The research investigated the association of the Neutrophil Percentage-to-Albumin Ratio (NPAR) with mortality risk in diabetes or prediabetes patients. NPAR is a metric that reflects both inflammation, as presented in neutrophils, and nutrition, as presented in albumin. The researchers had 6,080 American adults with diabetes or prediabetes data, obtained between 2001 and 2018, via the National Health and Nutrition Examination Survey (NHANES). The population was followed up for a total of 53,217 person-years over which 1,378 deaths occurred, 476 from cardiovascular disease.
The analysis identified higher NPAR levels to be strongly associated with increased risk of all-cause mortality and cardiovascular disease mortality. A J-shaped association was identified, where very low and very high levels of NPAR were linked to increased mortality. More specifically, when NPAR > 15.1, the risk of all-cause mortality was increased, and when NPAR > 14.2, the risk of cardiovascular mortality was increased. NPAR was identified as a strong mortality predictor with accuracy rates (AUC values) of 0.81-0.87 for survival predictability at 3, 5, and 10 years.
The significance of this research is its potential clinical application. Diabetes mellitus and cardiovascular disease are worldwide health concerns that are leading determinants of death globally, and chronic inflammation is a key factor in their development. NPAR provides a simple, low-cost, and readily available method of assessing mortality risk relative to other markers of inflammation, which may require specialized testing.
The findings suggest that clinical professionals can add NPAR to routine blood tests as a means of identifying at an early point those with a high risk of diabetes and prediabetes. Monitoring NPAR levels would place clinicians in the position of being able to implement timely interventions, including lifestyle change and targeted therapy, to decrease inflammation and improve global health outcomes.
Overall, this study emphasizes the value of NPAR as an affordable and useful predictive marker for mortality prediction in those with diabetes and prediabetes. Its ease of measurement and strong predictive power make it a valuable tool for health professionals in identifying high-risk patients and guiding preventive interventions to reduce mortality from cardiovascular diseases.
