Association of Neutrophil Percentage-to-Albumin Ratio With White Matter Hyperintensities in Patients With Ischemic Stroke

Objective: To investigate the association between neutrophil percentage-to-albumin ratio (NPAR) and white matter hyperintensities (WMHs) in patients with ischemic stroke. Methods: This retrospective study enrolled 187 patients with acute ischemic stroke admitted to the Department of Neurology at the First Affiliated Hospital of Anhui University of Science and Technology (Huainan First People's Hospital) from May 2021 to July 2022. Participants were categorized into WMHs and non-WMHs groups. Baseline characteristics were compared between groups, and logistic regression analysis was performed to assess the predictive value of NPAR for WMHs. Results: Among the included patients (mean age: 67.8 +/- 10.1 years; 64.2% male), 34.2% presented with WMHs. Compared to the non-WMHs group, the WMHs group exhibited significantly higher age (p = 0.001), hypertension prevalence (p = 0.011), neutrophil percentage (p = 0.001), and NPAR levels (p < 0.001), alongside lower total protein (p = 0.013) and albumin levels (p = 0.001). After adjusting for age, hypertension, and laboratory confounders, multivariate logistic regression identified elevated NPAR as an independent risk factor for WMHs (OR = 19.58, 95% CI: 4.83-79.39; p < 0.001). Moreover, ROC curve analysis established NPAR as the superior predictive marker for WMHs identification (AUC = 0.763; 95% CI, 0.694-0.833; p < 0.001), with an optimal cutoff value of 1.52 demonstrating 81.3% sensitivity and 72.1% specificity. Conclusion: NPAR serves as an independent predictor of WMHs in ischemic stroke patients, suggesting its potential utility as a biomarker for cerebrovascular injury monitoring.