{
  "abstract": "Preserved ratio impaired spirometry (PRISm) is an intermediate pulmonary phenotype with heightened cardiometabolic risk. Effective tools for its identification are lacking. However, its relationship with systemic inflammatory-nutritional balance is underexplored. The CALLY index integrates C-reactive protein, albumin, and lymphocyte count. This composite biomarker reflects inflammatory-nutritional homeostasis. This study aimed to investigate the association between the ln(CALLY) index and PRISm in a nationally representative U.S. adult population. We analyzed data from 7296 participants in the National Health and Nutrition Examination Survey (NHANES) 2007–2010. PRISm was defined as FEV1/FVC ≥ 0.7 with FEV1 < 80% predicted. Multivariable logistic regression models assessed the association between ln(CALLY) (as quartiles and per-standard-deviation increases) and PRISm, with sequential adjustment for demographic, socioeconomic, and cardiometabolic factors. Restricted cubic splines examined the dose-response relationship. Subgroup and sensitivity analyses evaluated the robustness of findings. Among participants, 920 (12.6%) had PRISm. Compared to those with normal pulmonary function, PRISm individuals had significantly lower ln(CALLY) values (1.21 vs 1.77, P < .001). In fully adjusted models, higher ln(CALLY) quartiles had progressively lower PRISm odds: Q2 (OR = 0.71, 95% CI:0.57–0.88), Q3 (OR = 0.63, 0.47–0.84), and Q4 (OR = 0.48, 0.35–0.66) vs Q1 (P-trend < 0.001). Each standard deviation increase in ln(CALLY) reduced PRISm risk by 24% (OR = 0.76, 0.68–0.85). Restricted cubic spline analysis showed a monotonic inverse linear dose-response relationship (P-overall < .001, P-nonlinear = .707). Subgroup analyses found stronger protective associations in women (P-interaction = .021) and significant heterogeneity across racial/ethnic groups (P-interaction = .036). Sensitivity analyses treating BMI continuously and using multiple imputation supported these findings. Higher ln(CALLY) is independently associated with lower PRISm prevalence in U.S. adults. Systemic inflammatory-nutritional status may be a modifiable risk factor for PRISm, supporting potential targeted prevention strategies. The CALLY index, derived from routine blood tests, could serve as a readily accessible tool for risk stratification of PRISm.",
  "abstract_shown": true,
  "affiliations": [
    "Health Management Center, Gansu Province Central Hospital, Lanzhou, P.R. China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Yucai Ye"
    },
    {
      "affs": [
        0
      ],
      "name": "Youhong Zhao"
    },
    {
      "affs": [
        0
      ],
      "name": "Liya Jin"
    },
    {
      "affs": [
        0
      ],
      "name": "Juanxue Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Qiong Jia"
    },
    {
      "affs": [
        0
      ],
      "name": "Wenjuan Bai"
    },
    {
      "affs": [
        0
      ],
      "name": "Yanjiong Wang",
      "orcid": "0009-0002-0273-2099"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/enhdd375mn44b.bib",
  "cited_by": 0,
  "doi": "10.1097/md.0000000000051472",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13747420/",
  "id": "enhdd375mn44b",
  "issns": [
    "0025-7974",
    "1536-5964"
  ],
  "landing_url": "https://doi.org/10.1097/md.0000000000051472",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "6700"
    ],
    [
      "heading",
      "Observational Study"
    ],
    [
      "heading",
      "Research Article"
    ],
    [
      "openalex",
      "2740|Chronic Obstructive Pulmonary Disease (COPD) Research"
    ]
  ],
  "openalex": "W7225420909",
  "pdf_url": null,
  "pmcid": "PMC13747420",
  "pmid": "42994884",
  "published": "2026-11-06",
  "publisher": "Wolters Kluwer Health",
  "ris": "https://research.draconitic.com/paper/enhdd375mn44b.ris",
  "sources": [
    {
      "first_seen": "2026-11-12T12:23:28Z",
      "native_id": "PMC13747420",
      "source": "pmc",
      "url": "https://doi.org/10.1097/md.0000000000051472"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Chronic Obstructive Pulmonary Disease (COPD) Research",
      "subfield": "general"
    }
  ],
  "title": "The CALLY index, a novel composite biomarker, is inversely associated with preserved ratio impaired spirometry (PRISm): A nationally representative cross-sectional study",
  "title_text": "The CALLY index, a novel composite biomarker, is inversely associated with preserved ratio impaired spirometry (PRISm): A nationally representative cross-sectional study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-13T12:24:18Z",
  "url": "https://research.draconitic.com/paper/enhdd375mn44b",
  "venue": "Medicine",
  "versions": []
}