Association of C-reactive protein to albumin ratio with prevalence and mortality in metabolic syndrome: NHANES 1999-2010.

BACKGROUND: Metabolic syndrome (MetS) is closely related to inflammation and oxidative stress. C-reactive protein to albumin ratio (CAR) is an inflammatory and nutritional marker, and this study aims to explore its relationship with the occurrence and prognosis of MetS. METHODS: The study utilized data derived from the National Health and Nutrition Examination Survey 1999-2010. Among the 11,669 adult participants, 4,290 (33%) were diagnosed with MetS. Multivariate logistic regression was employed to investigate the association between CAR and MetS. To assess the impact of CAR on all-cause and cardiovascular mortality among people with MetS, Kaplan-Meier survival curve, Cox proportional risk model, restricted cubic spline, and receiver operating characteristic (ROC) curve were used. RESULTS: This study showed that the highest CAR quantile level was strongly association with the prevalence of MetS in the population (OR = 4.92 95% CI 4.19-5.77 P < 0.001). In people with MetS, elevated CAR increased the risk of all-cause death (HR = 1.51 95% CI 1.27-1.79 P < 0.001) and cardiovascular death (HR = 1.65 95% CI 1.29-2.09 P < 0.001). The ROC curve indicated the predictive value of CAR for all-cause death in people with MetS (AUC = 0.64). CONCLUSION: Our findings demonstrate the predictive value of CAR for the prevalence and mortality due to MetS, and highlight the role of inflammation in the development and prognosis of MetS.