Association between Neutrophil-Percentage-to-Albumin Ratio and Gallstone Incidence: Evidence from NHANES

Introduction: This study aimed to explore the correlation between the Neutrophil-Percentage-to-Albumin Ratio (NPAR) and the incidence of gallstones. Methods: We conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020. Multiple logistic regression and smooth curve fitting were employed to investigate the association between NPAR and gallstones. Sensitivity analyses, including stratified and interaction analyses, were performed to assess potential interactions between covariates and NPAR. Additionally, we analyzed the relationship between NPAR and other inflammatory indicators, such as the systemic immune inflammation index (SII), platelet/lymphocyte ratio (PLR), and neutrophil/lymphocyte ratio (NLR), using the receiver operating characteristic (ROC) curve to evaluate their predictive power regarding the likelihood of gallstones. Results: Our study recruited a total of 5,798 individuals over the age of 20, of whom 617 reported having gallstones. After adjusting for multiple covariates, the multiple logistic regression models indicated a positive linear association between NPAR and gallstone incidence. Subgroup analyses and interaction tests confirmed that the association between NPAR and gallstones persisted across different strata. Furthermore, NPAR demonstrated greater predictive value for gallstones compared to SII, PLR, and NLR. Conclusion: The prevalence of gallstones is positively correlated with NPAR. Compared to SII, PLR, and NLR, NPAR offers enhanced predictive value for the prevalence of gallstones.