Ma Xinyu, Qian Yetao, Qian Chenhao, Lin Hongyu, Sun Yuanshui
College of Integrated Traditional Chinese and Western Clinical Medicine, Tongde Hospital of Zhejiang Provincial Affiliated to Zhejiang Chinese Medical University, Hangzhou, 310000, Zhejiang, China.
Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, 310000, Zhejiang, China.
Sci Rep. 2025 Jul 1;15(1):21496. doi: 10.1038/s41598-025-06540-6.
Previous studies have established associations between the C-reactive protein to lymphocyte ratio (CLR), inflammatory load index (IBI), and neutrophil to albumin ratio (NAR) with various conditions. However, the evidence for such associations in individuals with albuminuria remains unclear. This study aimed to investigate the relationship between inflammatory biomarkers and the presence of albuminuria by utilizing data derived from the National Health and Nutrition Examination Survey (NHANES). Participants were classified into two groups according to their urinary albumin-to-creatinine ratio (UACR): those who presented with albuminuria and those who did not. The association between inflammatory biomarkers and the occurrence of albuminuria was assessed through multivariate regression models. To explore possible non-linear relationships, restricted cubic spline (RCS) analysis was applied. Furthermore, subgroup and sensitivity analyses were conducted to ensure the reliability and consistency of the findings. The study included 18,876 participants, of whom 2,321 were classified in the albuminuria group and 16,555 in the non-albuminuria group. The results from a fully adjusted logistic regression model indicated a significant positive relationship between the natural logarithm-transformed inflammatory markers-Ln-CLR, Ln-IBI, and Ln-NAR-and the risk of presence albuminuria. Specifically, each unit increase in Ln-CLR, Ln-IBI, and Ln-NAR was linked with a 12%, 15%, and 79% heightened risk of albuminuria, respectively. RCS analysis showed a linear relationship between Ln-CLR, Ln-IBI and Ln-NAR and albuminuria. Subgroup analyses demonstrated consistent findings across various populations, and numerous sensitivity tests confirmed the reliability of these outcomes. This study demonstrates a positive correlation between CLR, IBI, and NAR and the presence albuminuria in US adults. Given these results, early monitoring of these inflammatory markers in high-risk populations is essential for identifying the onset of albuminuria and mitigating kidney damage progression.
以往的研究已经证实，C反应蛋白与淋巴细胞比值（CLR）、炎症负荷指数（IBI）以及中性粒细胞与白蛋白比值（NAR）与多种疾病之间存在关联。然而，蛋白尿患者中这些关联的证据仍不明确。本研究旨在利用美国国家健康与营养检查调查（NHANES）的数据，探讨炎症生物标志物与蛋白尿之间的关系。参与者根据尿白蛋白与肌酐比值（UACR）分为两组：有蛋白尿的参与者和无蛋白尿的参与者。通过多变量回归模型评估炎症生物标志物与蛋白尿发生之间的关联。为了探索可能的非线性关系，应用了受限立方样条（RCS）分析。此外，还进行了亚组分析和敏感性分析，以确保研究结果的可靠性和一致性。该研究纳入了18,876名参与者，其中2,321名被归类为蛋白尿组，16,555名被归类为无蛋白尿组。完全调整后的逻辑回归模型结果表明，自然对数转换后的炎症标志物——Ln-CLR、Ln-IBI和Ln-NAR——与蛋白尿风险之间存在显著正相关。具体而言，Ln-CLR、Ln-IBI和Ln-NAR每增加一个单位，分别与蛋白尿风险升高12%、15%和79%相关。RCS分析显示Ln-CLR、Ln-IBI和Ln-NAR与蛋白尿之间存在线性关系。亚组分析在不同人群中显示出一致的结果，多项敏感性测试证实了这些结果的可靠性。本研究表明，CLR、IBI和NAR与美国成年人蛋白尿的存在呈正相关。鉴于这些结果，对高危人群早期监测这些炎症标志物对于识别蛋白尿的发生和减轻肾脏损害进展至关重要。
