Monocyte-to-albumin ratio outperforms triglyceride-glucose index in associating with stroke prevalence among diabetics: an NHANES cross-sectional study

This NHANES analysis (N = 15,679) establishes elevated MAR as significantly associated with prevalent Stroke, outperforming the TyG Index especially in diabetics. Diabetic individuals in the highest MAR quartile exhibited 2.5-fold greater Stroke prevalence vs. the lowest quartile, with optimal prevalence discrimination at MAR > 0.152. BMI mediated 15.6% of this association, indicating modifiable pathways. Clinical translation requires prospective validation of the MAR threshold, confirmation of BMI-mediated mechanisms, and evidence for MAR-guided intervention efficacy. Provided sufficient longitudinal and interventional evidence is obtained, MAR shows promise as a dual-purpose tool for Stroke prevalence stratification and therapeutic monitoring along the inflammation-metabolism axis in high-risk populations, particularly diabetics.