Systemic Immune-inflammation Index Levels Research Articles

The Association Between Left Ventricular Global Function Index and Major Adverse Cardiovascular Events Linked to Systemic Inflammation in Acute Coronary Syndrome.

We aimed to investigate the association between systemic inflammation and the left ventricular global function index (LVGFI) and evaluate the diagnostic performance of LVGFI for MACEs across the acute coronary syndrome (ACS) spectrum. A total of 1697 patients (794 with ST-segment elevation myocardial infarction [STEMI] and 903 with non-STEMI [NSTEMI]) were evaluated. The LVGFI was calculated using echocardiography. Inflammatory status was assessed with C-reactive protein (CRP) and the systemic immune inflammation index (SII). MACEs were defined as non-fatal re-infarction, repeated revascularization of the target vessel, and all-cause mortality at a 3-year follow-up. While the STEMI group exhibited lower LVGFI values compared with the NSTEMI group (P < .001), it had a higher SII level (P < .001) and CRP level (P = .021). The association between higher LVGFI quartiles and lower levels of systemic inflammation was more pronounced in the STEMI group. The threshold value of LVGFI to predict MACEs was <21.8% (Sensitivity = 79.2%, Specificity = 68.7%) for STEMI, while it was <25.4% (Sensitivity = 77.4%, Specificity = 70.8%) for NSTEMI. Considering both the inflammatory status and ACS spectrum when evaluating LVGFI could provide a more comprehensive assessment of cardiac function and prognosis in ACS patients.

Second-Trimester Inflammatory Markers in Predicting Fetal Growth Restriction: A Retrospective Analysis.

Fetal growth restriction (FGR) is a critical pregnancy complication linked to increased perinatal morbidity and mortality. Inflammation plays a key role in FGR's pathophysiology, and systemic inflammation markers may serve as predictors. This study evaluates the role of various inflammation indices; systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), pan-immune-inflammation value (PIV), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), lymphocyte-to-platelet ratio (LMR), monocyte-to-platelet ratio (MPR), aggregate systemic inflammation index (AISI), systemic coagulation inflammation index (SCII), and immature granulocyte percentage (IG%) in predicting FGR. This retrospective study included 403 pregnant women treated at Ankara Etlik City Hospital between August 2022 and May 2024. The study population comprised 202 women with uncomplicated pregnancies (control group) and 201 women diagnosed with FGR per the Delphi Consensus Criteria. Second-trimester blood samples were used to calculate the inflammatory indices. SII and NLR levels were significantly higher in the FGR group compared to controls (p = 0.020, p = 0.028, respectively). However, no significant associations were found between these indices and adverse neonatal outcomes. Cut-off values for SII and NLR were 896 and 3.91, respectively, with moderate sensitivity and specificity. SII and NLR, measured in the second trimester, may be useful in predicting FGR. Although these indices did not correlate with adverse neonatal outcomes, further prospective studies with larger populations are needed to validate their clinical utility.

Systemic immunoinflammatory indexes in albuminuric adults are negatively associated with α-klotho: evidence from NHANES 2007–2016

Background Systemic Immune-Inflammation Index (SII) is a novel inflammatory biomarker closely associated with the inflammatory response and chronic kidney disease. Klotho is implicated as a pathogenic factor in the progression of kidney disease, and supplementation of Klotho may delay the progression of chronic kidney disease by inhibiting the inflammatory response. Our aim is to investigate the potential relationship between SII and Klotho in adult patients in the United States and explore the differences in the populations with and without albuminuria. Methods We conducted a cross-sectional study recruiting adult participants with complete data on SII, Klotho, and urine albumin-to-creatinine ratio (ACR) from the National Health and Nutrition Examination Survey from 2007 to 2016. SII was calculated as platelet count × neutrophil count/lymphocyte count, with abnormal elevation defined as values exceeding 330 × 10^9/L. Albuminuria was defined as ACR >30 mg/g. Weighted multivariable regression analysis and subgroup analysis were employed to explore the independent relationship between SII and Klotho. Results Our study included a total of 10,592 individuals. In all populations, non-albuminuria population, and proteinuria population with ACR ≥ 30, participants with abnormally elevated SII levels, as compared to those with SII less than 330 × 10^9/L, showed a negative correlation between elevated SII levels and increased Klotho, which persisted after adjusting for covariates. Conclusions There is a negative correlation between SII and Klotho in adult patients in the United States. This finding complements previous research but requires further analysis through large prospective studies.

