Evidence mapPaperPMID 40830746Full record

ArticleBMC cardiovascular disorders2025

Neutrophil percentage-to-albumin ratio mediates the association between life's crucial 9 with cardiorenal syndrome: a secondary data analysis from NHANES.

Zhe Fang, Jiawen Zhao, Hongyang Gong

Abstract read
In one paragraph

Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Zhe FangHealthcare management center, The Second Hospital of Shandong University, Jinan City, Shandong Province, China.
Jiawen ZhaoJiangxi Province Environmental Monitoring Centre, Nanchang City, Jiangxi Province, 330046, China.
Hongyang GongDepartment of Physiology, College of Medicine, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, Republic of Korea. hygong@chosun.ac.kr.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSeveral studies have suggested a potential link between cardiovascular health, inflammation, and cardiorenal syndrome (CRS). However, the exact mechanism by which inflammation affects the relationship between cardiovascular health and CRS remains unclear. CRS refers to a syndrome in which dysfunction in either the heart or kidneys leads to acute or chronic dysfunction in the other organ. Life's Crucial 9 (LC9) is a recently proposed cardiovascular health assessment tool. The neutrophil-to-albumin ratio (NPAR) is a novel inflammatory-nutritional composite biomarker that integrates neutrophil-mediated immune activation with the nutritional status reflected by albumin levels. This study aimed to explore the relationship between LC9 and CRS and assess whether NPAR modulates this association.

methodsThis study employed subgroup analysis, restricted cubic splines (RCS), threshold effect analysis, and multivariable logistic regression to investigate the relationships between LC9 and CRS, and NPAR and CRS. Additionally, mediation analysis was conducted to evaluate the potential role of NPAR in the relationship between LC9 and CRS.

resultsA total of 25,610 participants were included in the study, of whom 1,240 experienced CRS events. Multivariable logistic regression analysis revealed that for every 10-unit increase in LC9 score, the risk of CRS decreased by 36% (OR = 0.64, 95% CI: 0.55, 0.76). For each 1-unit increase in NPAR, the risk of CRS increased by 12% (OR = 1.12, 95% CI: 1.07, 1.17). After grouping LC9 and NPAR by tertiles, the highest LC9 tertile (T3) showed a 52% reduction in CRS risk compared to the lowest tertile (T1) (OR = 0.48, 95% CI: 0.26, 0.88), while the highest NPAR tertile (T3) had a 2.07-fold increase in CRS risk compared to the lowest tertile (T1) (OR = 2.07, 95% CI: 1.54-2.78). RCS analysis demonstrated a linear negative correlation between LC9 and CRS risk, whereas NPAR was non-linearly associated with CRS risk, with an inflection point at 13.66. Mediation analysis indicated that NPAR mediated 8.14% (P < 0.001) of the association between LC9 and CRS.

conclusionLC9 is significantly negatively associated with CRS risk, and this relationship is partially mediated by NPAR. Given the limitations of this cross-sectional study, further prospective studies are needed to confirm the causal relationship and explore the potential mechanisms.

Indexed as

Cardio-Renal SyndromeNeutrophilsSerum Albumin, HumanAdultAgedBiomarkersCross-Sectional StudiesFemaleHumansLeukocyte CountMaleMiddle AgedNutritional StatusNutrition AssessmentNutrition SurveysPredictive Value of TestsALB protein, humanBiomarkersSerum Albumin, HumanCardiorenal syndromeLife's crucial 9Mediation analysisNeutrophil percentage-to-albumin ratioNHANES

Identifiers

PMID40830746
PMCPMC12362869

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.