Association between inflammation indicators and albuminuria in US adults: a cross-sectional study

Previous studies have established associations between the C-reactive protein to lymphocyte ratio (CLR), inflammatory load index (IBI), and neutrophil to albumin ratio (NAR) with various conditions. However, the evidence for such associations in individuals with albuminuria remains unclear. This study aimed to investigate the relationship between inflammatory biomarkers and the presence of albuminuria by utilizing data derived from the National Health and Nutrition Examination Survey (NHANES). Participants were classified into two groups according to their urinary albumin-to-creatinine ratio (UACR): those who presented with albuminuria and those who did not. The association between inflammatory biomarkers and the occurrence of albuminuria was assessed through multivariate regression models. To explore possible non-linear relationships, restricted cubic spline (RCS) analysis was applied. Furthermore, subgroup and sensitivity analyses were conducted to ensure the reliability and consistency of the findings. The study included 18,876 participants, of whom 2,321 were classified in the albuminuria group and 16,555 in the non-albuminuria group. The results from a fully adjusted logistic regression model indicated a significant positive relationship between the natural logarithm-transformed inflammatory markers-Ln-CLR, Ln-IBI, and Ln-NAR-and the risk of presence albuminuria. Specifically, each unit increase in Ln-CLR, Ln-IBI, and Ln-NAR was linked with a 12%, 15%, and 79% heightened risk of albuminuria, respectively. RCS analysis showed a linear relationship between Ln-CLR, Ln-IBI and Ln-NAR and albuminuria. Subgroup analyses demonstrated consistent findings across various populations, and numerous sensitivity tests confirmed the reliability of these outcomes. This study demonstrates a positive correlation between CLR, IBI, and NAR and the presence albuminuria in US adults. Given these results, early monitoring of these inflammatory markers in high-risk populations is essential for identifying the onset of albuminuria and mitigating kidney damage progression.