{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:56:02Z","timestamp":1790916962291,"version":"4.1.0"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease associated with substantial morbidity and increased mortality. Although several composite inflammatory indices have been proposed as accessible biomarkers, their associations with RA and long-term prognosis remain incompletely understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 15,545 adults from five NHANES cycles (2001\u20132010), including 1,075 participants with self-reported RA. Survey-weighted multivariable logistic regression was used to assess associations between inflammatory indices and prevalent RA. Among participants with RA, survey-weighted Kaplan\u2013Meier and Cox regression analyses were used to evaluate all-cause mortality. Restricted cubic spline analyses examined potential nonlinear associations. An independent retrospective hospital-based cohort was used to assess the directional consistency of key RA-related associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 15,545 participants, 1,075 had self-reported RA. In the fully adjusted models, participants in the highest RAR quartile had greater odds of prevalent self-reported RA than those in the lowest quartile (OR, 1.86; 95% CI, 1.33\u20132.60), whereas higher CALLY was inversely associated with RA (Q4 vs. Q1: OR, 0.58; 95% CI, 0.43\u20130.78); both associations remained significant after FDR correction. Among participants with self-reported RA, higher RAR was associated with a greater hazard of all-cause mortality (Q4 vs. Q1: HR, 2.48; 95% CI, 1.62\u20133.77), whereas higher CALLY was associated with a lower mortality hazard (Q4 vs. Q1: HR, 0.44; 95% CI, 0.31\u20130.61), with both associations remaining significant after FDR correction. Restricted cubic spline analyses suggested nonlinear associations for several inflammatory indices. In the independent hospital-based cohort, several key RA-related inflammatory indices showed directionally consistent associations, supporting the reproducibility of the principal RA-related findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RAR and CALLY showed the most consistent associations with both prevalent RA and all-cause mortality. These accessible inflammatory indices may warrant further evaluation as markers of systemic inflammatory and nutritional status in RA, but prospective validation is needed before clinical application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1968785","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:42:06Z","timestamp":1790916126000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of systemic inflammatory indices with rheumatoid arthritis and all-cause mortality: a NHANES study with independent hospital-based replication"],"prefix":"10.3389","volume":"13","author":[{"given":"Lin","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Microbiology and Parasitology, Anhui Provincial key Laboratory of Zoonoses, School of Basic Medical Sciences, Anhui Medical University","place":["Hefei, Anhui, 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