Feng Jing, Gong Hongyang
Department of Geriatrics, Chengdu Sixth People's Hospital, Chengdu, China.
Department of Physiology, College of Medicine, Chosun University, Gwangju, Republic of Korea.
Front Med (Lausanne). 2025 Jun 23;12:1610945. doi: 10.3389/fmed.2025.1610945. eCollection 2025.
Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by persistent airflow limitation and chronic airway inflammation. Life's Crucial 9 (LC9) is a comprehensive tool for evaluating cardiovascular and metabolic health. The neutrophil-to-albumin ratio (NPAR) has been proposed as a novel inflammation-nutrition biomarker. This study aimed to elucidate the association between LC9 scores and the prevalence of COPD while also assessing the potential mediating role of NPAR.
A cross-sectional analysis was conducted using data from 25,634 U.S. participants in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Multivariable logistic regression, stratified subgroup analyses, and restricted cubic spline (RCS) models were employed to evaluate the association between LC9 and COPD.
Among the 25,634 participants, 1,248 reported a history of COPD. After adjusting for multiple covariates, each 10-unit increase in the LC9 score was associated with a 28% lower odds of COPD (OR = 0.72, 95% CI: 0.67-0.77), whereas each one-unit increase in NPAR was associated with a 6% higher odds of COPD (OR = 1.06, 95% CI: 1.03-1.10). Similar trends were observed when LC9 and NPAR were categorized into different levels (P for trend < 0.05). RCS analysis revealed a linear inverse relationship between LC9 scores and COPD prevalence. Mediation analysis indicated that NPAR accounted for 4.84% of the association between LC9 and COPD ( < 0.001).
Higher LC9 scores were associated with a reduced risk of COPD, with NPAR acting as a significant mediator in this relationship. These findings highlight the potential value of optimizing cardiovascular health in COPD prevention strategies and underscore the importance of controlling inflammation and improving nutritional status. Further prospective studies are warranted to validate these preliminary findings.
慢性阻塞性肺疾病（COPD）是一种进行性呼吸系统疾病，其特征为持续性气流受限和慢性气道炎症。生命关键9项指标（LC9）是评估心血管和代谢健康的综合工具。中性粒细胞与白蛋白比值（NPAR）已被提出作为一种新型的炎症-营养生物标志物。本研究旨在阐明LC9评分与COPD患病率之间的关联，同时评估NPAR的潜在中介作用。
使用2005年至2018年美国国家健康与营养检查调查（NHANES）中25634名参与者的数据进行横断面分析。采用多变量逻辑回归、分层亚组分析和受限立方样条（RCS）模型来评估LC9与COPD之间的关联。
在25634名参与者中，1248人报告有COPD病史。在调整多个协变量后，LC9评分每增加10个单位，COPD的患病几率降低28%（OR = 0.72，95%CI：0.67 - 0.77），而NPAR每增加1个单位，COPD的患病几率增加6%（OR = 1.06，95%CI：1.03 - 1.10）。当将LC9和NPAR分为不同水平时，观察到类似趋势（趋势P < 0.05）。RCS分析显示LC9评分与COPD患病率之间存在线性负相关关系。中介分析表明，NPAR占LC9与COPD之间关联的4.84%（< 0.001）。
较高的LC9评分与COPD风险降低相关，NPAR在这种关系中起重要中介作用。这些发现凸显了在COPD预防策略中优化心血管健康的潜在价值，并强调了控制炎症和改善营养状况的重要性。有必要进行进一步的前瞻性研究来验证这些初步发现。
