Association between the advanced lung cancer inflammation index and all-cause and cardiovascular mortality in patients with RA: Insights from NHANES data analysis.

ABSTRACT

Background: Rheumatoid arthritis (RA) is associated with significant mortality, which is primarily due to cardiovascular complications. Despite advancements in RA treatment, mortality rates remain high, highlighting the need for reliable prognostic markers. The advanced lung cancer inflammation index (ALI), which integrates inflammatory and nutritional biomarkers, has shown promise in predicting outcomes in various medical conditions. However, its role in RA prognosis remains unclear. Methods: This study aimed to investigate the associations between the ALI and all-cause mortality, as well as cardiovascular mortality, in RA patients using data from the National Health and Nutrition Examination Survey (NHANES). A total of 1568 RA patients were included, and the ALI was calculated using body mass index (BMI), serum ALB, and the neutrophil-to-lymphocyte ratio. Comprehensive demographic, lifestyle, and metabolic data from the NHANES enabled adjustments for potential confounders. Multivariate Cox regression and sensitivity analyses were conducted to assess the associations between the ALI and mortality outcomes. Results: Our findings demonstrate an inverse association between the ALI and both all-cause and cardiovascular mortality in RA patients. Furthermore, a nonlinear relationship was observed, with mortality risk increasing significantly below a certain ALI threshold. Stratified analyses revealed a protective effect of the ALI across various demographic and clinical subgroups, underscoring its potential as a prognostic marker in patients with RA. Conclusion: The ALI holds promise as a valuable prognostic marker for identifying high-risk individuals and guiding personalized management strategies for patients with RA. However, further validation in prospective studies is warranted to confirm its clinical utility. Nonetheless, the potential implications of the ALI for improving the prognosis of patients with RA underscore the importance of its continued investigation in clinical practice.