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Article

Inflammation-immune‑nutrition biomarkers and PSA variability: A population‑based study on the clinical potential of the CALLY index

  • Authors:
    • Hesong Jiang
    • Xiaobing Niu
    • Fei Mao
  • View Affiliations / Copyright

    Affiliations: Department of Urology, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu 223300, P.R. China, Department of Urology, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu 223300, P.R. China
  • Article Number: 181
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    Published online on: September 22, 2025
       https://doi.org/10.3892/br.2025.2059
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Abstract

Prostate cancer (PCa) is the second leading cause of cancer‑associated mortalities worldwide. Prostate‑specific antigen (PSA) testing is pivotal for screening for PCa, despite its limited specificity due to confounding factors such as inflammation and nutritional status. The present study investigated the association between the C‑reactive protein (CRP)‑albumin‑lymphocyte (CALLY) index and PSA levels in a population without PCa. Using data from 5,320 men aged ≥40 years from the 2003‑2010 national health and nutrition examination survey cycles, weighted multivariate linear regression and restricted cubic spline analyses were conducted. The findings revealed a significant inverse linear association: For each unit increase in the CALLY index, the PSA levels decreased by 0.09 ng/ml (β coefficient, ‑0.09; 95% confidence interval, ‑0.16 to ‑0.02). This association persisted across individuals with different ages, smoking habits and comorbidity subgroups. By integrating markers of systemic inflammation (such as the CRP levels), nutritional status (such as the albumin levels) and adaptive immunity (such as the lymphocyte counts), the CALLY index may refine the interpretation of the PSA levels and reduce the number of PCa false positive results, which occur due to subclinical inflammation. The present cross‑sectional study highlighted that the CALLY index, as an adjunct biomarker, may have increased the accuracy of the screening for PCa. However, due to the cross‑sectional design of the present study, causal associations cannot be established, and clinical applicability should be interpreted with caution. Therefore, further longitudinal and experimental studies are needed to elucidate the causal pathways and underlying mechanisms that link the CALLY index to the PSA levels.
View Figures

Figure 1

Association between the CALLY index
and PSA levels. A fitted curve from restricted cubic spline
regression that models the continuous association between the CALLY
index and serum PSA levels (red solid line). The shaded red area
indicates the 95% confidence interval. Both axes have continuous
scales. CALLY, C-reactive protein-albumin-lymphocyte; PSA,
prostate-specific antigen.

Figure 2

Subgroup analyses of the association
between the CALLY index and PSA levels. A forest plot revealed the
β coefficients and 95% CIs for the association between the CALLY
index and PSA levels across subgroups (such as age, smoking status,
alcohol use and comorbidities). CALLY, C-reactive
protein-albumin-lymphocyte; PSA, prostate-specific antigen; CI,
confidence interval.
View References

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Copy and paste a formatted citation
Spandidos Publications style
Jiang H, Niu X and Mao F: Inflammation-immune‑nutrition biomarkers and PSA variability: A population‑based study on the clinical potential of the CALLY index. Biomed Rep 23: 181, 2025.
APA
Jiang, H., Niu, X., & Mao, F. (2025). Inflammation-immune‑nutrition biomarkers and PSA variability: A population‑based study on the clinical potential of the CALLY index. Biomedical Reports, 23, 181. https://doi.org/10.3892/br.2025.2059
MLA
Jiang, H., Niu, X., Mao, F."Inflammation-immune‑nutrition biomarkers and PSA variability: A population‑based study on the clinical potential of the CALLY index". Biomedical Reports 23.5 (2025): 181.
Chicago
Jiang, H., Niu, X., Mao, F."Inflammation-immune‑nutrition biomarkers and PSA variability: A population‑based study on the clinical potential of the CALLY index". Biomedical Reports 23, no. 5 (2025): 181. https://doi.org/10.3892/br.2025.2059
Copy and paste a formatted citation
x
Spandidos Publications style
Jiang H, Niu X and Mao F: Inflammation-immune‑nutrition biomarkers and PSA variability: A population‑based study on the clinical potential of the CALLY index. Biomed Rep 23: 181, 2025.
APA
Jiang, H., Niu, X., & Mao, F. (2025). Inflammation-immune‑nutrition biomarkers and PSA variability: A population‑based study on the clinical potential of the CALLY index. Biomedical Reports, 23, 181. https://doi.org/10.3892/br.2025.2059
MLA
Jiang, H., Niu, X., Mao, F."Inflammation-immune‑nutrition biomarkers and PSA variability: A population‑based study on the clinical potential of the CALLY index". Biomedical Reports 23.5 (2025): 181.
Chicago
Jiang, H., Niu, X., Mao, F."Inflammation-immune‑nutrition biomarkers and PSA variability: A population‑based study on the clinical potential of the CALLY index". Biomedical Reports 23, no. 5 (2025): 181. https://doi.org/10.3892/br.2025.2059
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