The combined impact of neutrophil-percentage-to-albumin ratio and depressive symptoms on mortality in US arthritis patients: insights from NHANES (2005–2018)
BackgroundThe neutrophil-to-albumin ratio (NPAR) reflects inflammation and nutritional status, while depression significantly impacts survival in chronic disease patients. This study examines the independent and combined effects of NPAR and depressive symptoms on all-cause and cardiovascular mortali...
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Frontiers Media S.A.
2025-03-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1545250/full |
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| author | Jinyue Bai Taihong Lv Hanming Yu Zishuo Ji Xiu Gu Yun Gao Li Ma |
| author_facet | Jinyue Bai Taihong Lv Hanming Yu Zishuo Ji Xiu Gu Yun Gao Li Ma |
| author_sort | Jinyue Bai |
| collection | DOAJ |
| description | BackgroundThe neutrophil-to-albumin ratio (NPAR) reflects inflammation and nutritional status, while depression significantly impacts survival in chronic disease patients. This study examines the independent and combined effects of NPAR and depressive symptoms on all-cause and cardiovascular mortality in arthritis patients.MethodsWe analyzed a nationally representative sample of people with arthritisaged 40 and older from NHANES (2005–2018). NPAR assessed inflammation and nutritional status, while depressive symptoms were measured by PHQ-9. Weighted Cox regression examined the independent and joint associations of NPAR and PHQ-9 with all-cause and cardiovascular disease (CVD) mortality.ResultsOur analysis indicated that higher NPAR levels combined with lower depressive symptoms (PHQ-9 < 10) significantly increased all-cause and CVD mortality risks in arthritis patients. In this group, the hazard ratio (HR) for all-cause mortality was 2.087, with a similarly elevated CVD mortality risk (HR = 2.614), underscoring NPAR’s predictive strength in non-depressed individuals. Among those with higher depressive symptoms, while elevated NPAR was still associated with increased mortality, its impact on CVD mortality was less marked, highlighting the need for further research into the NPAR-depression interaction.ConclusionThis study identifies NPAR as a key predictor of mortality in arthritis patients, particularly those with fewer depressive symptoms. NPAR significantly predicts all-cause and CVD mortality, underscoring its value as an inflammation and nutrition biomarker. Integrating NPAR in clinical practice could enhance individualized risk assessment and intervention for arthritis patients. |
| format | Article |
| id | doaj-art-3293d8e67f304676a310e8cf685c9f8f |
| institution | DOAJ |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
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| spelling | doaj-art-3293d8e67f304676a310e8cf685c9f8f2025-08-20T03:15:23ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-03-011310.3389/fpubh.2025.15452501545250The combined impact of neutrophil-percentage-to-albumin ratio and depressive symptoms on mortality in US arthritis patients: insights from NHANES (2005–2018)Jinyue Bai0Taihong Lv1Hanming Yu2Zishuo Ji3Xiu Gu4Yun Gao5Li Ma6Department of General Practice, Aerospace Center Hospital, Beijing, ChinaDepartment of General Medicine, Beijing TianTan Hospital, Capital Medical University, Beijing, ChinaDepartment of Pulmonary and Critical Care Medicine, The Fourth Affiliated Hospital of China Medical University, Shenyang, ChinaDepartment of Neurology, Beijing TianTan Hospital, Capital Medical University, Beijing, ChinaDepartment of Pulmonary and Critical Care Medicine, The Fourth Affiliated Hospital of China Medical University, Shenyang, ChinaDepartment of General Practice, Aerospace Center Hospital, Beijing, ChinaDepartment of General Medicine, Beijing TianTan Hospital, Capital Medical University, Beijing, ChinaBackgroundThe neutrophil-to-albumin ratio (NPAR) reflects inflammation and nutritional status, while depression significantly impacts survival in chronic disease patients. This study examines the independent and combined effects of NPAR and depressive symptoms on all-cause and cardiovascular mortality in arthritis patients.MethodsWe analyzed a nationally representative sample of people with arthritisaged 40 and older from NHANES (2005–2018). NPAR assessed inflammation and nutritional status, while depressive symptoms were measured by PHQ-9. Weighted Cox regression examined the independent and joint associations of NPAR and PHQ-9 with all-cause and cardiovascular disease (CVD) mortality.ResultsOur analysis indicated that higher NPAR levels combined with lower depressive symptoms (PHQ-9 < 10) significantly increased all-cause and CVD mortality risks in arthritis patients. In this group, the hazard ratio (HR) for all-cause mortality was 2.087, with a similarly elevated CVD mortality risk (HR = 2.614), underscoring NPAR’s predictive strength in non-depressed individuals. Among those with higher depressive symptoms, while elevated NPAR was still associated with increased mortality, its impact on CVD mortality was less marked, highlighting the need for further research into the NPAR-depression interaction.ConclusionThis study identifies NPAR as a key predictor of mortality in arthritis patients, particularly those with fewer depressive symptoms. NPAR significantly predicts all-cause and CVD mortality, underscoring its value as an inflammation and nutrition biomarker. Integrating NPAR in clinical practice could enhance individualized risk assessment and intervention for arthritis patients.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1545250/fullneutrophil-to-albumin ratioarthritisNational Health and Nutrition Examination Surveyall-cause mortalitydepression |
| spellingShingle | Jinyue Bai Taihong Lv Hanming Yu Zishuo Ji Xiu Gu Yun Gao Li Ma The combined impact of neutrophil-percentage-to-albumin ratio and depressive symptoms on mortality in US arthritis patients: insights from NHANES (2005–2018) Frontiers in Public Health neutrophil-to-albumin ratio arthritis National Health and Nutrition Examination Survey all-cause mortality depression |
| title | The combined impact of neutrophil-percentage-to-albumin ratio and depressive symptoms on mortality in US arthritis patients: insights from NHANES (2005–2018) |
| title_full | The combined impact of neutrophil-percentage-to-albumin ratio and depressive symptoms on mortality in US arthritis patients: insights from NHANES (2005–2018) |
| title_fullStr | The combined impact of neutrophil-percentage-to-albumin ratio and depressive symptoms on mortality in US arthritis patients: insights from NHANES (2005–2018) |
| title_full_unstemmed | The combined impact of neutrophil-percentage-to-albumin ratio and depressive symptoms on mortality in US arthritis patients: insights from NHANES (2005–2018) |
| title_short | The combined impact of neutrophil-percentage-to-albumin ratio and depressive symptoms on mortality in US arthritis patients: insights from NHANES (2005–2018) |
| title_sort | combined impact of neutrophil percentage to albumin ratio and depressive symptoms on mortality in us arthritis patients insights from nhanes 2005 2018 |
| topic | neutrophil-to-albumin ratio arthritis National Health and Nutrition Examination Survey all-cause mortality depression |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1545250/full |
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