Abstract
PURPOSE: This study explored the association between the C-reactive protein-albumin-lymphocyte (CALLY) index and erectile dysfunction (ED). PATIENTS AND METHODS: Data from 2,128 participants in the 2001-2004 National Health and Nutrition Examination Survey (NHANES) were analyzed and classified into ED and non-ED groups.Additionally, a separate analysis of complete erectile dysfunction was conducted.A weighted multiple logistic regression model was used to assess the association between CALLY and ED, while smooth curve fitting was applied to explore their linear relationship.ROC analysis was conducted to compare the predictive accuracy (AUC) of CALLY, Systemic Inflammation Response Index (SIRI), Systemic Immune-Inflammation Index (SII), Aggregate Index of Systemic Inflammation (AISI), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and the product of platelet count and neutrophil count (PPN) for ED. RESULTS: After adjustment, Ln-CALLY was negatively associated with ED (OR = 0.77, 95% CI: 0.69-0.85, p < 0.0001) and complete ED (OR = 0.88, 95% CI: 0.78-1.00, p = 0.0450).The highest Ln-CALLY tertile (Q3) was associated with a significantly lower risk of ED compared to Q1 (OR = 0.40, 95% CI: 0.30-0.55, p < 0.0001).A similar trend was observed for complete ED (OR = 0.57, 95% CI: 0.38-0.85, p = 0.006).Curve fitting revealed a negative correlation between CALLY and both types of ED.Subgroup analysis confirmed the consistent and independent association.CALLY exhibited superior predictive performance for ED (AUC = 0.6512) and complete ED (AUC = 0.6237) compared to other markers. CONCLUSION: Higher CALLY levels were linked to a reduced ED risk and proved a superior predictor compared to other inflammatory markers.