Relationship of Neutrophil Percentage‐to‐Albumin Ratio With Stroke: Evidence From NHANES 1999–2020

The objective of this research is to examine the association between neutrophil percentage-to-albumin ratio (NPAR) and stroke, providing a reference for the prevention and prognosis of clinical stroke. The study included 56,566 participants from the National Health and Nutrition Examination Survey (NHANES) to explore the association between NPAR and stroke using logistic regression and restricted cubic splines. Upon identifying the nonlinear relationship, inflection points were calculated using recursive algorithms and two-stage linear regression models. Stratified analyses and interaction tests examined variations across population groups. After adjusting for confounders, NPAR was positively associated with stroke (OR: 1.09, 95% CI: 1.05-1.12). Restricted cubic spline analysis indicated a nonlinear trend. Beyond the inflection point, the increasing trend of stroke incidence with higher NPAR levels began to slow down. This relationship remained nonlinear in males but was linear in females. This study revealed a nonlinear positive association between NPAR and stroke, with higher NPAR increasing the risk of stroke.