Predictive value of system immune-inflammation index for the severity of coronary stenosis in patients with coronary heart disease and diabetes mellitus

Coronary heart disease (CHD) has been recognized as a chronic progressive inflammatory disorder, and Diabetes mellitus (DM) is an independent risk factor for the pathogenesis of CHD. Recent research has underscored the systemic immune-inflammation index (SII) as a potent prognostic indicator for individuals suffering from acute coronary syndrome (ACS). This study aimed to delve into the relationship between SII and the degree of coronary atherosclerotic stenosis in non-acute myocardial infarction patients with or without DM. We enrolled a total of 2760 patients with cardiovascular disease between November 2023 and May 2024. All eligible participants were divided into the CHD group and the DM & CHD group according to the existence of comorbid DM. Our study revealed that the SII values were significantly higher in diabetic patients with CHD compared to those with CHD alone (P < 0.05). Furthermore, among patients with both CHD and DM, higher SII values were associated with a greater likelihood of developing complex, triple-branch coronary artery lesions, while the opposite trend was observed in CHD populations (P < 0.05). In the regression model completely adjusted for potential confounders, the correlation between high SII levels and co-existing DM status in CHD patients persisted as statistically significant even after attaining guideline-recommended LDL-C and TG goals (P < 0.05). Moreover, our findings demonstrated a significant link between SII levels and the severity of coronary artery stenosis as assessed by coronary angiography, particularly in the DM and CHD patient cohorts (P < 0.05). Further stratified analysis revealed a novel finding that SII levels in DM and CHD patients maintained a positive linear relationship with coronary plaque burden even under stringent glycemic control (P < 0.01, r = 0.37), whereas this correlation was absent in CHD patients who had FBG of 7 mmol/L or lower upon admission (P < 0.01, r < 0.30). These important findings underscore the SII as an independent predictor of the severity of coronary plaque burden in diabetic patients with CHD, offering valuable insights that can aid clinicians in refining risk stratification and implementing personalized management strategies for those at elevated risk.

Relationship between systemic immune-inflammation index and long-term all-cause and cause-specific mortality among adult asthma patients: a population—based study

BackgroundPersistent inflammation in the airways is a hallmark of asthma, and researchers have extensively explored various inflammatory indicators that contribute to the condition. Despite this, there is limited research on the relationship between the systemic immune-inflammation index (SII), a novel marker of inflammation, and overall mortality rates as well as mortality rates due to specific causes in individuals with asthma.MethodsWe analyzed data from the National Health and Nutrition Examination Survey (NHANES) covering a 20-year period, from 1999 to 2018. To examine the association between SII and mortality rates in asthma patients, we used a combination of statistical methods, including weighted Kaplan-Meier analysis and multivariate-adjusted Cox analysis. Additionally, we applied restricted cubic spline (RCS) analysis to investigate the potential non-linear relationship between these variables. To further validate our findings, we performed subgroup and sensitivity analyses to ensure the reliability of the results.ResultsThis study analyzed data from 5,384 individuals with asthma, finding a link between increased SII levels and a higher risk of death from all-cause, cardiovascular disease and respiratory disease, but no association with cancer mortality. There were J-shaped non-linear relationships between SII and all-cause, cardiovascular and respiratory diseases mortality in asthma patients. The inflection points were 326, 350 and 355, respectively. Below these inflection points, each 100-unit increase in SII was associated with a decrease in mortality by 8%, 11% and 10%, while above these thresholds, mortality rates increased by 4%, 4%, and 3%, respectively. Subgroup analyses showed that SII was a significant predictor of all-cause mortality across various subgroups, and sensitivity analyses confirmed these findings, with the highest SII group consistently showing higher mortality rates for all-cause, cardiovascular, and respiratory disease mortality in the fully adjusted model.ConclusionsOur study initially demonstrated a strong link between elevated SII levels and a higher risk of death from all-cause, cardiovascular disease, and respiratory disease in individuals with asthma. Furthermore, our analysis showed that the relationship between SII and mortality rates in asthma patients followed a non-linear, J-shaped pattern for all-cause, cardiovascular, and respiratory disease mortality.Clinical trial numberClinical trial number not applicable.

Analysis of Risk Factors for Restenosis after Interventional Treatment of Tuberculous Airway Stenosis.

