ArticleFrontiers in medicine2026
Association between the C-reactive protein-albumin-lymphocyte index and incident depression in patients with chronic obstructive pulmonary disease: a prospective cohort study from the UK biobank.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Depression is a prevalent and underrecognized comorbidity in chronic obstructive pulmonary disease (COPD) that worsens outcomes. The C-reactive protein-albumin-lymphocyte (CALLY) index, a composite immune-nutritional biomarker, has demonstrated prognostic value in various chronic conditions, but its prospective association with incident depression in COPD remains unexplored. Methods: This prospective cohort study included 40,200 UK Biobank participants with baseline COPD. Cox proportional hazards regression was used to estimate the association between the CALLY index and incident depression, with progressive adjustment across five models. Restricted cubic spline (RCS) curves and two-segment Cox regression was applied to characterize non-linear associations and identify inflection points. Subgroup and sensitivity analyses were conducted to assess robustness. Results: During a mean follow-up of 13.1 ± 2.8 years, 2,059 incident depression events occurred. In the fully adjusted model, each one-standard deviation (SD) increment in ln-CALLY was associated with a 7% lower risk of depression (HR = 0.93, 95% CI: 0.88-0.97, Conclusions: In COPD patients, the CALLY index exhibits a significant L-shaped association with incident depression risk, characterized by a pronounced protective effect below the identified threshold and a risk plateau above it. These findings suggest that the CALLY index may serve as a clinically accessible tool for depression risk stratification, particularly in younger COPD patients, although the age-specific effect requires confirmation in future studies.
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