Background: The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel inflammatory marker that combines CRP, albumin, and lymphocytes, and the development of hepatic steatosis and fibrosis is closely related to inflammation. However, the correlation between the CALLY index and hepatic steatosis and fibrosis is unclear. The aim of this study was to investigate the relationship between CALLY and hepatic steatosis and fibrosis. Methods: A dataset from the National Health and Nutrition Examination Survey (NHANES) 2017-2020 was used for a cross-sectional investigation. Multivariate linear regression models were used to examine linear associations between CALLY and Controlled Attenuation Parameters (CAP) and Liver Stiffness Measurement (LSM). Fitted smoothed curves and threshold effects analyses were used to characterize nonlinear relationships. Results: This population-based study included 6226 adults aged 20 - 80 years. Based on multivariate linear regression analysis, ln CALLY was negatively associated with liver fibrosis (LSM, β = -0.35, 95% CI: -0.48, -0.23, p < 0.0001) and hepatic steatosis (CAP, β = -7.76, 95% CI: -9.49, -6.02, p < 0.001). Conclusion: CALLY is negatively associated with CAP and LSM in US adults. The results suggest that CALLY may be a valuable biomarker for assessing the severity of liver fibrosis and hepatic steatosis in individuals with NAFLD.
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