Association between neutrophil percentage to albumin ratio and chronic obstructive pulmonary disease in adult population: a cross-sectional study and verification

Abstract Background Chronic obstructive pulmonary disease (COPD), a prevalent chronic respiratory disorder, has prompted growing interest in the neutrophil percentage to albumin ratio (NPAR) as a novel inflammatory biomarker. However, the precise relationship between COPD and NPAR dynamics remains e...

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Main Authors: Lei Yang, Yang Li, Jiahuan Wu, Yang Zhang, Huijun Tan, Jinxian Yu, Yini Wang, Xianghong Tang, DePeng Jiang
Format: Article
Language:English
Published: SpringerOpen 2025-06-01
Series:The Egyptian Journal of Bronchology
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Online Access:https://doi.org/10.1186/s43168-025-00414-1
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author Lei Yang
Yang Li
Jiahuan Wu
Yang Zhang
Huijun Tan
Jinxian Yu
Yini Wang
Xianghong Tang
DePeng Jiang
author_facet Lei Yang
Yang Li
Jiahuan Wu
Yang Zhang
Huijun Tan
Jinxian Yu
Yini Wang
Xianghong Tang
DePeng Jiang
author_sort Lei Yang
collection DOAJ
description Abstract Background Chronic obstructive pulmonary disease (COPD), a prevalent chronic respiratory disorder, has prompted growing interest in the neutrophil percentage to albumin ratio (NPAR) as a novel inflammatory biomarker. However, the precise relationship between COPD and NPAR dynamics remains elusive. Methods This study investigated the correlation between NPAR and COPD in adults using National Health and Nutrition Examination Survey (NHANES) data from 2015 to 2018. Logistic regression models and smoothed curve fitting showed a threshold effect and two-segment linear regression. Subgroup analyses were conducted to assess demographic differences, strengthening the study’s reliability. The research included 729 COPD patients and 530 controls, identifying factors affecting NPAR in COPD patients and confirming the NPAR-COPD link with Pearson correlation. Results This study found that COPD patients had significantly higher NPAR than healthy controls (HCs) (p < 0.05), with older patients (≥ 60 years) showing higher NPAR than younger ones (p = 0.051). After adjusting for covariates, a significant link between COPD and NPAR was observed (OR = 1.016, 95% CI: 1.003–1.029, p = 0.017). The risk association was nonlinear, with an inflection point at NPAR of 9.36. Linear regression analysis suggested that factors like hypertension, hemoglobin, WBC count, neutrophil count, lymphocyte percentage, ALT, and AST could influence the NPAR index in COPD patients (all p < 0.05). The ROC curve analysis showed an AUC of 0.648, which improved to 0.778 upon validation with a retrospective cohort model. Conclusion This study reveals a significant correlation between elevated NPAR and COPD, particularly in the presence of aged above 60 years.
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spelling doaj-art-4e334d6ea8c94a2f9925e637d52c3da92025-08-20T03:25:16ZengSpringerOpenThe Egyptian Journal of Bronchology2314-85512025-06-0119111110.1186/s43168-025-00414-1Association between neutrophil percentage to albumin ratio and chronic obstructive pulmonary disease in adult population: a cross-sectional study and verificationLei Yang0Yang Li1Jiahuan Wu2Yang Zhang3Huijun Tan4Jinxian Yu5Yini Wang6Xianghong Tang7DePeng Jiang8Department of Respiratory Medicine, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Respiratory Medicine, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Respiratory Medicine, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Respiratory Medicine, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Respiratory Medicine, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Respiratory Medicine, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Respiratory Medicine, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Respiratory Medicine, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Respiratory Medicine, The Second Affiliated Hospital of Chongqing Medical UniversityAbstract Background Chronic obstructive pulmonary disease (COPD), a prevalent chronic respiratory disorder, has prompted growing interest in the neutrophil percentage to albumin ratio (NPAR) as a novel inflammatory biomarker. However, the precise relationship between COPD and NPAR dynamics remains elusive. Methods This study investigated the correlation between NPAR and COPD in adults using National Health and Nutrition Examination Survey (NHANES) data from 2015 to 2018. Logistic regression models and smoothed curve fitting showed a threshold effect and two-segment linear regression. Subgroup analyses were conducted to assess demographic differences, strengthening the study’s reliability. The research included 729 COPD patients and 530 controls, identifying factors affecting NPAR in COPD patients and confirming the NPAR-COPD link with Pearson correlation. Results This study found that COPD patients had significantly higher NPAR than healthy controls (HCs) (p < 0.05), with older patients (≥ 60 years) showing higher NPAR than younger ones (p = 0.051). After adjusting for covariates, a significant link between COPD and NPAR was observed (OR = 1.016, 95% CI: 1.003–1.029, p = 0.017). The risk association was nonlinear, with an inflection point at NPAR of 9.36. Linear regression analysis suggested that factors like hypertension, hemoglobin, WBC count, neutrophil count, lymphocyte percentage, ALT, and AST could influence the NPAR index in COPD patients (all p < 0.05). The ROC curve analysis showed an AUC of 0.648, which improved to 0.778 upon validation with a retrospective cohort model. Conclusion This study reveals a significant correlation between elevated NPAR and COPD, particularly in the presence of aged above 60 years.https://doi.org/10.1186/s43168-025-00414-1NHANESNeutrophil percentageAlbuminChronic obstructive pulmonary diseaseAdult population
spellingShingle Lei Yang
Yang Li
Jiahuan Wu
Yang Zhang
Huijun Tan
Jinxian Yu
Yini Wang
Xianghong Tang
DePeng Jiang
Association between neutrophil percentage to albumin ratio and chronic obstructive pulmonary disease in adult population: a cross-sectional study and verification
The Egyptian Journal of Bronchology
NHANES
Neutrophil percentage
Albumin
Chronic obstructive pulmonary disease
Adult population
title Association between neutrophil percentage to albumin ratio and chronic obstructive pulmonary disease in adult population: a cross-sectional study and verification
title_full Association between neutrophil percentage to albumin ratio and chronic obstructive pulmonary disease in adult population: a cross-sectional study and verification
title_fullStr Association between neutrophil percentage to albumin ratio and chronic obstructive pulmonary disease in adult population: a cross-sectional study and verification
title_full_unstemmed Association between neutrophil percentage to albumin ratio and chronic obstructive pulmonary disease in adult population: a cross-sectional study and verification
title_short Association between neutrophil percentage to albumin ratio and chronic obstructive pulmonary disease in adult population: a cross-sectional study and verification
title_sort association between neutrophil percentage to albumin ratio and chronic obstructive pulmonary disease in adult population a cross sectional study and verification
topic NHANES
Neutrophil percentage
Albumin
Chronic obstructive pulmonary disease
Adult population
url https://doi.org/10.1186/s43168-025-00414-1
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