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已发表论文
中性粒细胞/淋巴细胞比值与血清白蛋白比值联合分析及其与慢性阻塞性肺疾病的关联：基于1999-2018年美国国家健康与营养调查的研究结果
Authors Li C , Ao T , Huang Y , Ding L, Zhen P , Hu M , Wang J
Received 9 August 2025
Accepted for publication 19 November 2025
Published 5 December 2025 Volume 2025:20 Pages 3951—3964
DOI https://doi.org/10.2147/COPD.S559567
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Jill Ohar
Congfeng Li,1 Ting Ao,2 Yingxiu Huang,2 Lin Ding,1 Peng Zhen,2 Ming Hu,2 Jinxiang Wang1
1Department of Pulmonary and Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Infectious Disease, Beijing Luhe Hospital, Capital Medical University, Beijing, People’s Republic of China
Correspondence: Jinxiang Wang, Department of Pulmonary and Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University, No. 82, Xinhua South Road, Tongzhou District, Beijing, 101100, People’s Republic of China, Tel +86 13911469017, Email wangjx0090@sina.com
Background: The neutrophil-to-lymphocyte ratio (NLR) and serum albumin (ALB) are associated with the development and progression of chronic obstructive pulmonary disease (COPD). However, the relationship between NLR/ALB and COPD remains to be fully elucidated.
Objective: The primary objective of this study was to investigate the potential correlation between NLR/ALB and COPD, with the aim of identifying a potential biomarker that could serve as a rapid assessment for COPD.
Methods: We performed a retrospective analysis involving 39,055 participants extracted from the National Health and Nutrition Examination Survey (NHANES) dataset, which covered the period from 1999 to 2018. We utilized weighted multivariable logistic regression models to evaluate the association between NLR/ALB and COPD. Additionally, a restricted cubic spline (RCS) model was applied to investigate the potential non-linear relationship between NLR/ALB and the risk of COPD.
Results: Weighted multivariate logistic regression revealed a significant link between ln-transformed NLR/ALB and heightened COPD risk [odds ratio (OR): 1.35, 95% confidence interval (CI): 1.17– 1.55; P< 0.001)]. When ln-transformed NLR/ALB was converted into categorial variables (quartiles, Q), compared to the first quartile (Q1) of ln-transformed NLR/ALB, COPD risk for the greatest Q4 group was significantly higher. Meanwhile, a nonlinear association between ln-transformed NLR/ALB was observed. Subgroup and sensitivity analyses further validated the robustness and consistency of these findings.
Conclusion: Elevated NLR/ALB is associated with an increased risk of COPD, showing nonlinear patterns and threshold effects. NLR/ALB may serve as a potential biomarker for the occurrence of COPD.
Keywords: neutrophil to lymphocyte ratio/serum albumin ratio, chronic obstructive pulmonary disease, inflammation, national health and nutrition examination survey
1Department of Pulmonary and Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Infectious Disease, Beijing Luhe Hospital, Capital Medical University, Beijing, People’s Republic of China
Correspondence: Jinxiang Wang, Department of Pulmonary and Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University, No. 82, Xinhua South Road, Tongzhou District, Beijing, 101100, People’s Republic of China, Tel +86 13911469017, Email wangjx0090@sina.com
Background: The neutrophil-to-lymphocyte ratio (NLR) and serum albumin (ALB) are associated with the development and progression of chronic obstructive pulmonary disease (COPD). However, the relationship between NLR/ALB and COPD remains to be fully elucidated.
Objective: The primary objective of this study was to investigate the potential correlation between NLR/ALB and COPD, with the aim of identifying a potential biomarker that could serve as a rapid assessment for COPD.
Methods: We performed a retrospective analysis involving 39,055 participants extracted from the National Health and Nutrition Examination Survey (NHANES) dataset, which covered the period from 1999 to 2018. We utilized weighted multivariable logistic regression models to evaluate the association between NLR/ALB and COPD. Additionally, a restricted cubic spline (RCS) model was applied to investigate the potential non-linear relationship between NLR/ALB and the risk of COPD.
Results: Weighted multivariate logistic regression revealed a significant link between ln-transformed NLR/ALB and heightened COPD risk [odds ratio (OR): 1.35, 95% confidence interval (CI): 1.17– 1.55; P< 0.001)]. When ln-transformed NLR/ALB was converted into categorial variables (quartiles, Q), compared to the first quartile (Q1) of ln-transformed NLR/ALB, COPD risk for the greatest Q4 group was significantly higher. Meanwhile, a nonlinear association between ln-transformed NLR/ALB was observed. Subgroup and sensitivity analyses further validated the robustness and consistency of these findings.
Conclusion: Elevated NLR/ALB is associated with an increased risk of COPD, showing nonlinear patterns and threshold effects. NLR/ALB may serve as a potential biomarker for the occurrence of COPD.
Keywords: neutrophil to lymphocyte ratio/serum albumin ratio, chronic obstructive pulmonary disease, inflammation, national health and nutrition examination survey