Li Hongying, Xu Yue, Fan Shuhan, Wang Ziming, Chen Hao, Zhang Lin, Lu Yun, Miao Yifan
School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Department of Emergency Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Front Endocrinol (Lausanne). 2025 Mar 6;16:1552772. doi: 10.3389/fendo.2025.1552772. eCollection 2025.
The neutrophil-percentage-to-albumin ratio (NPAR), as a low-cost and easily accessible inflammatory biomarker, has garnered considerable attention in various disease studies in recent years. Specifically, existing research has suggested a significant correlation between NPAR and diabetic retinopathy, indicating its potential relevance to diabetic complications. However, despite diabetic kidney disease (DKD) being a complication that severely affects the quality of life of diabetic patients, the association between the prevalence of DKD and NPAR remains to be elucidated. Therefore, this study aims to explore the potential link between NPAR and DKD in patients with type 2 diabetes mellitus.
We extracted complete data on neutrophil percentage, plasma albumin, serum creatinine, and urine albumin-to-creatinine ratio from the National Health and Nutrition Examination Survey database spanning from 2009 to 2018. Multivariable logistic regression models were employed to examine the relationship between NPAR levels and DKD, and conducted sensitivity tests, subsequently employing Generalized Additive Models combined with smooth curve fitting methods to explore the relationships among variables. Then, subgroup analyses were conducted on the association between NPAR and DKD to investigate changes in the relationship across different subgroups. Finally, Receiver operating characteristic curves were used to assess the predictive performance of the independent variable, NPAR, for the dependent variable, DKD.
A total of 2,263 participants were enrolled in this cross-sectional study. After adjusting for confounding factors, the odds ratio for DKD was 1.44 (95% CI: 1.08-1.90) for the second quartile group, 1.75 (95% CI: 1.33-2.31) for the third quartile group, and 2.95 (95% CI: 2.22-3.93) for the fourth quartile group. Among patients with type 2 diabetes mellitus, a positive correlation was observed between NPAR and DKD. Results from subgroup analyses showed no significant differences among different populations. Receiver operating characteristic (ROC) analysis indicated that NPAR had good predictive performance for DKD.
The prevalence of DKD indicated a positive association with NPAR among individuals with T2DM. Additional large-scale prospective investigations may be helpful in corroborating these findings.
中性粒细胞百分比与白蛋白比值（NPAR）作为一种低成本且易于获取的炎症生物标志物，近年来在各种疾病研究中受到了广泛关注。具体而言，现有研究表明NPAR与糖尿病视网膜病变之间存在显著相关性，这表明其与糖尿病并发症可能相关。然而，尽管糖尿病肾病（DKD）是一种严重影响糖尿病患者生活质量的并发症，但DKD患病率与NPAR之间的关联仍有待阐明。因此，本研究旨在探讨2型糖尿病患者中NPAR与DKD之间的潜在联系。
我们从2009年至2018年的国家健康与营养检查调查数据库中提取了中性粒细胞百分比、血浆白蛋白、血清肌酐和尿白蛋白与肌酐比值的完整数据。采用多变量逻辑回归模型来检验NPAR水平与DKD之间的关系，并进行敏感性测试，随后采用广义相加模型结合平滑曲线拟合方法来探索变量之间的关系。然后，对NPAR与DKD之间的关联进行亚组分析，以研究不同亚组中这种关系的变化。最后，使用受试者工作特征曲线来评估自变量NPAR对因变量DKD的预测性能。
本横断面研究共纳入2263名参与者。在调整混杂因素后，第二四分位数组DKD的比值比为1.44（95%可信区间：1.08 - 1.90），第三四分位数组为1.75（95%可信区间：1.33 - 2.31），第四四分位数组为⒉95（95%可信区间：2.22 - 3.93）。在2型糖尿病患者中，观察到NPAR与DKD之间存在正相关。亚组分析结果显示不同人群之间无显著差异。受试者工作特征（ROC）分析表明NPAR对DKD具有良好的预测性能。
在2型糖尿病患者中，DKD的患病率与NPAR呈正相关。额外的大规模前瞻性研究可能有助于证实这些发现。
