Frontiers in Nutrition · Jun 16, 2026

Association between CALLY index and all-cause mortality in patients with rheumatoid arthritis

By Zhang T, Tang LV

PURPOSE: The CALLY index reflects immune, inflammatory, and nutritional status, but its prognostic role in rheumatoid arthritis (RA) remains uncertain. We investigated whether the CALLY index was independently associated with all-cause mortality in patients with RA, and further examined its nonlinear pattern, and consistency across clinical subgroups. METHODS: We included 5,626 participants with RA from the UK Biobank, with a median follow-up of 15.6 years. Multivariable Cox regression models were used to assess the association between the CALLY index and all-cause mortality. Restricted cubic splines were used to explore potential nonlinearity. Predictive performance was evaluated using time-dependent ROC analysis, IDI, and NRI. Subgroup and sensitivity analyses were performed to test the robustness of the findings. RESULTS: A higher CALLY index was independently associated with a lower risk of all-cause mortality in RA patients. This association showed a nonlinear inverse dose-response pattern, with an estimated inflection point of 1.054. The CALLY index showed better reclassification than its individual components and achieved non-inferior predictive performance compared with the combined three-biomarker model. The association was broadly consistent in clinical subgroups and stable in sensitivity analyses. CONCLUSION: The CALLY index may serve as a simple, low-cost biomarker for long-term mortality risk stratification in patients with RA.

doi.org/10.3389/fnut.2026.1829076 Open access PubMed 42382568 Biomarkers