Analysis of risk factors for restenosis after intervention for tuberculous airway stenosis. We retrospectively collected the clinical data of patients diagnosed with tuberculous airway stenosis in the Second Hospital of Lanzhou University and Lanzhou Pulmonary Hospital from January 2021 to June 2023. The patients were divided into the restenosis group and the non-restenosis group according to whether or not restenosis occurred in the airway within 1 year after the intervention, and the differences in the clinical data between the two groups were compared, and the variables with statistically significant differences in the univariate analysis were analyzed by multifactorial binary logistic regression. A total of 154 patients with tuberculous airway stenosis were included in this study, including 64 patients in the stenosis group, with a restenosis rate of 41.6%. The results of univariate analysis showed that the systemic immune inflammation index (SII) level was higher in the restenosis group compared with the non-restenosis group, and the composition of patients with diabetes mellitus, a stenosis length of >3cm, and a positive antacid staining of tracheal secretions was higher (all P<0.05). The composition of microscopic inactivity, antituberculosis treatment prior to intervention, and performing balloon dilatation was lower (all P<0.05). The results of multifactorial binary logistic regression analysis showed that diabetes(OR=5.758, 95%CI: 1.434~23.119), stenosis length (OR=6.349, 95%CI: 2.653~15.197), SII level (OR=1.002, 95%CI: 1.001~1.003), prior to interventional anti-tuberculosis treatment (OR=0.250, 95%CI: 0.084~0.746), and TBTB microscopic classification and staging(OR=0.306, 95%CI: 0.099~0.941) were independent influences on restenosis after interventional treatment for tuberculous airway stenosis. Diabetes, stenosis length>3cm, and high SII were independent risk factors for restenosis after intervention for tuberculous airway stenosis, prior to interventional anti-tuberculosis treatment and microscopic inactivity were independent protective factors.

Correlation of systemic immune inflammation and serum uric acid with gout: based on NHANES.

This study aimed to explore the relationship of systemic immune inflammation index (SII) and uric acid with gout using NHANES 2017-2018 data. Data were collected from the 2017-2018 circle of the NHANES database. SII was calculated based on the counts of lymphocytes (LC), neutrophils (NC), and platelets (PC). Data on gout patients were collected from questionnaires. Logistic regression analysis and subgroup analysis were used to explore the relationship between SII and gout. A total of 4517 participants were included in the study, with 273 individuals in the gout group and 4244 in the non-gout group. Logistic regression analysis showed that SII and serum uric acid were higher in the gout group than those in the non-gout group. SII ≥ 511.8 and uric acid ≥ 7.0mg/dL may be positively associated with gout. Further subgroup analysis revealed that the level of SII was positively associated with gout in the female group and the group with eGFR of 60-89.9mL/min/1.73 m2. Serum uric acid was positively associated with gout in the age, hypertension, hyperglycemia, and male groups and the group with eGFR ≥ 60mL/min/1.73 m2. There are positive correlations of SII and serum uric acid with gout. Our study suggests that SII could be a novel, valuable, and feasible inflammatory marker for gout. Key Points • Gout is a joint disease associated with hyperuricemia. The mechanism of the disease involves multiple complex factors, including metabolic disorders and inflammation. • Systemic immune inflammation index (Sll), as an evaluation index of systemic inflammatory responses, can reflect the body's inflammatory changes when the immune system is continuously activated with chronic inflammation of joints and other tissues. • We used the NHANES database to explore the relationship of SII and uric acid with gout, providing a basis for the diagnosis of gout and prognostic assessment of gout patients.

Systemic immune-inflammation index in the evaluation of Sjogren's syndrome associated with interstitial lung disease, interstitial pneumonia with autoimmune features, and idiopathic pulmonary fibrosis.

