Depression heightened the association of the systemic immune-inflammation index with all-cause mortality among osteoarthritis patient

Abstract

BackgroundSystemic immune-inflammatory index (SII) has been recognized as a novel inflammatory indicator in numerous diseases. It remains unknown how SII affects all-cause mortality among patients with osteoarthritis (OA). In this prospective cohort study, we intended to examine the relationship of SII with all-cause mortality among OA populations and assess the interaction between depression and SII. MethodsData was collected from National Health and Nutrition Examination Survey (NHANES) in 2005–2018. The National Death Index (NDI) provided vital status records. Multivariable Cox regression analyses with cubic spines were applied to estimate the association between SII and all-cause and CVD mortality. Stratified analysis and interaction tests assessed the interaction of SII and depression on all-cause mortality. ResultsIn total 3174 OA adults were included. The lowest quartile Q1 (HR:1.44, 95%CI:1.02–2.04) and highest quartile Q4 (HR:1.44, 95%CI:1.02–2.04) of SII presented a higher risk of death compared with those in second quartile Q2 (Ref.) and third quartile Q3 (HR:1.23, 95%CI:0.89–1.68. Restricted cubic splines analysis revealed a U-shaped association of SII with all-cause mortality, the inflection points were 412.93 × 109/L. The interaction test observed a more significant relationship of SII with all-cause mortality in depression patients than in non-depression patients, indicating that depression can modify this association. LimitationsFirst, the observational study design failed to make causal inferences. Second, the baseline SII cannot reflect the long-term level of inflammation. Finally, there may be potential bias. ConclusionSII was U-shaped associated with all-cause mortality in OA patients, and this association was significantly heightened by depression.