{"title":"Comparison of periglottic oxygen fraction, tracheal oxygen fraction and safe apnea time under different apneic oxygenation techniques: a randomised non-inferiority controlled study.","authors":"Weilian Geng, Changxing Chen, Yaobing Chen, Xiaojuan Yu, Xinhua Yu, Shaoqiang Huang","doi":"10.1186/s12890-025-03934-0","DOIUrl":"10.1186/s12890-025-03934-0","url":null,"abstract":"<p><strong>Background: </strong>Apneic oxygenation prolongs safe apnea time and reduces hypoxemia risk during airway management. The primary objective of this study was to compare the safe apnea time among various techniques, while the secondary objective was to evaluate intergroup differences in periglottic and tracheal oxygen fractions (FgO₂ and FtO₂).</p><p><strong>Methods: </strong>This randomized, non-inferiority trial enrolled 125 participants, assigned to five groups: modified nasopharyngeal airway with 10 L/min oxygen (Naso group), nasal cannula oxygenation at 2 L/min (L2 group), 5 L/min (L5 group), and 10 L/min (L10 group), and a control group without supplemental oxygen (L0 group).</p><p><strong>Results: </strong>The success rate in the L10 group was lower than that in the Naso group (82.6% vs. 95.7%; risk difference, -13.0%; 95%CI: -27.8% to 1.7%), and non-inferiority was not established, but had similar safe apnea times (15 [15 to 15] min vs 15 [15 to 15] min, P = 0.138).The L10 group demonstrated superior performance compared to the L0, L2, and L5 groups terms of achieving a safe apnea time of 15 min (82.6% vs 0、8.7% and 43.5%,respectively; P < 0.001). At all measured time points,FgO<sub>2</sub> and FtO<sub>2</sub> in the L10 group were lower than those in the Naso group, but higher than those in the L0, L2 and L5 groups (P < 0.001). FgO<sub>2</sub> at the end of the apnea was positively correlated with safe apnea time.</p><p><strong>Conclusion: </strong>The nasal cannula at 10 L/min, along with the modified nasopharyngeal airway, was associated with longer safe apnea times and relatively higher FgO₂ and FtO₂ levels. Higher oxygen flow rates were associated with increased FgO₂, FtO₂, and longer safe apnea duration.</p><p><strong>Trial registration: </strong>The study was approved by the Ethics Committee of the Obstetrics and Gynaecology Hospital of Fudan University (2022-197) on January 9, 2023. The study was registered on ChiCTR (ChiCTR2300067642) on January 16, 2023.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"451"},"PeriodicalIF":2.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12495629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Serum metabolic disparity between patients with lymph node tuberculosis and patients with sarcoidosis: towards differential diagnosis.","authors":"Alok Nath, Sachin Yadav, Kritika Singh, Vikas Agarwal, Ajmal Khan, Zia Hashim, Mansi Gupta, Dinesh Kumar","doi":"10.1186/s12890-025-03756-0","DOIUrl":"10.1186/s12890-025-03756-0","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Sarcoidosis (SAR) and lymph-node tuberculosis (LNTB) are granulomatous diseases that present diagnostic challenges, especially in TB-endemic regions. We hypothesized that serum-metabolic profiles would help in differentiating SARs from LNTBs.</p><p><strong>Objective: </strong>This study aimed to identify serum metabolic biomarkers to distinguish SAR from LNTB using NMR-based metabolomics analysis.</p><p><strong>Methods: </strong>Serum samples were collected from 26 SAR and 22 LNTB patients. The serum metabolic profiles were measured using 800 MHz NMR spectroscopy and quantified using the commercial software CHENOMX. The serum metabolic profiles were compared using multivariate partial least squares discriminant analysis (PLS-DA), and potential discriminatory metabolites were identified using variable importance in projection (VIP) scores and subsequently evaluated for statistical significance using a volcano plot. The diagnostic potential of the discriminatory metabolites was evaluated using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>PLS-DA demonstrated significant metabolic disparity between the SAR and LNTB groups. The key metabolic features identified included elevated levels of glutamate, pyroglutamate, acetate, and leucine and a decreased glutamate-to-glutamine ratio (EQR) and decreased levels of glutamine, pyruvate, and myo-inositol in TB patients. These metabolic changes suggest that TB-infection involves activated glutaminolysis and elevated host lipid metabolism. ROC curve analysis revealed several metabolites with high diagnostic potential (AUC > 0.8), including glutamate, pyroglutamate, and glutamine (AUC > 0.98).