Lai Guike, Zhao Yipin, Yang Cuiling, Zheng Yuanyuan, Sun Jingjing, Zhao Yingjie, Ding MingGe
Department of Geriatrics Cardiology, The Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China.
Department of Cardiology, Fuwai Central China Cardiovascular Hospital, Henan Provincial People's Hospital Heart Center, Zhengzhou, Henan, China.
Nutr Metab Cardiovasc Dis. 2025 Mar;35(3):103840. doi: 10.1016/j.numecd.2024.103840. Epub 2024 Dec 20.
The Naples Prognostic Score (NPS) predicts outcomes in various diseases, but its impact on cardiovascular disease (CVD) is understudied. This study investigates the association between NPS and CVD prevalence and mortality among US adults.
This study utilized data from the Continuous National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2016, with mortality follow-up data available through December 31, 2019. NPS was calculated using serum albumin, total cholesterol, neutrophil to lymphocyte ratio, and lymphocyte to monocyte ratio. Participants were stratified into low, moderate, and high NPS groups. Multiple logistic regression estimated odds ratios (OR) for CVD prevalence, while Cox proportional regression estimated hazard ratios (HR) for mortality. Of 39,572 participants, 20.24 % were in the low group, 69.79 % in the moderate group, and 9.96 % in the high group. After adjusting for confounders, the CVD prevalence ORs for moderate and high groups were 1.19 (95 % CI: 1.05, 1.34) and 1.78 (95 % CI: 1.53, 2.07), respectively (P for trend <0.001). Compared to the low group, the high group had adjusted HRs of 1.92 (95 % CI: 1.54, 2.41) for all-cause mortality, 1.61 (95 % CI: 1.12, 2.34) for cardiovascular mortality, and 1.83 (95 % CI: 1.11, 3.02) for cancer-related mortality (all P for trend <0.01). These associations remained significant across all subgroups.
NPS is an independent risk factor for CVD and is positively associated with all-cause and cardiovascular mortality in individuals with CVD.
那不勒斯预后评分（NPS）可预测多种疾病的预后，但对心血管疾病（CVD）的影响研究较少。本研究调查了美国成年人中NPS与CVD患病率及死亡率之间的关联。
本研究利用了1999年至2016年期间进行的连续国家健康与营养检查调查（NHANES）的数据，死亡率随访数据截至2019年12月31日。NPS通过血清白蛋白、总胆固醇、中性粒细胞与淋巴细胞比值以及淋巴细胞与单核细胞比值计算得出。参与者被分为低、中、高NPS组。多因素logistic回归估计CVD患病率的比值比（OR），而Cox比例回归估计死亡率的风险比（HR）。在39572名参与者中，20.24%属于低分组，69.79%属于中分组，9.96%属于高分组。在调整混杂因素后，中分组和高分组的CVD患病率OR分别为1.19（95%CI：1.05，1.34）和1.78（95%CI：1.53，2.07）（趋势P<0.001）。与低分组相比，高分组的全因死亡率调整后HR为1.92（95%CI：1.54，2.41），心血管死亡率为1.61（95%CI：1.12，2.34），癌症相关死亡率为1.83（95%CI：1.11，3.02）（所有趋势P<0.01）。这些关联在所有亚组中均保持显著。
NPS是CVD的独立危险因素，并且与患有CVD的个体的全因死亡率和心血管死亡率呈正相关。
