A cross-sectional study revealed a nonlinear positive association between the advanced lung cancer inflammation index and unstable asthma, suggesting the index's potential as a risk assessment tool for asthma exacerbations.

In the study, presented at the American College of Chest Physicians (CHEST) Annual Meeting, investigators utilized data from the 2007 to 2018 National Health and Nutrition Examination Survey. They analyzed data from 1,822 patients with current asthma and employed multifactorial logistic regression, subgroup analyses, interaction assessments, smoothed curve fitting, and threshold effect analysis models to examine the association between the advanced lung cancer inflammation index (ALI) and unstable asthma.

Among the key findings were:

• Higher levels of ALI were significantly associated with an increased risk of asthma exacerbations in fully adjusted models.
• The relationship between ALI and unstable asthma was not consistent across all subgroups.
• Subgroup analyses revealed independent significance in the body mass index (BMI) range of 25 to 29.9 and among non-Hispanic White participants.
• Interaction results indicated that BMI moderated the relationship between ALI and unstable asthma.
• Smoothed curve fitting demonstrated an inverted U-shaped relationship between log ALI and unstable asthma in individuals with BMI < 25, with inflection points at 1.53 and 2.13.

The study's implications for clinical practice included:

• The potential use of ALI as a risk assessment tool for asthma exacerbations.
• The importance of considering BMI when evaluating the relationship between ALI and asthma stability.
• The need for a nuanced approach to interpreting ALI values in different patient subgroups.

The investigators noted that the cross-sectional nature of the study limited causal inferences. They emphasized the need for additional prospective studies to confirm these results and establish the predictive value of ALI in asthma management.

The authors declared having no competing interests.