</p><p><strong>Conclusion: </strong>In conclusion, this study underscores the potential of serum metabolic profiling as a noninvasive tool for distinguishing SARs from LNTBs. However, further studies are imperative to validate these findings on independent patient cohorts and to facilitate their integration into routine clinical practice.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"448"},"PeriodicalIF":2.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Risk factors for bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation: a systematic review and meta-analysis.","authors":"Guangchen Pu, Guangmin Nong, Qing Wei, Yunyan He, Wenguang Jia, Zhenhao Lu, Guosheng Qiu, Jun Xie, Xun Chen","doi":"10.1186/s12890-025-03925-1","DOIUrl":"10.1186/s12890-025-03925-1","url":null,"abstract":"<p><strong>Background: </strong>Bronchiolitis obliterans syndrome (BOS) after hematopoietic stem cell transplantation (HSCT) is a late-onset complication that significantly impairs patients' quality of life and is associated with a high mortality rate. Currently, the risk factors for BOS after HSCT remain controversial. We therefore conducted a systematic review and meta-analysis to identify potential risk factors associated with BOS after HSCT.</p><p><strong>Methods: </strong>Three primary medical databases (PubMed, Web of Science, Embase) were exhaustively reviewed from their inception through November 2024 to assess contributing factors for BOS occurrence following HSCT. Data synthesis was conducted using RevMan 5.4 for meta-analytic evaluation.</p><p><strong>Results: </strong>Fourteen studies involving 10,317 HSCT recipients were included, 778 of whom developed BOS. Female sex (OR = 1.26; 95% CI: 1.08, 1.47; p = 0.003), ABO blood group incompatibility (OR = 1.39; 95% CI: 1.07, 1.81; p = 0.01), peripheral blood stem cell transplantation (PBSCT) (OR = 1.31; 95% CI: 1.04, 1.64; p = 0.02), myeloablative conditioning (MAC) (OR = 1.63; 95% CI: 1.23, 2.16; p = 0.0008), acute graft-versus-host disease (aGVHD) (OR = 1.93; 95% CI: 1.16, 3.23; p = 0.01), grade Ⅱ-Ⅳ aGVHD (OR = 1.41; 95% CI: 1.12, 1.77; p = 0.004), and extrapulmonary chronic graft-versus-host disease (cGVHD) (OR = 11.69; 95% CI: 5.29, 25.82; p < 0.00001) were associated with an increased risk of BOS after HSCT.</p><p><strong>Conclusions: </strong>Female sex, ABO blood group incompatibility, PBSCT, MAC, aGVHD (especially grade II-IV), and extrapulmonary cGVHD are associated with an increased risk of BOS after HSCT.</p><p><strong>Prospero registration: </strong>CRD42024609569.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"445"},"PeriodicalIF":2.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Integrative transcriptomic analysis reveals cross-species conserved core genes and pathways in alveolar macrophages during ALI/ARDS.","authors":"Aguo Li, Kenqi Zhang, Hongyan Wang, Jianhua Li, Yeping Yao, Yong-Sheng Tu","doi":"10.1186/s12890-025-03928-y","DOIUrl":"10.1186/s12890-025-03928-y","url":null,"abstract":"<p><strong>Background and purpose: </strong>acute respiratory distress syndrome (ARDS) is a severe pulmonary condition characterized by alveolar-capillary damage and refractory hypoxemia. Alveolar macrophages (AMs) play a crucial role in regulating inflammation and repair processes during acute lung injury (ALI)/ARDS. However, the transcriptional and functional changes in AMs during ALI/ARDS remain poorly understood, especially when considering species-specific differences between murine models and human pathophysiology. This study aims to elucidate these changes in AMs during ALI/ARDS by integrating in vitro and cross-species transcriptomic analyses.