Systemic Immune-inflammation Index Research Articles

ASO Author Reflections: Reflections on the Role of the Systemic Immune-Inflammation Index in Prognostic Assessment in HER2-Positive Metastatic Breast Cancer.

ASO Author Reflections: Reflections on the Role of the Systemic Immune-Inflammation Index in Prognostic Assessment in HER2-Positive Metastatic Breast Cancer.

Associations of systemic immune-inflammation index and systemic inflammation response index with maternal gestational diabetes mellitus: Evidence from a prospective birth cohort study.

The role of inflammation in the development of gestational diabetes mellitus (GDM) has recently become a focus of research. The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), novel indices, reflect the body's chronic immune-inflammatory state. This study aimed to investigate the associations between the SII or SIRI and GDM. A prospective birth cohort study was conducted at Beijing Obstetrics and Gynecology Hospital from from February 2018 to December 2020, recruiting participants in their first trimester of pregnancy. Baseline SII and SIRI values were derived from routine clinical blood results, calculated as follows: SII=neutrophil (Neut) count×platelet (PLT) count/lymphocyte (Lymph) count, SIRI=Neut count×monocyte (Mono) count/Lymph count, with participants being stratified into quartiles. Follow-up included a 75-g, 2-h oral glucose tolerance test (OGTT) at 20-32weeks of gestation, using the glucose thresholds of the International Association of Diabetes and Pregnancy Study Groups (IADPSG). Logistic regression was used to analyze the odds ratios (ORs) (95% confidence intervals [CIs]) for the SII, SIRI, and GDM risk. Among the 28,124 women included in the study, the average age was 31.8±3.8years, and 15.76% (4432/28,124) developed GDM. Higher SII and SIRI quartiles were correlated with increased GDM rates, with rates ranging from 12.26% (862/7031) in the lowest quartile to 20.10% (1413/7031) in the highest quartile for the SII ( Ptrend <0.001) and 11.92-19.31% for the SIRI ( Ptrend <0.001). The SII and SIRI were positively correlated with GDM risk. The ORs (95% CIs) of the second, third, and fourth SII quartiles were 1.09 (0.98-1.21), 1.21 (1.09-1.34), and 1.39 (1.26-1.54), respectively. The SIRI findings paralleled the SII outcomes. For the second through fourth quartiles, the ORs (95% CIs) were 1.24 (1.12-1.38), 1.41 (1.27-1.57), and 1.64 (1.48-1.82), respectively. These associations were maintained in subgroup and sensitivity analyses. The SII and SIRI are potential independent risk factors contributing to the onset of GDM.

Utility of systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio as a predictive biomarker in pediatric traumatic brain injury

Background: Traumatic brain injury (TBI) remains the predominant cause of mortality and disability among the pediatric population. At present, there are no radiation-free, simple, and cost-effective tools available to assess the severity and prognosis of pediatric TBI. The systemic immune-inflammation index (SII), neutrophilto-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) serve as inflammatory biomarkers that may assist in predicting the outcome of pediatric TBI. This research aims to assess the utility of SII, NLR, and PLR as a predictive biomarker in children with TBI. Methods: A retrospective analysis was conducted on SII, NLR, and PLR by reviewing the medical records of all pediatric (age ≤18 years) TBI cases who came to the emergency department in the period from January 2023 to August 2024. Patients were categorized according to 28-day mortality and the severity of TBI. The correlation between the biomarkers and outcomes was analyzed. Results: A total of 206 patients were included in this study. The mean age was 13.81 (1–18). The 28-day mortality rate was 5.3% (n = 11). There were no significant differences in SII, NLR, and PLR between the survivor and mortality groups (P = 0.317, P = 0.288, and P = 0.200, respectively). Based on the TBI severity, there was a significant difference in the SII, NLR, and PLR across mild, moderate, and severe TBI (P = 0.006, P = 0.002, P = 0.001, respectively). Conclusion: The findings of our study did not reveal a significant predictive relationship between SII, NLR, and PLR to 28-day mortality. Nonetheless, there were significant differences in SII, NLR, and PLR among mild, moderate, and severe TBI groups. Further research under more controlled conditions is essential to facilitate the use of SII, NLR, and PLR as predictive biomarkers in pediatric TBI.

