Sex-specific association of novel complex inflammatory markers with colorectal polyps: mediating effects of triglyceride-glucose and non-high-density lipoprotein cholesterol

The CRP-albumin-lymphocyte (CALLY) index has potential clinical value as a novel marker integrating inflammatory, nutritional and immune status in the development of colorectal polyps. This study examined whether gender factors influence the association between CALLY and colorectal polyps; in addition to elucidating whether metabolic pathways mediate this relationship. This is a cross-sectional study including 5409 adult health screening participants who completed colonoscopy. Logistic regression analysis, correlation analysis, linear regression analysis and restricted cubic spline modeling, and mediation analysis were employed to investigate the intricate associations between CALLY index, inflammatory biomarkers, metabolic factors and colorectal polyps. A total of 2201 subjects were diagnosed with colorectal polyps. Logistic regression analysis showed that higher CALLY index quartiles were inversely correlated with colorectal polyp prevalence (OR = 0.83,95% CI = 0.70–0.98, P = 0.025), and that this association was more pronounced in the female population (OR = 0.67,95% CI = 0.50–0.91, P = 0.011), while no significant association was observed in males (P > 0.05). Mediation analyses showed partial mediation of TyG (mediated effect: 15.14%, P < 0.01) and Non-HDL-C (mediated effect: 8.20%, P < 0.01) between CALLY index and colorectal polyps, whereas females showed stronger mediation of TyG (mediated effect: 15.49%, P = 0.020). There were sex differences in the negative association of CALLY index with colorectal polyps, with a stronger association in women; the glucose metabolism (TyG) and lipid metabolism (Non-HDL-C) pathways partially mediated the association, and the mediating effect of TyG was more significant in women.