A recent study published in Arthritis Research and Therapy revealed that the CRP-Albumin-Lymphocyte Index (CALLYI) demonstrated significant potential as a biomarker for predicting osteoarthritis risk in a large-scale analysis of U.S. adults.
Researchers analyzed data from 18,624 participants in the National Health and Nutrition Examination Survey (NHANES) conducted from 1999 to 2010. The investigation found a clear negative correlation between elevated CALLYI values and osteoarthritis prevalence, suggesting this composite biomarker could become an important clinical tool for rheumatologists. Among the study cohort, 1,977 individuals (10.62%) had osteoarthritis diagnoses. The mean CALLYI value across all participants was 5.13 (2.12, 12.86). After adjustments for confounding variables in the fully adjusted regression model, individuals in the highest quartile of CALLYI demonstrated a significant 28% reduction in osteoarthritis risk compared to those in the lowest quartile (OR = 0.72, 95% CI: 0.59-0.88, p = 0.001).
Notably, subgroup analyses revealed no significant interactions across different population segments (p > 0.05). The investigators developed and validated a clinical prediction model incorporating CALLYI alongside other relevant variables. This model achieved impressive predictive performance with an area under the curve (AUC) of 0.825 (95% CI: 0.817-0.834). Decision curve analysis confirmed the model’s clinical utility for practical applications.
CALLYI introduced by Hiroya Iida et al., is a relatively recent marker that reflects both nutritional and inflammatory status. Its components—C-reactive protein (CRP), serum albumin, and lymphocyte count—are routinely measured in clinical settings, making the index highly accessible and practical for everyday use. The CALLYI is calculated using the formula: (Albumin [g/L] × Lymphocyte count [/mm³]) ÷ (CRP [mg/L] + 1), and it serves as a composite indicator of systemic inflammation, nutritional condition, and immune competence. Widely studied in oncology, it has shown particular promise as a prognostic tool in cancers such as hepatocellular carcinoma and colorectal cancer. Higher values typically indicate better nutritional and immune status with lower inflammatory burden, correlating with more favorable clinical outcomes. In contrast, lower values are associated with poorer prognosis. Beyond prognosis, the CALLYI has also been employed to support treatment planning and patient stratification before interventions such as chemotherapy and surgery.
Numerous studies have validated its clinical utility across various malignancies. For instance, a retrospective analysis by Liu et al., using data from the INSCOC database (2013–2018), evaluated the prognostic relevance of the CALLYI in patients with non-small cell lung cancer (NSCLC). The study confirmed its value as a prognostic biomarker, and a nomogram incorporating the CALLY index demonstrated strong predictive accuracy for overall survival in NSCLC patients.
This study represents the first demonstration of a nonlinear negative relationship between CALLYI and osteoarthritis using NHANES data. The researchers created a visualization nomogram to facilitate clinical implementation of their prediction model. This analysis represents the first identification of a nonlinear negative association between CALLYI and OA in a nationally representative U.S. cohort. The validated prediction model suggests CALLYI may serve as a useful biomarker for OA risk assessment.
References
- Geng M, Zhang K. CRP-Albumin-Lymphocyte index (CALLYI) as a risk-predicting biomarker in association with osteoarthritis. Arthritis Res Ther. 2025 Mar 19;27(1):57.
- Iida H, Tani M, Komeda K, Nomi T, Matsushima H, Tanaka S, et al. Superiority of CRP-albumin-lymphocyte index (CALLY index) as a non-invasive prognostic biomarker after hepatectomy for hepatocellular carcinoma. HPB (Oxford). 2022 Jan;24(1):101-115.
- Liu XY, Zhang X, Zhang Q, Ruan GT, Liu T, Xie HL, et al. The value of CRP-albumin-lymphocyte index (CALLY index) as a prognostic biomarker in patients with non-small cell lung cancer. Support Care Cancer. 2023 Aug 23;31(9):533.