ALI and Serum Vitamin D: Strong Predictors of Mortality in Asthma Patients: Study
Researchers have identified that higher serum vitamin D and advanced lung cancer inflammation index (ALI) levels are key for asthma patients' mortality prediction. In the new study, researchers established that greater ALI is linked with lower mortality due to all causes and respiratory disease, while death risk rises in the case of vitamin D deficiency. These results highlight the need for monitoring inflammatory and nutritional markers in asthma care to enhance patient outcomes. The study was conducted by Ting Li and colleagues published in the BMC Nutrition Journal.
Systemic inflammation, nutritional status, and vitamin D status have significant effects on asthma prognosis. Yet, their prognostic role in predicting mortality risk has remained uncertain. ALI, which includes body mass index (BMI), serum albumin, and the neutrophil–lymphocyte ratio (NLR), is a good indicator of systemic inflammation and nutritional status. The aim of the study was to evaluate the independent and joint impacts of ALI and serum vitamin D on mortality risk in asthma patients.
The analysis was based on data of 2,870 asthma patients covered in the NHANES database for the period between 2001 and 2018. Cox regression was used to analyze the association of ALI and vitamin D with mortality risks. The predictive accuracy of ALI was compared with that of its elements (NLR, albumin, neutrophils, lymphocytes, and BMI) by receiver operator characteristic (ROC) curve analysis. Joint analysis was used to explore the combined effects of ALI and levels of vitamin D on mortality.
Key Findings
Increased levels of ALI greatly decreased all-cause mortality (adjusted hazard ratio [aHR] = 0.64, p < 0.05) and respiratory disease mortality (aHR = 0.34, p < 0.05).
Vitamin D deficiency was linked to a higher risk of all-cause mortality (aHR = 2.06, p < 0.05) and respiratory disease mortality (aHR = 2.73, p < 0.05).
ALI had better predictive power for 1-year, 5-year, and 10-year all-cause mortality than its individual components.
Patients with both elevated ALI and adequate vitamin D had the lowest risk of all-cause mortality (aHR = 0.31, p < 0.05) and mortality due to respiratory disease (aHR = 0.17, p < 0.05).
The study authors concluded that ALI and vitamin D levels are independent and combined predictors of asthma mortality. Sufficient vitamin D status, in conjunction with increased ALI, may be associated with improved survival, and targeted interventions in asthma treatment are therefore recommended.
Reference:
Li, T., Wang, Q., Li, Y. et al. Predictive effects of advanced lung cancer inflammation index and serum vitamin D on mortality in patients with asthma. Nutr J 24, 26 (2025). https://doi.org/10.1186/s12937-024-01065-6
