Association between albumin-related inflammatory biomarkers and breast cancer risk: A secondary analysis of NHANES 1998–2018

Breast cancer (BC) is a leading cause of cancer-related mortality among women globally. Inflammation and nutritional status play critical roles in BC development and progression. Albumin-related inflammatory biomarkers, which reflect both inflammatory and nutritional status, have been increasingly recognized as important indicators in cancer initiation and progression. However, their role in BC risk remains largely unexplored. This study aimed to investigate the association between albumin-related inflammatory biomarkers and BC risk. Female' data within the age range of 20 to 80 from the National Health and Nutrition Examination Survey (1998-2018) were extracted. Weighted logistic regression and restricted cubic spline regression analyses were performed to explore the association between 4 albumin-related inflammatory biomarkers (neutrophil percentage-to-albumin ratio [NPAR], lymphocyte-to-albumin ratio [LYAR], leukocyte-to-albumin ratio, and platelet-to-albumin ratio) and BC risk. Subgroup analyses were conducted to assess the influence of covariates, and sensitivity analyses were performed to ensure the robustness of the findings. Among 14,211 female participants, 357 were diagnosed with BC. A linear positive relationship was observed between NPAR and BC (odds ratio = 1.08; 95% confidence interval: 1.02-1.14; P = .008), with participants in the highest quartile of NPAR exhibiting a significantly increased risk compared to those in the lowest quartile (odds ratio = 1.60; 95% confidence interval: 1.05-2.44; P for trend = 0.016). In contrast, LYAR demonstrated a nonlinear protective association with BC (P for overall < .001; P for nonlinear < .001), with higher levels linked to reduced risk. Leukocyte-to-albumin ratio and platelet-to-albumin ratio were not significantly associated with BC. Findings from subgroup and sensitivity analyses were consistent with the main findings. Our study highlighted the potential role of NPAR and LYAR in BC risk assessment. They may serve as available and cost-effective tools for identifying high-risk individuals and facilitating early intervention. Further studies are warranted to evaluate the potential of albumin-related inflammatory biomarkers in the early diagnosis of BC.