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.

New systemic inflammatory indices as predictors of ascending aortic dilation in children with bicuspid aortic valve: A retrospective cross-sectional study.

Systemic inflammatory indices, originally developed to predict the prognosis of cancer patients, have found increasing application in various medical areas, including cardiovascular research. This study aimed to investigate the relationship between ascending aortic dilatation in bicuspid aortic valve patients and systemic inflammatory indices. This retrospective cross-sectional study included 122 patients with bicuspid aortic valves. These patients were divided into 2 groups based on the presence or absence of dilatation according to ascending aorta z-scores. Complete blood counts were analyzed, focusing on leukocyte, neutrophil, lymphocyte, monocyte, and platelet counts. Additionally, systemic inflammatory indices including neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio (PLR), Systemic Immune-Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI), and monocyte-to-lymphocyte ratio (MLR) and pan-immune-inflammation value (PIV) were calculated from these parameters. MLR, SIRI, and PIV demonstrated acceptable diagnostic power in detecting ascending aortic dilatation in bicuspid aortic valve patients, with area under the curve (AUC) values of 0.709, 0.741, and 0.779, respectively. PLR and SII exhibited fair diagnostic power, with AUC values of 0.673 and 0.688, respectively. According to the receiver operating characteristic analysis, PIV had the highest AUC value of 0.779 (95% confidence interval [CI] = 0.69-0.86), with a sensitivity of 70.9% and specificity of 70.8% at a cutoff value of 224.93. A relationship exists between PLR, MLR, SII, SIRI, PIV, and ascending aorta dilatation in pediatric patients with bicuspid aortic valves. These findings suggest that inflammation may play a role in the dilatation of the ascending aorta in bicuspid aortic valve patients.

Immune inflammation markers and physical fitness during a congested match play period in elite male soccer players

Background/ObjectiveCellular immune markers of inflammation such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune inflammation index (SII) are frequently used in patient care. The adoption of these markers to elite sports, e.g. soccer could be beneficial when monitoring training and aiming to maximize physical fitness. This study investigated cellular immune inflammation markers and physical fitness in elite male soccer players in relation to changes in training and match exposure during a congested match play period.MethodsFifteen elite male soccer players were evaluated three times (T1, T2, and T3) over 12 weeks (T1–T2: six weeks uncongested period of match play and T2–T3: six weeks congested period of match play). Players performed vertical jump tests (squat jumps [SJ], countermovement jumps [CMJ]), the 20-meter sprint test, and the Yo-Yo intermittent recovery test (YYIRL1) at T1, T2 and T3. Measurements included counts of leucocytes and its subtypes, as well as platelets. Cellular immune inflammation markers (NLR, PLR and SII) were calculatedat T1, T2, and T3. Training session rating of perceived exertion was also recorded on a daily basis.ResultsSignificant increases in leucocyte, neutrophil, eosinophil, basophil and monocyte counts occurred at T3 compared with T2 (0.002 < p < 0.04, -0.56 < ES < -0.40) and T1 (-0.78 < ES < -0.49). Lymphocyte counts were lower at T3 as compared to T2 and T1 (p = 0.038, -0.48 < ES <-0.25), while NLR, PLR and SII were greater at T3 compared to T2 (0.001 < p < 0.015, -1.01 < ES < -0.44) and T1 (-0.99 < ES < -0.21). There was a negative correlation between YYIRL1 performance with NLR (r= -0.56; p = 0.02), PLR (r=-0,44, p = 0.015), and SII (r= -0.63; p = 0.01) after the congested period of match play (i.e., T3). Values for maximal oxygen uptake (VO2max), estimated from the YYIRL1 test, negatively correlated with NLR (r= -0.56; p = 0.02), PLR (r=-0,44, p = 0.015), and SII (p = 0.01; r= -0.63). There was a positive correlation between NLR, and SII with workload parameters. In addition, a clear positive correlation was observed between NLR and SII with competitive loadinstead (r= [0.59–0.64; p˂ 0.001), training load (TL) (r= [0.65–0.68]; p˂ 0.001), session rating of perceived exertion (S-RPE) (r= [0.65–0.68]; p = 0.001), and training volume (r= [0.60–0.61; p = 0.001).ConclusionAn intensive period of congested match play significantly alterated immune cell counts and cellular markers of inflammation (NLR, PLR and SII). Changes in NLR and SII were related to workload parameters, suggesting the usefulness of these markers in regulating training intensity and competitive load. An association between physical fitness (YYIRL1, VO2max) and NLR, PLR and SII suggests that these biomarkers are promising tools to monitor aerobic physical fitness of elite soccer players during congested periods of match play.