</p><p><strong>Methods: </strong>We conducted RNA sequencing on LPS-stimulated MH-S cells and integrated the data with publicly available murine (GSE225406) and human (GSE40885) AM datasets to identify conserved differentially expressed genes (DEGs). Functional enrichment analysis and protein-protein interaction (PPI) network analysis were performed to explore the underlying mechanisms. Core genes were identified and validated using qRT-PCR, Western blot, immunohistochemical staining, and immunofluorescence staining. Additionally, we analyzed the diagnostic potential of these core genes using clinical datasets (GSE121871 and GSE243066).</p><p><strong>Results: </strong>We identified 45 conserved upregulated genes and 4 downregulated genes across species, highlighting core transcriptional regulators of LPS-induced Macrophage activation. Functional enrichment analysis revealed significant involvement of immune-inflammatory pathways. PPI network analysis identified 10 core genes potentially central to AM-mediated ALI/ARDS pathogenesis. Experimental validation confirmed the upregulation of key genes and demonstrated that LPS treatment significantly impaired the efferocytosis capacity of AMs with dysregulated expression of stabilin-2, suggesting a potential association with this functional defect. Furthermore, the core gene set showed diagnostic potential in ARDS patient samples (AUC = 0.86).</p><p><strong>Conclusion: </strong>This analysis identifies cross-species conserved core genes and inflammatory pathways in AMs during ALI/ARDS. Our findings provide insights into AM-mediated inflammatory mechanisms and highlight candidate genes for further functional studies to explore their potential as therapeutic targets.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"447"},"PeriodicalIF":2.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pleural effusion following thoracoscopic sympathectomy in a patient with palmar hyperhidrosis.","authors":"Pei Zhou, Qing Peng, Jun Li, Du Fan","doi":"10.1186/s12890-025-03933-1","DOIUrl":"10.1186/s12890-025-03933-1","url":null,"abstract":"<p><p>Thoracoscopic sympathectomy can be used to treat primary hyperhidrosis (PH). Nonetheless, there is a paucity of literature addressing the postoperative complications associated with this procedure. We report a case of a 21-year-old male patient who developed prolonged bilateral pleural effusion after undergoing thoracoscopic sympathectomy for PH. This case aims to raise awareness of this rare complication and discuss effective management strategies for it.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"446"},"PeriodicalIF":2.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12492963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xin Huang, Yankui Wu, Linyu Xie, Haiqing Li, Shan Gong, Nan Di, QiLan Wu, Jinding Pu, Guoping Hu
{"title":"The cross-sectional area of the pectoralis major muscle and future exacerbations in patients presenting with bronchiectasis exacerbation: a prospective observational study.","authors":"Xin Huang, Yankui Wu, Linyu Xie, Haiqing Li, Shan Gong, Nan Di, QiLan Wu, Jinding Pu, Guoping Hu","doi":"10.1186/s12890-025-03927-z","DOIUrl":"10.1186/s12890-025-03927-z","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether the cross-sectional area of the pectoralis major muscle (PMM<sub>CSA</sub>), measured via chest CT, can serve as a biomarker for predicting 1-year outcomes in patients previously hospitalized for bronchiectasis exacerbation(BE).</p><p><strong>Methods: </strong>Upon admission, the PMM<sub>CSA</sub> of patients with BE was calculated on the basis of chest CT imaging. Multivariate Cox and Poisson regression analyses were used to analyse the associations between the PMM<sub>CSA</sub> and the risk of 1-year first rehospitalization, all-cause mortality, and the frequency of rehospitalization for BE.