Association of a Composite Inflammatory Score with Stroke Prevalence: A Cross-Sectional Study

Systemic inflammation plays a key role in cerebrovascular disease. While C-reactive protein (CRP) and white blood cell (WBC) count are individual risk markers, the predictive value of a combined inflammatory score (IS) for stroke prevalence remains unclear. This study aimed to investigate this association in a national population. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010. An IS was calculated as the sum of standardized Z-scores for CRP and WBC. Weighted multivariable logistic regression assessed the IS-stroke association, adjusting for demographics and clinical confounders. Restricted cubic spline (RCS) models and subgroup analyses were performed. Among 9963 included participants, 345 reported a history of stroke. After full adjustment, individuals in the highest IS quartile had 1.60-fold higher odds of stroke (OR = 1.60, 95% CI: 1.08-2.36) compared to the lowest quartile. Each unit increase in IS was associated with 6% higher odds (OR = 1.06, 95% CI: 1.01-1.12). RCS analysis revealed that higher composite IS is independently associated with increased stroke prevalence, suggesting a nonlinear association. The composite IS remained a significant predictor in models where the individual CRP and WBC components did not. This combined index may capture inflammatory burden more comprehensively than either marker alone in cross-sectional analyses. However, given the cross-sectional design, these findings should be interpreted cautiously and require confirmation in prospective studies.