Interstitial lung disease (ILD) damages the lungs and can be caused by environmental exposures and collagen-vascular diseases. The systemic immune-inflammation index (SII) is investigated to diagnose and manage ILDs in different etiological diseases. The study aims to examine the usefulness of SII in diagnosing specific ILDs like Sjogren's syndrome (SjS)-ILD, interstitial pneumonia with autoimmune features (IPAF), and idiopathic pulmonary fibrosis (IPF). In this cross-sectional study, we included 109 patients with IPAF, IPF, and SjS-ILD. Demographic characteristics, symptoms, lung patterns, autoantibodies, and SII were assessed. Morphologic, serologic, and clinical factors determined the classification of IPAF. Student's t-test, Mann-Whitney U test, Pearson-Spearman's method, and receiver operating characteristic (ROC) curves were used to analyze data. Male patients were more common in IPF and IPAF, while SjS-ILD had mostly female patients. Raynaud's phenomenon and dry mouth/eyes were more common in SjS-ILD compared to IPF and IPAF. The groups had significant differences in patterns, antinuclear antibody positivity, and SII levels. SII levels differed significantly between IPAF, SjS-ILD, and IPF patients, and were correlated with CRP in IPAF and SjS-ILD. The cut-off value of the SII between IPAF and IPF in patients with ILD was 576.1 with 76.0% sensitivity and 76.0% specificity. Evaluation of SII provides valuable information for understanding and identifying different disease groups with ILDs.

Differential systemic immune-inflammation index levels in people with and without HIV infection.

HIV infection is linked to persistent inflammation despite effective antiretroviral therapy (ART). The Systemic Immune-Inflammation Index (SII) is a marker of inflammation in various conditions. We compared SII values between PWH and PWoH. Clinical blood laboratory data were used to calculate the SII for each participant using the formula [(Platelet count × Neutrophil count) / Lymphocyte count]. Differences in SII values between the groups were analyzed using the Wilcoxon test, and the impact potential confounders was assessed with multivariable regression models. The study included 343 PWH and 199 PWoH. Age and race did not significantly differ, but sex distribution did (83.1% male in PWH vs. 55.8% in PWoH, P < 0.0001). Among PWH, median [IQR] nadir and current CD4 counts were 199 cells/μL [50, 350] and 650 [461,858], respectively. Nearly all PWH were on ART, with 97.2% achieving viral suppression. PWH had lower SII values than PWoH (327 [224, 444] vs. 484 [335,657], P = 1.35e-14). PWH also had lower neutrophils and platelets (ps < 0.001) and higher lymphocyte counts (P = 0.001). These differences remained significant after adjusting for age, sex, and other potential confounders. Contrary to expectations, PWH had lower SII levels, likely due to altered hematologic parameters influenced by HIV and ART. These findings suggest that SII interpretation in PWH requires consideration of unique hematologic profiles and underscore the need for further research to understand the mechanisms and clinical implications of SII in HIV management.

Systemic immune-inflammation index and long-term mortality in patients with hypertension: a cohort study.

The objective of this study was to examine the relationship between systemic inflammation and long-term mortality in patients with hypertension. The study employed a retrospective cohort design. The study population was derived from the National Health and Nutrition Examination Survey (NHANES), and the mortality data for this population was acquired from the National Death Index (NDI) database. Systemic inflammation was quantified by the Systemic Immune Inflammation Index (SII) and the Systemic Inflammatory Response Index (SIRI), which were then categorized into four groups (Q1-Q4, with Q4 representing the highest level of SII or SIRI). Weighted Cox regression models were constructed to investigate the association between mortality and SII and SIRI, with hazard ratios (HRs) subsequently calculated. A total of 7431 participants were included in the analysis. The highest quantile (Q4) of SII was associated with a higher risk of all-cause mortality (hazard ratio 1.36, 95% CI 1.1-1.69, P < 0.001). After adjustment for important covariates, the association remained significant (hazard ratio 1.70, 95% CI 1.27-2.30, P < 0.001). The highest quantile (Q4) of SIRI was also associated with the highest risk of mortality (hazard ratio 2.11, 95% CI 1.64-2.70, P < 0.001), and this association remained significant after adjustment for important covariates (hazard ratio 1.64, 95% CI 0.61-1.22, P = 0.001). Both SII and SIRI scores were found to be associated with mortality rates in patients with hypertension. The findings suggest that these scores may serve as complementary biomarkers to the neutrophil-to-lymphocyte ratio (NLR) for assessing mortality risk in patients with hypertension. Further investigation is warranted to elucidate the underlying mechanisms that underpin this association.

Serum inflammation biomarkers level in cystoid and diffuse diabetic macular edema.

