{"id":"https://openalex.org/W7225420909","doi":"https://doi.org/10.1097/md.0000000000051472","title":"The CALLY index, a novel composite biomarker, is inversely associated with preserved ratio impaired spirometry (PRISm): A nationally representative cross-sectional study","display_name":"The CALLY index, a novel composite biomarker, is inversely associated with preserved ratio impaired spirometry (PRISm): A nationally representative cross-sectional study","publication_year":2026,"publication_date":"2026-11-06","ids":{"openalex":"https://openalex.org/W7225420909","doi":"https://doi.org/10.1097/md.0000000000051472","pmid":"https://pubmed.ncbi.nlm.nih.gov/42994884"},"language":"en","primary_location":{"id":"doi:10.1097/md.0000000000051472","doi":"https://doi.org/10.1097/md.0000000000051472","is_oa":true,"landing_page_url":"https://doi.org/10.1097/md.0000000000051472","pdf_url":null,"source":{"id":"https://openalex.org/S28966261","display_name":"Medicine","issn_l":"0025-7974","issn":["0025-7974","1536-5964"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310318547","host_organization_name":"Wolters Kluwer","host_organization_lineage":["https://openalex.org/P4310318547"],"host_organization_lineage_names":["Wolters Kluwer"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medicine","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1097/md.0000000000051472","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5161103190","display_name":"Yucai Ye","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210114785","display_name":"Gansu Provincial Hospital","ror":"https://ror.org/02axars19","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210114785"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Yucai Ye","raw_affiliation_strings":["Health Management Center, Gansu Province Central Hospital, Lanzhou, P.R. China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Health Management Center, Gansu Province Central Hospital, Lanzhou, P.R. China","institution_ids":["https://openalex.org/I4210114785"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5109907203","display_name":"Youhong Zhao","orcid":"https://orcid.org/0000-0001-9986-3727","observed_orcids":["https://orcid.org/0000-0001-9986-3727"]},"institutions":[{"id":"https://openalex.org/I4210114785","display_name":"Gansu Provincial Hospital","ror":"https://ror.org/02axars19","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210114785"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Youhong Zhao","raw_affiliation_strings":["Health Management Center, Gansu Province Central Hospital, Lanzhou, P.R. China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Health Management Center, Gansu Province Central Hospital, Lanzhou, P.R. China","institution_ids":["https://openalex.org/I4210114785"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161032537","display_name":"Liya Jin","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210114785","display_name":"Gansu Provincial Hospital","ror":"https://ror.org/02axars19","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210114785"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Liya Jin","raw_affiliation_strings":["Health Management Center, Gansu Province Central Hospital, Lanzhou, P.R. China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Health Management Center, Gansu Province Central Hospital, Lanzhou, P.R. China","institution_ids":["https://openalex.org/I4210114785"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161080273","display_name":"Juanxue Zhang","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210114785","display_name":"Gansu Provincial Hospital","ror":"https://ror.org/02axars19","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210114785"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Juanxue Zhang","raw_affiliation_strings":["Health Management Center, Gansu Province Central Hospital, Lanzhou, P.R. China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Health Management Center, Gansu Province Central Hospital, Lanzhou, P.R. China","institution_ids":["https://openalex.org/I4210114785"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5086972677","display_name":"Qiong Jia","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210114785","display_name":"Gansu Provincial Hospital","ror":"https://ror.org/02axars19","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210114785"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Qiong Jia","raw_affiliation_strings":["Health Management Center, Gansu Province Central Hospital, Lanzhou, P.R. China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Health Management Center, Gansu Province Central