</p><p><strong>Result: </strong>In total, 241 patients with BE were included in the present study. Fourteen patients died within 1 year after discharge from the hospital. A total of 80 patients had 143 rehospitalizations for BE within 1 year after discharge from the hospital. Cox regression analysis revealed that a PMM<sub>CSA</sub><37.51cm<sup>2</sup> was a risk factor for 1-year first hospitalization for BE. Poisson regression analysis revealed that a PMM<sub>CSA</sub> <37.51cm<sup>2</sup> was a risk factor for the frequency of rehospitalization for BE. Cox regression analyses revealed that the PMM<sub>CSA</sub> was not associated with 1-year mortality.</p><p><strong>Conclusion: </strong>A PMM<sub>CSA</sub><37.51cm<sup>2</sup> was a risk factor for 1-year first hospitalization and frequency of rehospitalization in patients with BE but was not associated with 1-year mortality.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"444"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ju Yeon Lee, Jiyoul Yang, Jin Young Kim, Yeji Do, Min-Sik Kim, Dong Eun Kye, Geonhui Min, In-Sook Jeon, Eung-Gook Kim, Joong Kook Choi, Minjae Choi, Hyun Lee, Bumhee Yang
{"title":"Bronchoalveolar lavage proteomics in exacerbation of bronchiectasis.","authors":"Ju Yeon Lee, Jiyoul Yang, Jin Young Kim, Yeji Do, Min-Sik Kim, Dong Eun Kye, Geonhui Min, In-Sook Jeon, Eung-Gook Kim, Joong Kook Choi, Minjae Choi, Hyun Lee, Bumhee Yang","doi":"10.1186/s12890-025-03904-6","DOIUrl":"10.1186/s12890-025-03904-6","url":null,"abstract":"<p><strong>Background: </strong>The molecular pathophysiology underlying the development of bronchiectasis with exacerbation at the proteomic level has not been clarified using bronchoalveolar lavage fluid samples. This study aimed to evaluate the bronchoalveolar lavage fluid inflammatory profiles associated with exacerbation of bronchiectasis.</p><p><strong>Methods: </strong>We analyzed the bronchoalveolar lavage fluid specimens from 4 patients in the exacerbation status and 4 patients in a stable status using liquid chromatography-tandem mass spectrometry.</p><p><strong>Results: </strong>A total of 1,577 proteins were identified using proteomic analysis, with 127 differentially expressed proteins. Of 127 differentially expressed proteins, 23 proteins showed more than 2-fold differences between exacerbation and stable status groups. The exacerbation status was associated with 18 upregulated proteins (TPI1, CRP, BPI, ORM1, PTPRE, S100A9, BPY2, TPM4, ERVFC1-1, CYS1, CLEC3B, S100A8, PSAT1, NDUFA10, MDGA1, SPRR3, ALDOA, and PSMB2) and five downregulated proteins (MUC5B, HSPE1, KLK13, IGHA1, and MUC5AC). Pathway analysis revealed that the neutrophil degranulation pathway (R-HSA-6798695) was the most enriched pathway in these proteins, followed by the C-type lectin receptor pathway (R-HSA-5621481).</p><p><strong>Conclusion: </strong>The bronchoalveolar lavage fluid protein expression in patients in the exacerbation status of bronchiectasis was significantly different from that in patients in the stable status, indicating that neutrophil degranulation and C-type lectin receptor pathways are the most enriched pathways during exacerbation.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"441"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diana Petkova, Rosen Petkov, Vladimir Hodzhev, Yavor Ivanov, Veselin Hadjiev
{"title":"Efficacy and safety of Atusin<sup>®</sup> CAP in the treatment of acute uncomplicated bronchitis in the primary care setting: a multi-center, randomized, double-blind, placebo-controlled study (AABA).","authors":"Diana Petkova, Rosen Petkov, Vladimir Hodzhev, Yavor Ivanov, Veselin Hadjiev","doi":"10.1186/s12890-025-03912-6","DOIUrl":"10.1186/s12890-025-03912-6","url":null,"abstract":"<p><strong>Background: </strong>Acute bronchitis (AB) is a lower respiratory tract infection manifested by cough, which is challenging to manage at the moment. Therefore, this study aimed to evaluate the efficacy and safety of a food supplement (Atusin<sup>®</sup> CAP) combining 4 types of purified essential oils, bromelain, and green Brazilian propolis in adults.