",
  "pdf_url": "https://www.dovepress.com/article/download/121566",
  "pmcid": "PMC13729764",
  "pmid": "42979126",
  "published": "2026-10-30",
  "publisher": "Dove Press",
  "ris": "https://research.draconitic.com/paper/0ktn4e6djgbcz.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:22:30Z",
      "native_id": "PMC13729764",
      "source": "pmc",
      "url": "https://doi.org/10.2147/copd.s640670"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Chronic Obstructive Pulmonary Disease (COPD) Research",
      "subfield": "general"
    }
  ],
  "title": "L-Shaped Association of C-Reactive Protein-Albumin-Lymphocyte Index and COPD Incidence: A Nationwide Cohort Study in the UK Biobank",
  "title_text": "L-Shaped Association of C-Reactive Protein-Albumin-Lymphocyte Index and COPD Incidence: A Nationwide Cohort Study in the UK Biobank",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:22:30Z",
  "url": "https://research.draconitic.com/paper/0ktn4e6djgbcz",
  "venue": "International Journal of Chronic Obstructive Pulmonary Disease",
  "versions": []
}