Predictive role of neutrophil percentage-to-albumin ratio, neutrophil-to-lymphocyte ratio, and systemic immune-inflammation index for mortality in patients with MASLD

There are no studies discussing the significance of neutrophil-to-lymphocyte ratio (NLR), neutrophil-percentage-to-albumin ratio (NPAR), and systemic immune-inflammation index (SII) in predicting poor prognosis in patients with metabolic dysfunction associated steatotic liver disease (MASLD); this study aimed to investigate the relationship between these three inflammatory markers and all-cause mortality and cardiovascular disease (CVD) mortality in patients with MASLD. Survival data for 3970 participants were obtained from National Death Index (NDI) records associated with the National Health and Nutrition Examination Survey (NHANES) dataset, the associations of NPAR, NLR, and SII with all-cause and CVD mortality were analyzed using multivariate COX regression modeling, restricted cubic spline (RCS) was used to explore nonlinear relationships and to determine the inflection point, regrouping was done according to the nonlinear inflection point, using multivariate COX regression modeling, subgroup analysis, and the Kaplan-Meier survival curves to evaluate differences in risk of death between the two groups. Time-dependent receiver operating characteristic curve (ROC) analysis was conducted to assess the predictive efficacy of NPAR, NLR, and SII on survival outcomes. Multivariate COX regression and RCS analyses revealed a positive linear correlation between NLR and all-cause and CVD mortality, whereas a nonlinear relationship was found between NPAR and SII and all-cause and CVD mortality. Further reclassified into two groups according to the inflection point, multivariate COX regression analyses showed a significant difference in the risk of death between the two NPAR groups (HR 1.37, 95% CI = (1.01, 1.86) for all-cause mortality and HR 2.03, 95% CI = (1.24, 3.32) for CVD mortality ) and no difference in the risk of death between the two SII groups (HR 1.11, 95% CI = (0.87, 1.42) for all-cause mortality and HR 1.35, 95% CI = (0.86, 2.12) for CVD mortality), and Kaplan-Meier survival curves showed that both all-cause and CVD mortality rates were higher in patients with MASLD above the NPAR inflection point (log-rank P < 0.05). Subgroup analyses showed that the associations between high levels of NPAR and all-cause mortality were generally consistent across populations (P interaction > 0.05). Also, COPD subgroups had a significant effect on the correlation between high levels of NPAR and CVD mortality (P interaction < 0.05). Time-dependent ROC show the predictive value of NPAR, NLR, and SII for all-cause and CVD mortality in MASLD patients. The correlation between NPAR and mortality was nonlinear, and NLR was linearly and positively correlated with mortality, Measuring NPAR and NLR may be useful in assessing risk and predicting prognosis in populations of patients with MASLD.

Predictive Factors for Primary and Secondary Nonresponders to Upadacitinib in Patients with Moderate-to-Severe Atopic Dermatitis: A Real-World Study.