To assess serum inflammatory biomarker levels in patients with different subtypes of diabetic macular edema (DME). We retrospectively analyzed 50 eyes from 37 treatment-naïve DME patients who underwent intravitreal injection therapy between June and December 2023. Based on the morphological characteristics of macular edema in optical coherence tomography (OCT), the eyes were categorized into the cystoid macular edema (CME) group (n = 25) and diffuse retinal thickening (DRT) group (n = 25). Additionally, 25 eyes with diabetes retinopathy but without DME served as the control group. Comprehensive clinical data were reviewed, including best-corrected visual acuity (BCVA), central macular thickness (CMT), macular cube volume (VOL) and hematological examination. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) were calculated. NLR and SII levels were significantly higher in the CME group compared to the DRT group and control group (all P < 0.01). The optimal ROC cutoff value of NLR for CME was 2.27, with 88.0% sensitivity and 68.0% specificity. The optimal ROC cutoff value of SII for CME was 447.33, with 84.0% sensitivity and 60.0% specificity. After initial intravitreal injection therapy, BCVA and VOL significantly improved in each group (all P < 0.01). However, no significant correlation was found between systemic inflammatory marker levels and postoperative changes in BCVA, CMT and VOL (all P > 0.05). Our study suggests that elevated NLR and SII levels are significantly associated with CME. Elevated serum inflammatory biomarkers may indicate a higher incidence of CME in these patients.

The Predictive Value of Preoperative Systemic Immune-Inflammation Index in Patients with Granulomatous Mastitis.

The systemic immune-inflammation index (SII) comprehensively reflects the balance between immune status and host inflammation. We aimed to investigate the potential predictive value of the SII in the prognosis of granulomatous mastitis (GM). We enrolled 245 patients with GM who underwent surgery between 2015 and 2020 in this study. Using the receiver operating characteristic (ROC) curve, we divided the patients into low SII groups (SII≤836×109/L) and high SII groups (SII>836×109/L). The associations between SII and clinical parameters were assessed using chi-squared or Fisher's exact tests. Kaplan-Meier plots and Log rank tests were performed to investigate the clinical outcomes of cumulative no-recurrence rates. Risk factors were analyzed by using logistic regression analysis. We found a correlation between the recurrence of GM and the preoperative level of SII, and the high SII group exhibited a higher recurrence rate than the low SII group. To further explore the factors affecting the risk of recurrence, we found that young age at disease onset, skin rupture, and the postoperative use of corticosteroids could increase the risk of GM recurrence. Multivariate logistic regression analysis suggested that young age and postoperative corticosteroid use were the risk factors for disease recurrence. As a noninvasive and readily available clinical parameter, the preoperative SII level has great significance in evaluating the efficacy and prognosis of surgical treatment for GM combined with age and postoperative corticosteroid use, which provides valuable insights for making treatment decisions.

The Association between Systemic Inflammation and the Prostate Cancer: based on the National Health and Nutrition Examination Survey and Mendelian Randomization Analysis.

The purpose of this combination research was to examine the relationship between systemic inflammation and the risk of prostate cancer (PCa) through the National Health and Nutrition Examination Survey (NHANES) cross-sectional study and two-sample Mendelian randomization (MR) analysis. We incorporated NHANES data spanning the years 2001 to 2010, with exposure as systemic inflammation, evaluated using systemic immune-inflammation index (SII) and outcome as PCa, and performed multivariate logistic regression and restricted cubic spline (RCS) to test the correlation between SII and PCa. Further, two-sample MR was used to identify causal associations between specific immune cells and PCa. A total of 7706 participants (age≥40 years) were included in the analysis in the cross-sectional study, including 350 PCa cases, 7356 controls. Higher SII levels were associated with increased odds of PCa (P<.05). The odds ratio (OR) for PCa was 1.51 (95% CI 1.09-2.08) for the highest versus lowest quartile of SII levels in the fully adjusted model. Also, the RCS analysis showed a threshold effect, with SII levels above 8.90 associated with increased odds of PCa. In addition, MR results suggested a causal relationship between CD62L- monocyte, CD62L- HLA DR+ monocyte, CD14+ CD16+ monocyte, CD62L- Dendritic Cell, Monocytic Myeloid-Derived Suppressor Cell, CD28- CD8dim T cell, CD39+ resting CD4 regulatory T cell and PCa (P<.05). This combination analysis provides evidence for a significant causal relationship between systemic inflammation and PCa risk. These findings highlight systemic inflammation and inflammatory immune responses as potential modifiable risk factors for PCa.

Association of systemic immune-inflammation index with all-cause and cardio-cerebrovascular mortality in individuals with diabetic kidney disease: evidence from NHANES 1999-2018.

