{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:36:58Z","timestamp":1787938618601,"version":"build-2784847793"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":33,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mediators of Inflammation"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    The relationship between the C\u2010reactive protein (CRP)\u2010albumin\u2010lymphocyte (CALLY) index and disease activity of rheumatoid arthritis (RA) has not been explored at present. This study included 1058 RA patients and used a multiple linear regression model to evaluate the association between the CALLY index and 28 joint disease activity scores (DAS28) and further explored its potential nonlinear relationship using a two\u2010stage segmented linear regression model. Multivariate adjusted analysis showed that CALLY was significantly negatively correlated with DAS28\u2010erythrocyte sedimentation rate (ESR) (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u2009\u22120.119, 95% confidence interval [CI]: \u22120.145 to \u22120.093) and DAS28\u2010CRP (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u2009\u22120.201, 95% CI: \u22120.226 to \u22120.177) (both\n                    <jats:italic>p<\/jats:italic>\n                    \u2009 &lt; 0.001), and there was a dose\u2013response relationship (trend\n                    <jats:italic>p<\/jats:italic>\n                    \u2009 &lt; 0.001). Segmented regression analysis revealed a significant nonlinear correlation between the two, with inflection points of 0.499 and 0.555, respectively. Below the inflection point, CALLY has a significant negative impact on disease activity (DAS28\u2010ESR:\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u2009\u22122.102, 95% CI: \u22122.498 to \u22121.706); DAS28\u2010CRP:\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u2009\u22122.311, 95% CI: \u22122.591 to \u22122.031); after exceeding the inflection point, this negative correlation effect significantly weakens but still maintains statistical significance. The results of this study indicate a significant nonlinear relationship between the CALLY index and the DAS28 score, especially at low CALLY levels. This study suggests the potential of CALLY as a novel composite biomarker reflecting the inflammatory status and disease severity of RA.\n                  <\/jats:p>","DOI":"10.1155\/mi\/9969741","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T14:07:41Z","timestamp":1770127661000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Threshold Effect of C\u2010Reactive Protein\u2010Albumin\u2010Lymphocyte (CALLY) Index on Disease Activity in Rheumatoid Arthritis: Unveiling a Nonlinear Association"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0278-8535","authenticated-orcid":false,"given":"Lina","family":"Leng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quanyi","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinfeng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaorong","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7919-8691","authenticated-orcid":false,"given":"Xiaoli","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"key":"e_1_2_12_1_2","doi-asserted-by":"publisher","DOI":"10.1002\/mco2.509"},{"key":"e_1_2_12_2_2","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.2023-0334"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms232112989"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00211-4"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30173-8"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1185\/03007990903422307"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25627"},{"key":"e_1_2_12_8_2","first-page":"65","article-title":"The Development of the Disease Activity Score (DAS) and the Disease Activity Score Using 28 joint Counts (DAS28)","volume":"32","author":"van Riel P. 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