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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1436311

Associations Between Neutrophil Percentage to Albumin Ratio and Rheumatoid Arthritis Versus Osteoarthritis: A Comprehensive Analysis Utilizing the NHANES Database

Provisionally accepted
Wenquan Ding Wenquan Ding 1*Rui La Rui La 1*Shenghao Wang Shenghao Wang 1*Zhiyuan He Zhiyuan He 1*Dinghua Jiang Dinghua Jiang 1*Zhigang Zhang Zhigang Zhang 1*Hao Ni Hao Ni 2*Wu Xu Wu Xu 1*Lixin Huang Lixin Huang 1*Qian Wu Qian Wu 1,3*
  • 1 Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
  • 2 Department of Pathology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
  • 3 College of Medicine, Jeonbuk National University, Jeonju, North Jeolla, Republic of Korea

The final, formatted version of the article will be published soon.

    Objectives: The association between the neutrophil percentage to albumin ratio (NPAR) and the risk of osteoarthritis (OA) and rheumatoid arthritis (RA) remains unclear. This study aims to investigate the association between NPAR and the risk of OA and RA. Methods: This cross-sectional study analyzed data from 92,062 American adults in the NHANES database between 1999 and 2016. Various statistical analyses were conducted to investigate the associations between NPAR and the risks of OA and RA, including multivariable logistic regression, subgroup analysis, smooth curve fitting, and threshold effect analysis.Results: After screening, the final study population included 36,147 participants, with 3,881 individuals diagnosed with OA and 2,178 with RA. After adjusting for confounding factors, higher NPAR levels were associated with an increased risk of RA (OR = 1.06; 95% CI: 1.04-1.08; P < 0.0001), but not with OA (OR = 1.01; 95% CI: 0.99-1.02; P = 0.4510). This association was remarkably consistent across subgroups by age, sex, body mass index (BMI), alcohol consumption, hypertension, diabetes and smoking status. Further analyses using curve fitting and threshold effect models revealed a nonlinear association between NPAR and RA, with an inflection point identified at 15.56. Conclusion: High levels of NPAR significantly increased the prevalence of RA. This provides us with new insights for the management and treatment of RA patients.

    Keywords: Rheumatoid arthritis, Osteoarthritis, Neutrophil percentage-to-albumin ratio, Inflammation, National Health and Nutrition Examination Survey, Cross-sectional study

    Received: 21 May 2024; Accepted: 06 Jan 2025.

    Copyright: © 2025 Ding, La, Wang, He, Jiang, Zhang, Ni, Xu, Huang and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Wenquan Ding, Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
    Rui La, Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
    Shenghao Wang, Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
    Zhiyuan He, Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
    Dinghua Jiang, Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
    Zhigang Zhang, Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
    Hao Ni, Department of Pathology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
    Wu Xu, Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
    Lixin Huang, Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
    Qian Wu, Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China

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