Emerging evidence suggests a potential role of immune response and inflammation in the pathogenesis of diabetic kidney disease (DKD). The systemic immune-inflammation index (SII) offers a comprehensive measure of inflammation; however, its relationship with the prognosis of DKD patients remains unclear. Using data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2018, this cross-sectional study involved adults diagnosed with DKD. Cox proportional hazards models were utilized to assess the associations between SII and all-cause or cardio-cerebrovascular disease mortality. Additionally, restricted cubic spline, piecewise linear regression, and subgroup analyses were performed. Over a median follow-up duration of 6.16 years, 1338 all-cause deaths were recorded. After adjusting for covariates, elevated SII levels were significantly associated with increased risks of all-cause and cardio-cerebrovascular disease mortality. Specifically, per one-unit increment in natural log-transformed SII (lnSII), there was a 29% increased risk of all-cause mortality (P < 0.001) and a 23% increased risk of cardio-cerebrovascular disease mortality (P = 0.01) in the fully adjusted model. Similar results were observed when SII was analyzed as a categorical variable (quartiles). Moreover, nonlinear association was identified between SII and all-cause mortality (P < 0.001) through restricted cubic spline analysis, with threshold value of 5.82 for lnSII. The robustness of these findings was confirmed in subgroup analyses. Likewise, the statistically significant correlation between SII levels and cardio-cerebrovascular disease mortality persisted in individuals with DKD. Increased SII levels, whether examined as continuous variables or categorized, demonstrate a significant association with elevated risks of all-cause and cardio-cerebrovascular disease mortality among DKD patients. These findings imply that maintaining SII within an optimal range could be crucial in reducing mortality risk.

The systemic immune-inflammation index and systemic inflammation response index are useful for predicting mortality in patients with diabetic nephropathy

BackgroundThis study investigated the correlation between the systemic immune-inflammation index (SII) and the systemic inflammation response index (SIRI) and all-cause, cardiovascular, and kidney disease mortality in patients with diabetic nephropathy (DN). It aimed to provide a new predictive assessment tool for the clinic and a scientific basis for managing inflammation in DN.MethodsThe data utilized in this study were obtained from the National Health and Nutrition Examination Survey (NHANES) database, spanning 1999 to 2018. A total of 2641 patients diagnosed with DN were included in the analysis. The association between SII and SIRI levels and mortality in patients with DN was investigated using multivariate Cox proportional risk regression models. These relationships were further validated by Kaplan-Meier survival curves and restricted cubic spline (RCS) modeling, and subgroup analyses were performed to explore the heterogeneity among different characteristic subgroups.ResultsThe multivariate Cox regression analysis indicated that SII and SIRI levels were independently associated with all-cause mortality and cardiovascular mortality in patients with DN. SIRI levels were found to be an independently associated factor with kidney disease mortality in patients with DN. Patients in the highest quartile of SII and SIRI exhibited a 1.49-fold and 1.62-fold increased risk of all-cause mortality, respectively, compared to patients in the lowest quartile. The risk of cardiovascular mortality was 1.31 and 1.73 times higher than that in patients in the lowest quartile, respectively. The risk of kidney disease mortality in patients in the highest quartile of SIRI was 2.74 times higher than that in patients in the lowest quartile. Kaplan-Meier survival curve and RCS analyses further confirmed the positive association between SII and SIRI and mortality and a significant nonlinear relationship between SII and all-cause mortality. The SII and SIRI indices offer incremental value in model predictive power for mortality in patients with DN. Subgroup analyses demonstrated that the correlation between SII and SIRI and mortality risk was stable but heterogeneous across different subgroups.ConclusionSII and SIRI can be utilized as biomarkers for forecasting the likelihood of all-cause and cardiovascular mortality in patients with DN.

The Predictive Value of the Systemic Immune-Inflammation Index for Cardiovascular Events in Chronic Total Occlusion Patients Who Prior Coronary Artery Bypass Grafting.