Hospital, Lanzhou, P.R. China","institution_ids":["https://openalex.org/I4210114785"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161065281","display_name":"Wenjuan Bai","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210114785","display_name":"Gansu Provincial Hospital","ror":"https://ror.org/02axars19","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210114785"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Wenjuan Bai","raw_affiliation_strings":["Health Management Center, Gansu Province Central Hospital, Lanzhou, P.R. China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Health Management Center, Gansu Province Central Hospital, Lanzhou, P.R. China","institution_ids":["https://openalex.org/I4210114785"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5161017757","display_name":"Yanjiong Wang","orcid":"https://orcid.org/0009-0002-0273-2099","observed_orcids":["https://orcid.org/0009-0002-0273-2099"]},"institutions":[{"id":"https://openalex.org/I4210114785","display_name":"Gansu Provincial Hospital","ror":"https://ror.org/02axars19","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210114785"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Yanjiong Wang","raw_affiliation_strings":["Health Management Center, Gansu Province Central Hospital, Lanzhou, P.R. China"],"raw_orcid":"https://orcid.org/0009-0002-0273-2099","affiliations":[{"raw_affiliation_string":"Health Management Center, Gansu Province Central Hospital, Lanzhou, P.R. China","institution_ids":["https://openalex.org/I4210114785"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I4210114785"],"apc_list":{"value":1950,"currency":"USD","value_usd":1950},"apc_paid":{"value":1950,"currency":"USD","value_usd":1950},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"105","issue":"45","first_page":"e51472","last_page":"e51472"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10143","display_name":"Chronic Obstructive Pulmonary Disease (COPD) Research","score":0.9868000149726868,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10143","display_name":"Chronic Obstructive Pulmonary Disease (COPD) Research","score":0.9868000149726868,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11355","display_name":"Inflammatory Biomarkers in Disease Prognosis","score":0.007499999832361937,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10051","display_name":"Asthma and respiratory diseases","score":0.0019000000320374966,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/cally-index","display_name":"CALLY index","score":0.953000009059906},{"id":"https://openalex.org/keywords/preserved-ratio-impaired-spirometry","display_name":"preserved ratio impaired spirometry","score":0.9959999918937683},{"id":"https://openalex.org/keywords/c-reactive-protein","display_name":"C-reactive protein","score":0.7760000228881836},{"id":"https://openalex.org/keywords/albumin","display_name":"albumin","score":0.7929999828338623},{"id":"https://openalex.org/keywords/lymphocyte-count","display_name":"lymphocyte count","score":0.9959999918937683},{"id":"https://openalex.org/keywords/cardiometabolic-risk","display_name":"cardiometabolic risk","score":0.8870000243186951},{"id":"https://openalex.org/keywords/lung-function","display_name":"lung function","score":0.7049999833106995},{"id":"https://openalex.org/keywords/dose-response-relationship","display_name":"dose-response relationship","score":0.734000027179718},{"id":"https://openalex.org/keywords/sex-differences","display_name":"sex differences","score":0.9399999976158142},{"id":"https://openalex.org/keywords/nhanes-adults","display_name":"NHANES adults","score":0.6980000138282776},{"id":"https://openalex.org/keywords/biomarkers","display_name":"biomarkers","score":0.32499998807907104},{"id":"https://openalex.org/keywords/smoking","display_name":"smoking","score":0.3149999976158142},{"id":"https://openalex.org/keywords/diabetes-mellitus","display_name":"diabetes mellitus","score":0.44600000977516174},{"id":"https://openalex.org/keywords/hypertension","display_name":"hypertension","score":0.5320000052452087},{"id":"https://openalex.org/keywords/exercise","display_name":"physical activity","score":0.4339999854564667},{"id":"https://openalex.org/keywords/socioeconomic-status","display_name":"socioeconomic status","score":0.367000013589859},{"id":"https://openalex.org/keywords/body-mass-index","display_name":"body mass index","score":0.3409999907016754}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9434999823570251},{"id":"https://openalex.org/C68443243","wikidata":"https://www.wikidata.org/wiki/Q2786686","display_name":"Quartile","level":3,"score":0.8019000291824341},{"id":"https://openalex.org/C2780333948","wikidata":"https://www.wikidata.org/wiki/Q653305","display_name":"Spirometry","level":3,"score":0.7236999869346619},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.5304999947547913},{"id":"https://openalex.org/C2779874844","wikidata":"https://www.wikidata.org/wiki/Q1967281","display_name":"National