Zhao Jin, Fan Xingfu, Li Xiaofang, Luo Yang, Liu Shiping
Department of General Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China.
J Health Popul Nutr. 2025 Mar 25;44(1):85. doi: 10.1186/s41043-025-00819-0.
Stroke is a complex neurological condition characterized by high rates of incidence, recurrence, disability, and mortality, making it one of the leading causes of death and disability worldwide. The Naples prognostic score (NPS), an index that combines markers of inflammation and nutritional status, has demonstrated prognostic value in various diseases. This research investigated the relationships among NPS, stroke prevalence, and overall mortality in stroke individuals, drawing on data from the National Health and Nutrition Examination Survey from 2007 to 2018.
The cross-sectional analysis included 20,798 participants aged beyond 40 years with 1155 persons with stroke analyzed for mortality. Stroke prevalence was self-reported, and the NPS was derived from serum albumin, total cholesterol, the neutrophil-to-lymphocyte ratio, and the lymphocyte-to-monocyte ratio (Galizia et al. in Cancer 60:1273-1284, 2017). Weighted Logistic regression and Cox models assessed associations among NPS, stroke, and mortality, adjusting for demographic and clinical factors.
Higher NPS scores were linked to increased stroke prevalence (OR 3.573, 95% CI 2.745-4.652, P < 0.001) and elevated all-cause mortality risk (HR 3.281, 95% CI 1.978-5.442, P < 0.001) in stroke individuals. The triglyceride-glucose index (TYG) significantly modified the relationship between the NPS and stroke prevalence.
This study supports the clinical utility of the NPS as a predictor of both stroke prevalence and all-cause mortality. The NPS may serve as a valuable tool for risk stratification in stroke prevention and long-term prognosis.
中风是一种复杂的神经系统疾病，具有高发病率、高复发率、高致残率和高死亡率的特点，使其成为全球死亡和残疾的主要原因之一。那不勒斯预后评分（NPS）是一种综合炎症和营养状况标志物的指标，已在多种疾病中显示出预后价值。本研究利用2007年至2018年美国国家健康与营养检查调查的数据，探讨了NPS、中风患病率和中风患者全因死亡率之间的关系。
横断面分析纳入了20798名40岁以上的参与者，其中1155名中风患者被分析死亡率。中风患病率通过自我报告获得，NPS由血清白蛋白、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得出（Galizia等人，《癌症》60:1273 - 1284，2017）。加权逻辑回归和Cox模型评估了NPS、中风和死亡率之间的关联，并对人口统计学和临床因素进行了调整。
在中风患者中，较高的NPS评分与中风患病率增加（比值比3.573，95%置信区间2.745 - 4.652，P < 0.001）和全因死亡风险升高（风险比3.281，95%置信区间1.978 - 5.442，P < 0.001）相关。甘油三酯 - 葡萄糖指数（TYG）显著改变了NPS与中风患病率之间的关系。
本研究支持NPS作为中风患病率和全因死亡率预测指标的临床实用性。NPS可能是中风预防和长期预后风险分层的有价值工具。
