Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec;28(12):1136-1146.
doi: 10.1111/resp.14589. Epub 2023 Sep 1.

Predictive role of neutrophil-percentage-to-albumin, neutrophil-to-lymphocyte and eosinophil-to-lymphocyte ratios for mortality in patients with COPD: Evidence from NHANES 2011-2018

Chou-Chin Lan  1   2 , Wen-Lin Su  1   2 , Mei-Chen Yang  1   2 , Sin-Yi Chen  1 , Yao-Kuang Wu  1   2
Affiliations

Predictive role of neutrophil-percentage-to-albumin, neutrophil-to-lymphocyte and eosinophil-to-lymphocyte ratios for mortality in patients with COPD: Evidence from NHANES 2011-2018

Chou-Chin Lan et al. Respirology. 2023 Dec.

Erratum in

Abstract

Background and objective: This study evaluated the predictive roles of hematologic inflammatory biomarkers including neutrophil-percentage-to-albumin ratio (NPAR), neutrophil-to-lymphocyte ratio (NLR) and eosinophil-to-lymphocyte ratio (ELR) for mortality in community-dwelling individuals with chronic obstructive pulmonary disease (COPD).

Methods: This longitudinal study extracted data of adults 40-79 years who had physician-diagnosed COPD from the United States (US) National Health and Nutrition Examination Survey (NHANES) 1999-2018. Cox regressions determined the associations between NPAR, NLR, ELR and their components, with all-cause mortality, cardiovascular disease (CVD) mortality and mortality from chronic lower respiratory disease (CLRD). Receiver operating characteristic (ROC) curve analysis estimated the predictive performances of these biomarkers for 5-year all-cause mortality.

Results: Data of 1158 subjects were analysed. After adjustment, higher NPAR was significantly associated with increased all-cause and CVD mortality, and mortality from CLRD (adjusted hazard ratio [aHR] = 1.14, 1.15 and 1.16). Higher NLR was associated with an increased all-cause and CVD mortality (aHR = 1.16 and 1.29). Higher neutrophil was associated with increased all-cause mortality and mortality from CLRD (aHR = 1.13 and 1.34). Albumin was associated with decreased all-cause and CVD mortality (aHR = 0.91 and 0.86). ELR, eosinophil or lymphocyte was not significantly associated with either mortality outcomes. Adjusted AUC of NPAR and NLR in predicting 5-year all-cause mortality were 0.808 (95% CI: 0.722-0.845) and 0.799 (95% CI: 0.763-0.835), respectively.

Conclusion: In community-dwelling US adults with COPD, increased NPAR and NLR are associated with mortality risks. NPAR outperforms the other hematologic inflammatory biomarkers in predicting 5-year all-cause mortality.

Keywords: COPD; National Health and Nutrition Examination Survey (NHANES); chronic obstructive pulmonary disease; eosinophil-to-lymphocyte ratio; mortality; neutrophil-percentage-to-albumin ratio; neutrophil-to-lymphocyte ratio.

PubMed Disclaimer

References

REFERENCES

    1. Szalontai K, Gémes N, Furák J, Varga T, Neuperger P, Balog JÁ, et al. Chronic obstructive pulmonary disease: epidemiology, biomarkers, and paving the way to lung cancer. J Clin Med. 2021;10(13):2889.
    1. Agarwal AK, Raja A, Brown BD. Chronic obstructive pulmonary disease. StatPearls. Treasure Island, FL: StatPearls Publishing; 2022.
    1. Christenson SA, Smith BM, Bafadhel M, Putcha N. Chronic obstructive pulmonary disease. Lancet. 2022;399(10342):2227-2242.
    1. Jurevičienė E, Burneikaitė G, Dambrauskas L, Kasiulevičius V, Kazėnaitė E, Navickas R, et al. Epidemiology of chronic obstructive pulmonary disease (COPD) comorbidities in Lithuanian National Database: a cluster analysis. Int J Environ Res Public Health. 2022;19(2):970.
    1. Nathan C. Points of control in inflammation. Nature. 2002;420(6917):846-852.

LinkOut - more resources