Association of nine composite inflammatory indices with cardiovascular diseases in US adults: national health and nutrition examination survey (NHANES, 2005–2018)

Across nine indices evaluated on a single platform using complex survey methods, NPR and SIRI consistently tracked higher CVD burden, LMR and PAR tracked lower burden, and index-specific nonlinearity was evident. Across markers, incremental gains in discrimination were modest (ΔAUC approximately 0-0.006), with prespecified analyses indicating that these small improvements were most apparent in normal-weight adults. These findings support pragmatic use of complete blood count (CBC)-based composites for inflammation-centric risk dialogues and motivate prospective studies to determine whether incorporating these indices into cardiovascular risk stratification improves clinical decision-making and outcomes.