There is limited research on the long-term prognosis of percutaneous coronary intervention (PCI) in coronary chronic total occlusion (CTO) patients who have previously undergone coronary artery bypass grafting (CABG). Additionally, the prognostic value of a novel systemic immune inflammation index (SII) in this specific patient population remains unclear. To adjust for differences in baseline features and minimize bias, 335 pairs of patients with or without prior CABG undergone PCI were obtained after probability score matching (PSM) in a single-center cohort. The clinical characteristics were collected, and the primary outcomes were major cardiovascular events (MACE), which included all-cause death, nonfatal MI and unplanned revascularization, were recorded during the follow-up period after discharge. The group with prior CABG were divided according to the median level of SII: Lower SII group (SII ≤ 570.10, N = 167) and higher SII group (SII ≥ 570.10, N = 168). The SII values were significantly higher in the prior CABG group than in the without prior CABG group [570.10 (444.60, 814.12) vs 519.65 (446.86, 565.84), P < 0.001, respectively]. The survival Kaplan-Meier analysis showed that patients with prior CABG was significantly associated with a higher risk of MACE than patients without prior CABG (P = 0.016) in the long-term follow-up. As SII levels increased, the cumulative risk of MACE became significantly higher in the patients with prior CABG (P = 0.023) stratified by the median value of SII. The Cox proportional hazards regression model analysis indicated that the level of SII (hazard ratio = 2.035, 95% CI, 1.103-3.753, P = 0.023) emerged as independent predictors of MACE. The restricted cubic spline (RCS) analysis illustrated that the HR for MACE increased with increasing SII. SII is a reliable predictor of long-term cardiovascular events after PCI in CTO patients with prior CABG, suggesting that SII may be helpful in identifying high-risk patients who need more aggressive treatment and follow-up strategies.

Predictive Value of the Systemic Immune-Inflammation Index in the 28-Day Mortality for Patients with Sepsis-Associated Acute Kidney Injury and Construction of a Prediction Model.

The predictive value of the Systemic Immune-Inflammation Index (SII) on mortality in patients with sepsis-associated acute kidney injury (S-AKI) remains unclear. This study aims to investigate the predictive value of SII levels at the Intensive Care Unit (ICU) on the 28-day mortality of S-AKI patients. S-AKI patients admitted to the ICU of Henan Provincial People's Hospital from January 1, 2023, to December 31, 2023. Patients who were diagnosed with S-AKI were divided into survival and death groups based on their 28-day outcome after ICU admission. Using receiver operating characteristic (ROC) curves to determine the best cut-off values and prognostic abilities of various parameters. Kaplan-Meier survival curves describe the 28-day survival of patients after ICU admission. Cox regression analysis identified the main risk factors associated with mortality in S-AKI patients, constructing a predictive nomogram. The concordance index (C-index) and decision curve analysis were used to validate the predictive ability of this model. A total of 216 patients with S-AKI were included. ROC analysis showed that SII had the highest predictive value for mortality risk in S-AKI patients after ICU admission. Compared with the low-SII group, the high-SII group had higher 28-day (86.7% vs 32.4%, respectively, P <0.001) mortality rate. Based on Cox regression analysis, a nomogram predictive model was constructed, including age, respiratory failure, SII levels, number of organ dysfunctions at ICU admission, sequential organ failure assessment (SOFA), and acute physiology and chronic health evaluation II (APACHEII). The C-index for predicting the 28-day survival rate was 0.682. Decision curve analysis indicated a high level of clinical predictive efficacy. SII serves as a potential biomarker for predicting the prognosis of S-AKI patients. The constructed nomogram prognostic model can aid in assessing the prognosis of S-AKI patients.

Association Between Systemic Immune-Inflammation Index and CA125 in Older Women: Insights from a Cross-Sectional NHANES Study.

The Systemic Immune-Inflammation Index (SII) is a novel biomarker that has been implicated in the pathogenesis of various neoplastic and non-neoplastic diseases. This study aimed to evaluate the association between SII and the conventional tumor marker CA125 (Carbohydrate antigen 125) in a population of postmenopausal women. This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES), focusing on postmenopausal women with available data on SII and CA125. The SII was calculated using the formula: platelet count × neutrophil count/lymphocyte count. To evaluate the relationship between the SII and cancer antigen 125 (CA125), we conducted multivariate regression analyses. The linear association between these variables was further explored by fitting a smoothed curve to examine nuances in their relationship. Additionally, subgroup analyses were performed based on age, age at menarche and menopause, and hormone replacement therapy status to assess the heterogeneity of the relationship between SII and CA125 between different demographic groups. A total of 741 postmenopausal women with a mean age of 72.0 (±8.24) years were included in this analysis. The results demonstrated a significant positive correlation between SII and CA125 levels (β = 0.01; 95% CI, 0.00-0.02, p = 0.0128). Subgroup analyses and interaction tests revealed that variables such as age, age at menarche and menopause, and hormone replacement therapy did not significantly modify this association (p > 0.05). This study demonstrated a positive correlation between SII and C125 in older female patients in the United States.

