Association of neutrophil percentage-to-albumin ratio and sarcopenia: Data from NHANES 2011–2018

The precise correlation between the neutrophil percentage-to-albumin ratio (NPAR) and the incidence of sarcopenia has not yet been definitively established. This investigation seeks to ascertain if an elevated NPAR correlates with an increased risk of developing sarcopenia. This analysis encompassed 6943 individuals derived from the National Health and Nutrition Examination Survey (2011-2018), whose mean age was 38.99 ± 11.50 years. Of these, 3480 (50.12%) were male, and 3463 (49.88%) were female. The NPAR was expressed as the ratio of neutrophil percentage-to-albumin levels. The sarcopenia index is defined as the appendicular skeletal muscle mass divided by body mass index. A sarcopenia index of <0.512 for females and <0.789 for males indicates sarcopenia. Weighted multivariable logistic regression, subgroup analyses, and interaction terms were employed to assess the independent association between NPAR and sarcopenia. In the model with full adjustments, a significant association between NPAR and sarcopenia was noted (odds ratio = 1.110 [1.047-1.177], P = .005). The tests for interaction indicated that variables encompassing age, gender, hypertension, smoking habits, and alcohol intake did not substantially influence the link between NPAR and sarcopenia. However, a more pronounced positive association between NPAR and sarcopenia was detected among participants who did not have diabetes (odds ratio = 1.13 [1.09-1.18], P for interaction = .001). Elevated NPAR is significantly associated with sarcopenia risk and serves as a key predictive biomarker, offering new insights for early detection, intervention, and targeted treatment to improve patient outcomes.