</p><p><strong>Methods: </strong>A post-surveillance, multi-center, randomized, double-blind, placebo-controlled, parallel-group clinical study was conducted over 6 months. Participants with acute uncomplicated bronchitis were administered the combination preparation (verum group) or placebo for 10 days in total. The primary outcome was clinical cure, defined as a ≥ 75% reduction in baseline Bronchitis Severity Scale (BSS) score after 10 days.</p><p><strong>Results: </strong>In total, 310 participants were randomized 1:1, of which 155 and 150 participants in the verum and placebo group, respectively, were included in the efficacy and safety analysis sets. A statistically significantly higher number of clinically cured participants was observed in the verum group compared to the placebo group on all reporting days until the end of study intervention administration (Day 10: p = 0.029). The mean BSS score was statistically significantly different between the study intervention groups from Day 7 (p = 0.050) until Day 10 (p = 0.011). In addition, there were no differences in the incidence of adverse events between the verum and placebo group.</p><p><strong>Conclusions: </strong>The study shows that the studied combination preparation, containing scientifically proven active substances that bring together key mechanisms for cough relief, is effective in the treatment of acute uncomplicated bronchitis.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT06142994. Registered on 22 November 2023.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"443"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kaijun Zhang, Rongting Zhang, Rongrong Zhong, Yong Fang, Zhiyi Ma
{"title":"Prevalence and prognostic value of elevated urinary albumin excretion in patients with asthma: analysis of NHANES 2001-2018.","authors":"Kaijun Zhang, Rongting Zhang, Rongrong Zhong, Yong Fang, Zhiyi Ma","doi":"10.1186/s12890-025-03896-3","DOIUrl":"10.1186/s12890-025-03896-3","url":null,"abstract":"<p><strong>Background: </strong>Elevated urinary albumin excretion, quantified as the urinary albumin-to-creatinine ratio (UACR), is a marker of endothelial injury and chronic kidney disease. This study investigates the prevalence and prognostic significance of elevated UACR in asthma patients.</p><p><strong>Methods: </strong>Using data from the National Health and Nutrition Examination Survey (NHANES 2001-2018), 6,930 adults with asthma were analyzed. Participants were stratified by UACR categories: < 30 mg/g (Group 1), 30-300 mg/g (Group 2), and ≥ 300 mg/g (Group 3). Furthermore, for Group1, we further divided it into tertiles. Kaplan-Meier curves, Cox proportional hazards models, restricted cubic splines, and subgroup analyses were employed to assess associations between UACR and mortality.</p><p><strong>Results: </strong>Among 6,930 adults with asthma, 809 all-cause and 195 cardiovascular deaths occurred. Elevated UACR was prevalent in 12.6% (Group 2: 10.5%, Group 3: 2.1%). Compared to Group 1, Group 3 had a higher risk of all-cause mortality (HR: 2.60, 95% CI:1.44-4.71) and cardiovascular mortality (HR: 2.50, 95% CI:1.13-5.55) after full adjustment. Even within the normal range (UACR < 30 mg/g), the highest tertile (Tertile 3) exhibited increased all-cause mortality (HR: 1.69, 95% CI:1.10-2.59). Restricted cubic splines revealed a linear dose-response relationship between UACR and mortality (P for nonlinearity > 0.05). Subgroup analyses confirmed consistency across age, sex, BMI, and comorbidity strata.</p><p><strong>Conclusions: </strong>Elevated UACR is independently associated with higher all-cause mortality in adults with asthma, even at levels below the traditional threshold for albuminuria. These findings underscore UACR as a prognostic biomarker for risk stratification in asthma management.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"25 1","pages":"431"},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12486820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}