Higher Remnant Cholesterol Inflammatory Index is Associated with Mortality in Patients with Lung Cancer: A UK Biobank Prospective Cohort Study with a Supportive External Cohort.
5 affiliations
- 1Department of Thoracic Surgery, Longyan First Hospital, Longyan, Fujian, People's Republic of China.
- 2Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, People's Republic of China.
- 3Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fujian Province University, Fuzhou, People's Republic of China.
- 4Clinical Research Center for Thoracic Tumors of Fujian Province, Fuzhou, People's Republic of China.
- 5National Key Clinical Specialty of Thoracic Surgery, Fuzhou, People's Republic of China.
Abstract
Background
We evaluated the association between the remnant cholesterol inflammatory index (RCII) and all-cause mortality (ACM) and lung cancer-specific mortality (LCM) among patients with lung cancer, and explored indirect associations through circulating immune-inflammatory indicators.Methods
The primary analysis included 4,128 UK Biobank participants with incident lung cancer, and the supportive external cohort included 452 pathologically confirmed patients from Longyan First Hospital. Cox proportional hazards models, Kaplan-Meier analyses, restricted cubic splines, interval-based sensitivity analyses, and a Fine-Gray competing-risk model for LCM were used. Neutrophil count, leukocyte count, red blood cell distribution width-coefficient of variation (RDW-CV), neutrophil-to-lymphocyte ratio (NLR), and systemic inflammation response index (SIRI) were examined in separate exploratory single-mediator models.Results
During a median follow-up of 7.0 years in the UK Biobank cohort, 3,130 all-cause deaths and 2,563 lung cancer-specific deaths occurred. After full adjustment, each 1-standard deviation increase in RCII was associated with a 6% higher hazard of ACM (HR, 1.06; 95% CI, 1.02-1.10) and a 5% higher hazard of LCM (HR, 1.05; 95% CI, 1.01-1.09). Relative to the lowest quartile, the highest RCII quartile was associated with 19% and 16% higher hazards of ACM (HR, 1.19; 95% CI, 1.07-1.32) and LCM (HR, 1.16; 95% CI, 1.03-1.30), respectively. In the supportive external cohort, the fully adjusted HRs per 1-standard deviation increase were 1.41 (95% CI, 1.08-1.82) for ACM and 1.52 (95% CI, 1.17-1.98) for LCM. Exploratory analyses identified significant statistical indirect effects through neutrophil and leukocyte counts for both outcomes, whereas indirect effects through RDW-CV, NLR, and SIRI were significant only for ACM.Conclusion
Higher RCII was associated with higher hazards of ACM and LCM after lung cancer diagnosis, with directionally similar findings in the supportive external cohort. RCII represents an integrated host metabolic-inflammatory marker relevant to lung cancer prognosis and warrants further evaluation in prospective, clinically characterized cohorts.
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BibTeX
@article{wang2026higher,
title = {{Higher Remnant Cholesterol Inflammatory Index is Associated with Mortality in Patients with Lung Cancer: A UK Biobank Prospective Cohort Study with a Supportive External Cohort.}},
author = {Hongjin Wang and Jiehuan Lin and Pengtao Huang and Guobing Xu},
journal = {Journal of inflammation research},
year = {2026},
month = oct,
doi = {10.2147/jir.s644334},
url = {https://europepmc.org/article/MED/42936274},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Higher Remnant Cholesterol Inflammatory Index is Associated with Mortality in Patients with Lung Cancer: A UK Biobank Prospective Cohort Study with a Supportive External Cohort.
AU - Hongjin Wang
AU - Jiehuan Lin
AU - Pengtao Huang
AU - Guobing Xu
PY - 2026
DA - 2026/10/22
JO - Journal of inflammation research
DO - 10.2147/jir.s644334
UR - https://europepmc.org/article/MED/42936274
AB - Background We evaluated the association between the remnant cholesterol inflammatory index (RCII) and all-cause mortality (ACM) and lung cancer-specific mortality (LCM) among patients with lung cancer, and explored indirect associations through circulating immune-inflammatory indicators.Methods The primary analysis included 4,128 UK Biobank participants with incident lung cancer, and the supportive external cohort included 452 pathologically confirmed patients from Longyan First Hospital. Cox proportional hazards models, Kaplan-Meier analyses, restricted cubic splines, interval-based sensitivity analyses, and a Fine-Gray competing-risk model for LCM were used. Neutrophil count, leukocyte count, red blood cell distribution width-coefficient of variation (RDW-CV), neutrophil-to-lymphocyte ratio (NLR), and systemic inflammation response index (SIRI) were examined in separate exploratory single-mediator models.Results During a median follow-up of 7.0 years in the UK Biobank cohort, 3,130 all-cause deaths and 2,563 lung cancer-specific deaths occurred. After full adjustment, each 1-standard deviation increase in RCII was associated with a 6% higher hazard of ACM (HR, 1.06; 95% CI, 1.02-1.10) and a 5% higher hazard of LCM (HR, 1.05; 95% CI, 1.01-1.09). Relative to the lowest quartile, the highest RCII quartile was associated with 19% and 16% higher hazards of ACM (HR, 1.19; 95% CI, 1.07-1.32) and LCM (HR, 1.16; 95% CI, 1.03-1.30), respectively. In the supportive external cohort, the fully adjusted HRs per 1-standard deviation increase were 1.41 (95% CI, 1.08-1.82) for ACM and 1.52 (95% CI, 1.17-1.98) for LCM. Exploratory analyses identified significant statistical indirect effects through neutrophil and leukocyte counts for both outcomes, whereas indirect effects through RDW-CV, NLR, and SIRI were significant only for ACM.Conclusion Higher RCII was associated with higher hazards of ACM and LCM after lung cancer diagnosis, with directionally similar findings in the supportive external cohort. RCII represents an integrated host metabolic-inflammatory marker relevant to lung cancer prognosis and warrants further evaluation in prospective, clinically characterized cohorts.
SN - 1178-7031
ER -