Negative association between the neutrophil percentage-to-albumin ratio (NPAR) and psoriasis: a retrospective cross-sectional study

Among patients with psoriasis, there was not much research regarding the assessment of neutrophil percentage-to-albumin ratio (NPAR) in patients with psoriasis. This cross-sectional study aimed to investigate the association between NPAR and prevalence of psoriasis in US adults. Data from adults aged 20 to 80 years in the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2006 and 2009 to 2014 was utilized. Institutional Review Board approval and documented written consent was obtained from participants by NHANES (Protocol #2005-06). Differences between the groups were further explored. The univariate, multivariate logistic regressions and restricted cubic splines (RCS) regression were used to investigate the correlation between NPAR and psoriasis, with results expressed as odds ratios (OR) and 95% confidence intervals (CI). Subgroup analysis of the associations between NPAR and psoriasis was carried out to investigate if the impact of the NPAR varied among different subgroups. Of the 17,489 adults included in the study, 500 (2.9%) were diagnosed with psoriasis. NPAR (per 10 unit) was negatively associated with prevalence of psoriasis (β = 0.55, 95% CI 0.37, 0.82), after being fully adjusted. A non-linear was observed in the dose-response relationship between NPAR and prevalence of psoriasis (P for non-linearity 0.021). In the subgroup analysis, effect size of NPAR on the presence of psoriasis in subgroups was stable (all P values > 0.05). There exists a stable and strong negative non-linearly association between NPAR and prevalence of psoriasis. The potential role and value in the clinical diagnosis and prognostic assessment of the NPAR in psoriasis calls for further longitudinal studies.

Association between dietary niacin intake and dyslipidemia prevalence in the National Health and Nutrition Examination Surveys (NHANES)

BACKGROUND AND OBJECTIVES

The association of niacin intake with dyslipidemia remains uncertain. The aim of this study was to explore the association between dietary niacin intake and the prevalence of dyslipidemia among adults in the United States (US).

METHODS AND STUDY DESIGN

Data were obtained from the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2014. The exposure variable was dietary niacin intake, measured through 24-hour dietary recall interviews and treated as both a continuous and categorical variable. Dyslipidemia, defined by diagnostic criteria, was the outcome. Logistic regression and restricted cubic spline models were applied to examine the association between niacin intake and the prevalence of dyslipidemia.

RESULTS

Among the 19,275 individuals, the prevalence of dyslipidemia was 78.8%. Compared with individuals with lower niacin consumption Q1 (≤15.9 mg/day), the adjusted OR values for dietary niacin intake and dyslipidemia in Q3 (22.7-31.8 mg/day) and Q4 (≥31.8 mg/day) were 0.78 (95% CI: 0.64-0.94, p = 0.011) and 0.77 (95% CI: 0.61-0.98, p = 0.033), respectively. The association between niacin intake and the prevalence of dyslipidemia followed a L-shaped dose-response curve (non-linear, p = 0.009). Participants with a niacin intake of <22.3 mg/day exhibited an OR of 0.98 (95% CI: 0.96-0.99, p = 0.040) for dyslipidemia. In subgroup analyses, the inverse associations of niacin intake with the prevalence of dyslipidemia remained robust only in female.

CONCLUSIONS

In the 2005-2014 NHANES popu-lation, higher levels of niacin intake were associated with decreased odds of dyslipidemia overall. Further studies are needed to examine the potential protective effects of niacin on dyslipidemia risk.

Prescription Opioid Use and Laboratory Value Derangements: A Cross-Sectional Analysis of NHANES Data

BACKGROUND

The use of opioids for the treatment of pain is a risk versus benefit analysis and metabolic disease is an often overlooked variable in the equation and may lead to increased risk of comorbidities of cardiovascular and cerebrovascular disease and diabetes.

OBJECTIVES

Our objective was to identify and describe abnormalities among the comprehensive metabolic and lipid panels of individuals taking prescription opioids.

STUDY DESIGN

We performed a cross-sectional study of the laboratory values with 3 cycles (2011-2016) of the National Health and Nutrition Examination Survey (NHANES) in March 2020.

SETTING

NHANES sampling is conducted using a multistaged, stratified, cluster sampling technique to create a representative sample of the United States.

METHODS

We excluded patients with histories of cancer and under the age of 25 years. Our final sample size was 11,061 (n = 162,547,635), with 797 reportedly using a prescription opioid in the past 30 days-a weighted percent representing 22.95% of the US population. Our analyses identified mean differences in biomarkers between individuals taking prescription opioids and the US population.

RESULTS

Laboratory values from the comprehensive metabolic panel were all within reference ranges for both groups, with only bilirubin levels being statistically lower in the group currently taking prescription opioids. Values from the lipid panel of both the opioid using and comparison groups were above reference range for total cholesterol and fasting glucose. The opioid using group was also higher than the reference range for triglycerides (mean [M] = 165.4, standard deviation [SD] = 14.2) and insulin (M = 15.5, SD = 2.2), whereas the comparison group was not.  The oral glucose measure was within normal ranges for both groups; however, the opioid using group was 13.7 points higher than the comparison group (M = 122.3, SD = 1.8; M = 108.6, SD = 4.0; P < 0.01).

LIMITATIONS

While our study uses a large sample for a robust generalizable analysis it is a correlation study and a longitudinal cohort would provide better evidence linking potential disease states to prescription opioid use.

CONCLUSIONS

Although all Americans should be alarmed at the lipid levels reported in this study, specific combinations of heightened lipid laboratory values among prescription opioid users accelerate the trajectories toward comorbidities-heart disease, cerebrovascular disease, and diabetes-leading to diminished quality of life. Therefore pain management and comprehensive drug recovery programs should include nutritional counseling and physical activity as part of their overall treatment plan.