ArticleMediators of inflammation2026
Association Between Neutrophil Percentage-Albumin Ratio and Biological Aging in Rheumatoid Arthritis in the United States: A Cross-Sectional Study of NHANES.
Article in Mediators of inflammation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Epigenetic Age Acceleration as a Modifiable Public Health Target: A Systematic Review and Meta-Analysis of Environmental, Behavioral, and Social Determinants with Development of the MEAB-Index.International journal of molecular sciences · 2026Pooled it
- Association of Neutrophil Percentage-to-Albumin Ratio With Urinary Albumin Excretion in U.S. Adults: Implications for Rheumatic Disease Research.International journal of rheumatic diseases · 2026Article
- Association Between Neutrophil Percentage-Albumin Ratio and Biological Aging in Rheumatoid Arthritis in the United States: A Cross-Sectional Study of NHANES.Mediators of inflammation · 2026Article
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9 authors.
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Abstract
Background: The accelerating process of global aging has made the burden of age-related diseases increasingly severe, and traditional chronological age fails to reflect individual heterogeneity in aging. The neutrophil percentage-to-albumin ratio (NPAR), is a multidimensional health assessment index composed of inflammatory markers (neutrophils) and nutritional markers (albumin) to reflect inflammation and nutritional status, has shown unique potential in rheumatoid arthritis (RA) research. However, its association with biological age (BA; such as Klemera-Doubal method [KDM] age and phenotypic age, PhenoAge) has not yet been systematically validated in RA patients. By evaluating NPAR indicators in patients with RA, this study intends to reveal its value as a potential biomarker for predicting biological aging and its acceleration. Methods: This study was based on the National Health and Nutrition Survey 1999-2018 cycle database, and a cross-sectional analysis of 1053 adult patients with RA was included. Core variable definitions include: neutrophil-albumin ratio (NPAR) = percentage of neutrophils (%)/albumin (g/dL); BA was calculated by the KDM (including 10 biomarkers) and the PhenoAge algorithm, respectively. Accelerated aging is quantified as the difference between BA and chronological age. The statistical analysis used a multi-model validation strategy: 1) multivariate linear regression to evaluate the association between NPAR and continuous aging acceleration indicators; 2) the restricted cubic spline (RCS) model explores the nonlinear relationship; 3) stratified subgroup analysis to test for effect heterogeneity. All models were stratified for sociodemographic characteristics (age, sex, and ethnicity), lifestyle factors (smoking, alcohol consumption, and physical activity), and clinical covariates (body mass index [BMI], hypertension, and history of diabetes). Results: In an analysis of 1053 RA patients in the United States, women accounted for 56.48% and men for 43.52%; the group with the highest NPAR (T3) showed more significant aging characteristics (≥65 years old 34.75%, females 62.80%, and diabetes 27.69%) and higher biological aging acceleration rates (KDM acceleration 42.81% vs. low group 25.81%; PhenoAge acceleration 62.13% vs. 37.74%; all Discussion: Elevated NPAR is significantly associated with accelerated biological aging in RA patients, and the mechanism may involve neutrophil migration dysfunction, oxidative damage caused by albumin deficiency, and chronic inflammatory pathways (such as NF-
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