Data Sheet 1_Association of advanced lung cancer inflammation index with all-cause and cardiovascular mortality in US patients with asthma.pdf

BackgroundAsthma poses a significant global health challenge, representing a chronic respiratory disorder marked by airway inflammation. The advanced lung cancer inflammation index (ALI) served as a comprehensive index to assess inflammation. However, few studies have investigated the association between ALI and both all-cause and cardiovascular mortality in US patients with asthma.
MethodsWe used data from the National Health and Nutrition Examination Survey (NHANES) to explore the association of ALI with all-cause and cardiovascular mortality in US patients with asthma. This study used Kaplan–Meier curves to examine the ALI index's impact on asthma patients' survival. We applied weighted Cox models and restricted cubic splines (RCS) analysis to assess the ALI-mortality link, identifying non-linear thresholds with a recursive algorithm. Subgroup analyses and sensitivity analyses were conducted, excluding those with missing covariates and cancer patients.
ResultsA total of 6,211 asthma patients were enrolled and categorized into three groups based on ALI tertiles. The risk of all-cause mortality decreased as ALI increased in the fully adjusted multivariate Cox regression analysis; the hazard ratio (HR) is 0.95 (95% CI: 0.91–0.99, P = 0.01). Compared with the lowest ALI group, T1, the fully adjusted HR values for ALI and all-cause mortality in T2, T3 were 0.68 (95% CI: 0.55–0.85, P < 0.001), 0.53 (95% CI: 0.41–0.68, P < 0.001). The risk of cardiovascular mortality was also lower in the groups of T2 (HR: 0.84, 95% CI: 0.55–1.28) and T3 (HR: 0.47, 95% CI: 0.31–0.71, P for trend < 0.001), respectively. In addition, the results of the subgroup analyses were robust.
ConclusionsThis cohort study demonstrated the higher accuracy of ALI in predicting mortality in asthma patients, highlighting its important clinical value of ALI in risk assessment and prognosis evaluation.

研究背景
哮喘作为一种以气道炎症为特征的慢性呼吸道疾病，是一项严峻的全球公共卫生挑战。晚期肺癌炎症指数（advanced lung cancer inflammation index, ALI）是一种用于评估炎症状态的综合指标。然而，目前鲜有研究探讨美国哮喘患者中ALI与全因死亡率及心血管死亡率之间的关联。
研究方法
本研究利用美国国家健康与营养调查（National Health and Nutrition Examination Survey, NHANES）的数据，探讨美国哮喘患者ALI水平与全因死亡率、心血管死亡率的关联。本研究采用Kaplan–Meier曲线分析ALI指数对哮喘患者生存情况的影响；应用加权Cox模型与限制性立方样条（restricted cubic splines, RCS）分析评估ALI与死亡率的关联，并通过递归算法确定非线性阈值。此外，本研究开展了亚组分析与敏感性分析，剔除了存在协变量缺失的受试者以及癌症患者。
研究结果
本研究共纳入6211名哮喘患者，并根据ALI三分位位数将其分为三组。经完全校正的多因素Cox回归分析显示，随着ALI水平升高，全因死亡风险逐渐降低，风险比（hazard ratio, HR）为0.95（95%置信区间：0.91–0.99，P=0.01）。以ALI最低组T1为参照，T2、T3组的ALI与全因死亡率关联的经校正HR分别为0.68（95%CI：0.55–0.85，P<0.001）、0.53（95%CI：0.41–0.68，P<0.001）。T2、T3组的心血管死亡风险同样显著低于T1组，HR分别为0.84（95%CI：0.55–1.28）与0.47（95%CI：0.31–0.71），趋势检验P<0.001。此外，亚组分析结果稳健可靠。
研究结论
本队列研究证实ALI在预测哮喘患者死亡率方面具有更高的准确性，凸显了其在风险评估与预后评估中的重要临床应用价值。