Health and Nutrition Examination Survey","level":3,"score":0.5135999917984009},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.4244999885559082},{"id":"https://openalex.org/C48921125","wikidata":"https://www.wikidata.org/wiki/Q10861030","display_name":"Linear regression","level":2,"score":0.42100000381469727},{"id":"https://openalex.org/C119043178","wikidata":"https://www.wikidata.org/wiki/Q320723","display_name":"Covariate","level":2,"score":0.39340001344680786},{"id":"https://openalex.org/C77350462","wikidata":"https://www.wikidata.org/wiki/Q1125472","display_name":"Confounding","level":2,"score":0.38339999318122864},{"id":"https://openalex.org/C187960798","wikidata":"https://www.wikidata.org/wiki/Q7631152","display_name":"Subgroup analysis","level":3,"score":0.3328999876976013},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.328900009393692},{"id":"https://openalex.org/C152877465","wikidata":"https://www.wikidata.org/wiki/Q208042","display_name":"Regression analysis","level":2,"score":0.3156999945640564},{"id":"https://openalex.org/C198433322","wikidata":"https://www.wikidata.org/wiki/Q3910099","display_name":"Predictive value of tests","level":2,"score":0.3010999858379364},{"id":"https://openalex.org/C61427482","wikidata":"https://www.wikidata.org/wiki/Q6656244","display_name":"Anthropometry","level":2,"score":0.2833000123500824},{"id":"https://openalex.org/C2780221984","wikidata":"https://www.wikidata.org/wiki/Q131191","display_name":"Body mass index","level":2,"score":0.26669999957084656},{"id":"https://openalex.org/C156957248","wikidata":"https://www.wikidata.org/wiki/Q1862216","display_name":"Odds ratio","level":2,"score":0.26510000228881836},{"id":"https://openalex.org/C63428231","wikidata":"https://www.wikidata.org/wiki/Q9043","display_name":"Norwegian","level":2,"score":0.2581000030040741}],"mesh":[{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002097","descriptor_name":"C-Reactive Protein","qualifier_ui":"Q000032","qualifier_name":"analysis","is_major_topic":true},{"descriptor_ui":"D003430","descriptor_name":"Cross-Sectional Studies","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005541","descriptor_name":"Forced Expiratory Volume","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009749","descriptor_name":"Nutrition Surveys","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D013147","descriptor_name":"Spirometry","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":"Q000453","qualifier_name":"epidemiology","is_major_topic":false},{"descriptor_ui":"D015415","descriptor_name":"Biomarkers","qualifier_ui":"Q000097","qualifier_name":"blood","is_major_topic":false},{"descriptor_ui":"D018655","descriptor_name":"Lymphocyte Count","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1097/md.0000000000051472","doi":"https://doi.org/10.1097/md.0000000000051472","is_oa":true,"landing_page_url":"https://doi.org/10.1097/md.0000000000051472","pdf_url":null,"source":{"id":"https://openalex.org/S28966261","display_name":"Medicine","issn_l":"0025-7974","issn":["0025-7974","1536-5964"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310318547","host_organization_name":"Wolters Kluwer","host_organization_lineage":["https://openalex.org/P4310318547"],"host_organization_lineage_names":["Wolters Kluwer"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medicine","raw_type":"journal-article"},{"id":"pmid:42994884","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42994884","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medicine","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.1097/md.0000000000051472","doi":"https://doi.org/10.1097/md.0000000000051472","is_oa":true,"landing_page_url":"https://doi.org/10.1097/md.0000000000051472","pdf_url":null,"source":{"id":"https://openalex.org/S28966261","display_name":"Medicine","issn_l":"0025-7974","issn":["0025-7974","1536-5964"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310318547","host_organization_name":"Wolters Kluwer","host_organization_lineage":["https://openalex.org/P4310318547"],"host_organization_lineage_names":["Wolters