广西医学2025，Vol.47Issue(4)：514-521,8.DOI:10.11675/j.issn.0253-4304.2025.04.05
中性粒细胞百分比/白蛋白值与糖尿病和癌症共病患者全因死亡风险的关系——基于NHANES数据的研究
Relation of neutrophil percentage to albumin ratio with all-cause mortality risk in patients with diabetes and cancer comorbidities:a study based on NHANES data
摘要
Abstract
Objective To investigate the relation of neutrophil percentage to albumin ratio(NPAR)with all-cause mortality risk in patients with diabetes and cancer comorbidities based on National Health and Nutrition Examination Survey(NHANES).Methods Based on the NHANES data of 1258 patients with diabetes and cancer comorbidities included from 1999 to 2018 in the NHANES database,the receiver operating characteristic(ROC)curve was adopted to determine the optimal cut-off value of NPAR in predicting all-cause mortality in patients with diabetes and cancer comorbidities.Patients were assigned to high NPAR group(664 cases)or low NPAR group(594 cases)based on the optimal cut-off value.The survival curves of the two groups were drawn by the Kaplan-Meier method,and the survival curves of the two groups were compared by the log-rank test.The multivariate COX regression model was adopted to analyze the relation between NPAR and all-cause mortality risk,and the subgroup analysis was conducted.The dose-response relation of NPAR with all-cause mortality risk was analyzed by employing restricted cubic spline(RCS)and threshold effects.Results The median follow-up time of 1258 patients with diabetes and cancer comorbidities was 89 months,and 512 patients died,with a mortality rate of 40.7%.The ROC curve analysis revealed that the optimal cut-off value of NPAR in predicting all-cause mortality in patients with diabetes and cancer comorbidities was 14.639.The survival curve analysis suggested that all-cause mortality risk in the low NPAR group was lower than that in the high NPAR group(P<0.05).The results of multivariate COX regression model expressed that all-cause mortality risk in the high NPAR group was 1.60 times higher than that in the low NPAR group after adjusting for confounding factors(P<0.05).The RCS analysis and threshold effect analysis interpreted that a U-shaped nonlinear relation between NPAR and all-cause mortality risk(Pnonlinear<0.05).When NPAR≤12.819,all-cause mortality risk of patients with diabetes and cancer comorbidities decreased with the increase of NPAR,whereas when NPAR>12.819,all-cause mortality risk of patients with diabetes and cancer comorbidities increased with the increase of NPAR(P<0.05).Subgroup analysis exhibited that there was no interaction effect of the correlation of NPAR with all-cause mortality risk in patients with diabetes and cancer comorbidities between various subgroups(Pinteraction effect>0.05).Conclusion There is a U-shaped non-linear relation between NPAR and all-cause mortality risk in patients with diabetes and cancer comorbidities.NPAR can be used as an independent predictor of all-cause mortality risk in patients with diabetes and cancer comorbidities.关键词
糖尿病/癌症/共病/中性粒细胞百分比/白蛋白值/全因死亡/美国国家健康与营养检查调查Key words
Diabetes mellitus/Cancer/Comorbidity/Neutrophil percentage to albumin ratio/All-cause mortality/National Health and Nutrition Examination Survey分类
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雷丽华,李小梅,韦芳梅,覃江焕,李玲,黄柳云,谢明杰,黄德斌..中性粒细胞百分比/白蛋白值与糖尿病和癌症共病患者全因死亡风险的关系——基于NHANES数据的研究[J].广西医学,2025,47(4):514-521,8.基金项目
广西医科大学第一附属医院护理临床研究攀登计划创新项目(YYZS2023018) （YYZS2023018）