A NOMOGRAM BASED ON THE VALUE OF THE DYNAMIC EVOLUTION OF SYSTEMIC IMMUNE INFLAMMATORY INDEX IN THE EVALUATION OF SEVERE HEATSTROKE.

Background : Severe heatstroke patients have a poor prognosis. There are few descriptions of the inflammatory response to heatstroke in clinical studies. Systemic immune-inflammation index (SII) is a new index to reflect the inflammatory state of disease. Methods : This retrospective observational study included patients who had severe heatstroke between 2010 and 2023. Multivariate logistic regression and nomogram were performed to determine the ability of the SII to predict the prognosis of these patients, and subgroup analysis was performed according to SII levels. Results : Of the 177 patients included in our study, 28 (15.8%) died. There was no difference in SII values between the first day ( P = 0.810) and the second day ( P = 0.184) in multivariate analysis. The SII value of the third day (SII 72) was elevated in patients with heatstroke who died compared to that in those who survived ( P = 0.035). In multivariable logistic regression, Sequential Organ Failure Assessment (SOFA) score (odds ratio [OR], 1.717; confidence interval [CI], 1.073-2.747; P = 0.024) and SII 72 (OR, 1.001; 95% CI, 1.000-1.002; P = 0.035) were found to be independent predictors of mortality. SII 72 combined with SOFA score distinguished between patients who died and those who survived better than did the separate SOFA score. Patients with SII 72 > 1,000 had poor clinical prognosis. Conclusions : Compared to SII results from the first and second days, third-day results more meaningfully predict poor heatstroke prognosis. SII 72 may be a good indicator and, when combined with SOFA, offers enhanced predictive value.

Relationship Between Serum Interleukin-6 Levels, Systemic Immune-Inflammation Index, and Other Biomarkers Across Different Rheumatoid Arthritis Severity Levels.

Background Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by joint inflammation, pain, and progressive disability. Identifying biomarkers that accurately reflect disease severity is crucial for effective management. Interleukin-6 (IL-6) is a pro-inflammatory cytokine involved in the pathogenesis of RA, and the systemic immune-inflammation index (SII) is emerging as a useful marker of systemic inflammation. This study aims to explore the relationship between serum IL-6 levels, SII, and various biomarkers to better predict disease severity in RA patients. Objective To determine the relationship between serum IL-6 levels and the SII, along with various biomarkers, across different severity levels for predicting the severity of RA in patients. Methods This cross-sectional, observational study was conducted at the Mardan Medical Complex from January 2024 to August 2024, involving 67 RA patients.Clinical assessments included demographic data, disease activity (DAS28), pain (VAS), joint damage (Larsen score), and functional status (HAQ-DI). Serum IL-6 levels, along with other biomarkers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and the SII, were measured through fasting blood samples. Statistical analyses, including density plots, scatter plots, boxplots with ANOVA, and random forest models, were performed to explore associations between IL-6 and all other variables. Significance was set at p < 0.05. Results The study included 67 RA patients (mean age: 41.79 ± 10.51 years, 53.73% male). Elevated IL-6 levels (mean: 80.28 ± 35.27 pg/mL) were strongly associated with disease severity. Patients with DAS28 > 5.5 had IL-6 levels over 100 pg/mL, while those in remission had around 40 pg/mL. IL-6 levels correlated with joint damage (100 pg/mL in severe cases) and pain (over 120 pg/mL for severe pain). Patients with metabolic and cardiovascular comorbidities had the highest IL-6 levels, particularly with diabetes and hypertension (98.6 pg/mL) or cardiovascular disease (119.3 pg/mL). IL-6 correlated strongly with CRP (r = 0.65), ESR (r = 0.51), and SII (r = 0.62). Regression confirmed IL-6 as an independent predictor of severity (p < 0.001), with comorbidities being key predictors. Conclusion Elevated IL-6 and SII levels serve as critical markers for predicting the severity of RA. Addressing these markers may lead to more targeted and effective therapeutic strategies for managing disease progression.