Kluwer"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Medicine","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":18,"referenced_works":["https://openalex.org/W3120395915","https://openalex.org/W3208278115","https://openalex.org/W4200070125","https://openalex.org/W4200503566","https://openalex.org/W4225396384","https://openalex.org/W4309161951","https://openalex.org/W4361272976","https://openalex.org/W4392851918","https://openalex.org/W4393203879","https://openalex.org/W4398218277","https://openalex.org/W4405910271","https://openalex.org/W4406937568","https://openalex.org/W4409702423","https://openalex.org/W4409780321","https://openalex.org/W4413805482","https://openalex.org/W4414301410","https://openalex.org/W4414364380","https://openalex.org/W4416068456"],"related_works":["https://openalex.org/W7170648103","https://openalex.org/W4409335598","https://openalex.org/W7171312619","https://openalex.org/W4416636762","https://openalex.org/W4408555243","https://openalex.org/W4400907141","https://openalex.org/W4405910271","https://openalex.org/W4407037874","https://openalex.org/W7159803465","https://openalex.org/W4296771621"],"abstract_inverted_index":{"Preserved":[0],"ratio":[1],"impaired":[2],"spirometry":[3],"(PRISm)":[4],"is":[5,28,261],"an":[6],"intermediate":[7],"pulmonary":[8,146],"phenotype":[9],"with":[10,24,89,110,144,264],"heightened":[11],"cardiometabolic":[12,117],"risk.":[13],"Effective":[14],"tools":[15],"for":[16,113,280,302],"its":[17,22],"identification":[18],"are":[19],"lacking.":[20],"However,":[21],"relationship":[23,220],"systemic":[25],"inflammatory-nutritional":[26,44,272],"balance":[27],"underexplored.":[29],"The":[30,287],"CALLY":[31,288],"index":[32,56],"integrates":[33],"C-reactive":[34],"protein,":[35],"albumin,":[36],"and":[37,57,76,105,108,116,127,184,238,252],"lymphocyte":[38],"count.":[39],"This":[40,46],"composite":[41],"biomarker":[42],"reflects":[43],"homeostasis.":[45],"study":[47],"aimed":[48],"to":[49,142],"investigate":[50],"the":[51,54,73,99,123,131],"association":[52,100],"between":[53,101],"ln(CALLY)":[55,102,153,166,200,260],"PRISm":[58,82,148,171,202,266],"in":[59,72,199,233,268],"a":[60,215,276,298],"nationally":[61],"representative":[62],"U.S.":[63,269],"adult":[64],"population.":[65],"We":[66],"analyzed":[67],"data":[68],"from":[69,291],"7296":[70],"participants":[71],"National":[74],"Health":[75],"Nutrition":[77],"Examination":[78],"Survey":[79],"(NHANES)":[80],"2007-2010.":[81],"was":[83],"defined":[84],"as":[85,297],"FEV1/FVC":[86],"\u2265":[87],"0.7":[88],"FEV1":[90],"<":[91,159,193,222],"80%":[92],"predicted.":[93],"Multivariable":[94],"logistic":[95],"regression":[96],"models":[97],"assessed":[98],"(as":[103],"quartiles":[104,167],"per-standard-deviation":[106],"increases)":[107],"PRISm,":[109,281],"sequential":[111],"adjustment":[112],"demographic,":[114],"socioeconomic,":[115],"factors.":[118],"Restricted":[119,210],"cubic":[120,211],"splines":[121],"examined":[122],"dose-response":[124,219],"relationship.":[125],"Subgroup":[126,227],"sensitivity":[128],"analyses":[129,228,248],"evaluated":[130],"robustness":[132],"of":[133,305],"findings.":[134,258],"Among":[135],"participants,":[136],"920":[137],"(12.6%)":[138],"had":[139,150,168],"PRISm.":[140,306],"Compared":[141],"those":[143],"normal":[145],"function,":[147],"individuals":[149],"significantly":[151],"lower":[152,170,265],"values":[154],"(1.21":[155],"vs":[156,190],"1.77,":[157],"P":[158],".001).":[160],"In":[161],"fully":[162],"adjusted":[163],"models,":[164],"higher":[165],"progressively":[169],"odds:":[172],"Q2":[173],"(OR":[174,180,186,206],"=":[175,181,187,207,225,236,245],"0.71,":[176],"95%":[177],"CI:0.57-0.88),":[178],"Q3":[179],"0.63,":[182],"0.47-0.84),":[183],"Q4":[185],"0.48,":[188],"0.35-0.66)":[189],"Q1":[191],"(P-trend":[192],"0.001).":[194],"Each":[195],"standard":[196],"deviation":[197],"increase":[198],"reduced":[201],"risk":[203,278,303],"by":[204],"24%":[205],"0.76,":[208],"0.68-0.85).":[209],"spline":[212],"analysis":[213],"showed":[214],"monotonic":[216],"inverse":[217],"linear":[218],"(P-overall":[221],".001,":[223],"P-nonlinear":[224],".707).":[226],"found":[229],"stronger":[230],"protective":[231],"associations":[232],"women":[234],"(P-interaction":[235,244],".021)":[237],"significant":[239],"heterogeneity":[240],"across":[241],"racial/ethnic":[242],"groups":[243],".036).":[246],"Sensitivity":[247],"treating":[249],"BMI":[250],"continuously":[251],"using":[253],"multiple":[254],"imputation":[255],"supported":[256],"these":[257],"Higher":[259],"independently":[262],"associated":[263],"prevalence":[267],"adults.":[270],"Systemic":[271],"status":[273],"may":[274],"be":[275],"modifiable":[277],"factor":[279],"supporting":[282],"potential":[283],"targeted":[284],"prevention":[285],"strategies.":[286],"index,":[289],"derived":[290],"routine":[292],"blood":[293],"tests,":[294],"could":[295],"serve":[296],"readily":[299],"accessible":[300],"tool":[301],"stratification":[304]},"counts_by_year":[],"updated_date":"2026-11-09T13:22:03.289127","created_date":"2026-11-07T00:00:00"}