Evidence map›Paper›PMID 42433990›Full record

ArticleFrontiers in medicine2026

The CALLY index for risk stratification of advanced cardiovascular-kidney-metabolic syndrome and mortality: a dual-cohort study from NHANES and a real-world clinical setting.

Peiting Chen, Zhenjia Deng, Wei Zhou, Fangqi Zhu, Yanni Tan, Yuting Tang, Ruier Huang, Jian Wang, Xi Li

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Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Peiting Chen *Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Zhenjia Deng *Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Wei ZhouKey Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Fangqi ZhuKey Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Yanni TanKey Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Yuting TangKey Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Ruier HuangKey Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Jian WangKey Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Xi LiKey Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Cardiovascular Kidney Metabolic (CKM) syndrome is a complex systemic condition, but identifying patients at advanced stages (Stages 3 or 4) remains a clinical challenge due to the lack of readily available markers. The C-reactive Protein-Albumin-Lymphocyte (CALLY) index is a composite measure reflecting the axis of inflammation, nutrition, and immunity. However, its role across integrated advanced CKM risk stratification and all-cause mortality assessment, particularly with cross-population validation, remains insufficiently clarified. Methods: This study used a dual-cohort design. We analyzed a nationally representative population from the United States (NHANES, Results: In the NHANES cohort, a higher CALLY index was associated with a lower risk of advanced CKM (Q4 vs. Q1: OR 0.70, 95% CI 0.54-0.90) and all-cause mortality (Q4 vs. Q1: HR 0.64, 95% CI 0.55-0.76). In the external validation cohort, participants in the highest CALLY quartile had lower odds of advanced CKM (Q4 vs. Q1: OR 0.41, 95% CI 0.28-0.62). Both cohorts showed a clear L-shaped non-linear association. Adding the CALLY index to conventional models significantly improved risk reclassification (NRI 0.1968 in NHANES and 0.4134 in the validation cohort, both Conclusion: The CALLY index is a simple, routinely available composite indicator that may support advanced CKM risk stratification and mortality risk assessment. It provided incremental risk-stratification information in this study and may help identify individuals at higher risk across the CKM spectrum.

Indexed as

all-cause mortalityCALLY indexcardiovascular-kidney-metabolic syndromedual cohort studyrisk stratification

Identifiers

PMID42433990
PMCPMC13352524

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