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<p>This study examined the relationship between the neutrophil-to-albumin ratio (NPAR) and both all-cause and cardiovascular mortality in U.S. patients with cardiovascular disease (CVD) and abnormal glucose metabolism, using NHANES data from 1999 to 2018. Restricted cubic spline analysis identified a significant nonlinear association between NPAR and mortality (p &lt; 0.001). Cox regression results showed that patients in the highest NPAR group (T3, ≥ 15.8) had higher risks of all-cause (HR 1.75, 95% CI 1.50–2.04) and cardiovascular mortality (HR 2.03, 95% CI 1.53–2.68) compared to the lowest group (T1, &lt; 13.5), both with p &lt; 0.0001. Kaplan–Meier survival curves confirmed greater mortality in the T3 group. Mediation analysis found that renal function, measured by eGFR, accounted for 14.49% of the effect on all-cause mortality and 13.38% on cardiovascular mortality. Among the 3163 participants, 1342 experienced all-cause deaths and 462 cardiovascular deaths. This study demonstrated a significant correlation of high NPAR and increased mortality in patients with abnormal glucose metabolism and CVD, suggesting that NPAR may represent a reliable predictor of mortality risk in this population, and emphasizing the importance of both inflammation and renal function monitoring.</p>

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Neutrophil to albumin ratio predicts cardiovascular and all cause mortality in CVD patients with abnormal glucose metabolism

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月1日

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  • Jiaxin Li,
  • Mingyue Yang,
  • Xue Zhang,
  • Rui Huang,
  • Ying Zhang,
  • Kuanlu Fan

摘要

This study examined the relationship between the neutrophil-to-albumin ratio (NPAR) and both all-cause and cardiovascular mortality in U.S. patients with cardiovascular disease (CVD) and abnormal glucose metabolism, using NHANES data from 1999 to 2018. Restricted cubic spline analysis identified a significant nonlinear association between NPAR and mortality (p < 0.001). Cox regression results showed that patients in the highest NPAR group (T3, ≥ 15.8) had higher risks of all-cause (HR 1.75, 95% CI 1.50–2.04) and cardiovascular mortality (HR 2.03, 95% CI 1.53–2.68) compared to the lowest group (T1, < 13.5), both with p < 0.0001. Kaplan–Meier survival curves confirmed greater mortality in the T3 group. Mediation analysis found that renal function, measured by eGFR, accounted for 14.49% of the effect on all-cause mortality and 13.38% on cardiovascular mortality. Among the 3163 participants, 1342 experienced all-cause deaths and 462 cardiovascular deaths. This study demonstrated a significant correlation of high NPAR and increased mortality in patients with abnormal glucose metabolism and CVD, suggesting that NPAR may represent a reliable predictor of mortality risk in this population, and emphasizing the importance of both inflammation and renal function monitoring.