Background: Some patients with atopic dermatitis (AD) do not sufficiently respond to upadacitinib, a Janus kinase 1 inhibitor. However, predictive factors for nonresponders remain unclear in real-world practice. Objective: To identify predictive factors for primary and secondary nonresponders to upadacitinib 15 mg; primary nonresponders are defined as patients with investigator's global assessment (IGA) >2 at week 12, while secondary nonresponders are defined as patients with IGA ≤2 at week 12 and IGA >2 at week 24. Methods: A prospective study was conducted from August 2021 to March 2024, involving 204 Japanese AD patients treated with upadacitinib 15 mg. Baseline clinical and laboratory indexes were compared between nonresponders and responders. Results: Primary nonresponders showed higher baseline eczema area and severity index (EASI), immunoglobulin E (IgE), thymus and activation-regulated chemokine (TARC), lactate dehydrogenase (LDH), neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) compared with responders. Secondary nonresponders had a higher proportion of previous systemic therapies, dupilumab, and corticosteroids. Conclusions: Higher baseline EASI, IgE, TARC, LDH, NLR, CRP, SII, and SIRI may predict primary nonresponders to upadacitinib 15 mg, while previous systemic dupilumab or corticosteroids may predict secondary nonresponders.

The association between systemic immune-inflammation index (SII) and early nosocomial infections after cardiopulmonary bypass surgery in children with congenital heart disease

BackgroundInfections occurring postoperatively in pediatric patients with congenital heart disease (CHD) following cardiopulmonary bypass (CPB) surgery pose a considerable challenge, affecting the duration of hospitalization, financial costs, and patient outcomes. Studies investigating the association between systemic immune-inflammation index (SII) and early infections after CHD surgery are very rare. This study seeks to delineate the link between SII and the occurrence of early nosocomial infections in pediatric patients undergoing CPB surgery for CHD.MethodsA cross-sectional analysis was performed on 325 pediatric patients who underwent CPB surgery for CHD between July 2020 and June 2023. The primary exposure was the SII value on the first postoperative day. The outcome was the occurrence of nosocomial infections within the first week following CPB surgery. Multivariable logistic regression models and subgroup analyses were employed to evaluate the association between SII and the risk of early nosocomial infections.ResultsThe median age of the study cohort was 4.4 years, with a male preponderance of 51.7%. The median SII value was recorded at 0.6 × 10^12/L. The rate of nosocomial infections within the first week post-CPB surgery was 53.5%. An inverse association was observed between SII and the incidence of early nosocomial infections. After controlling for multiple confounders, an increment of 1 × 10^12/L in SII corresponded to a 25% reduction in the likelihood of nosocomial infections (OR = 0.75; 95%CI: 0.57, 0.99; P = 0.044). Subgroup analyses substantiated the consistency of these findings.ConclusionsThe study demonstrated that an elevated SII corresponded to a reduced likelihood of early nosocomial infections after CPB surgery in children with CHD, a finding that merits additional investigation.

Combined systemic immune-inflammatory index and prognostic nutritional index predicts the efficacy and prognosis of ES-SCLC patients receiving PD-L1 inhibitors combined with first-line chemotherapy

BackgroundThere is a strong association between inflammation and the formation, progression, and metastasis of malignant tumors, according to earlier studies. Some composite inflammation-nutritional indicators, such as the systemic immune-inflammation index (SII) and the prognostic nutritional index (PNI), have a certain predictive effect on the prognosis of patients with small cell lung cancer (SCLC). However, the relationship between these indicators and the efficacy of immunotherapy in SCLC patients is still not well understood. Therefore, the purpose of this study was to explore how the pre-treatment SII-PNI score can predict the tumor response and prognosis of extensive-stage SCLC patients treated with PD-L1 inhibitors and first-line chemotherapy.MethodsThis research conducted a retrospective review of 70 ES- SCLC patients from December 2019 to January 2023. According to the SII-PNI score, all patients were categorized into three groups. Overall survival (OS) was assessed by implementing the Kaplan Meier and Cox regression models. In addition, we devised a nomogram and scrutinized its accuracy in prediction through receiver operating characteristic (ROC) curve analysis and visualized it by calibration plots. Subsequently, a risk classification system was established.ResultsPatients with higher SII-PNI scores exhibited notably poorer survival outcomes compared to their counterpart with low SII-PNI score (p=0.008), as well as poorer short-term curative effects (p=0.004). The results of the multivariate analysis revealed that the SII-PNI score (p=0.036) had an independent association with a less favorable OS. The nomogram has been demonstrated to be a reliable prognostic tool for ES-SCLC patients. A notable difference was identified between the two different levels of risk.ConclusionThe baseline SII-PNI score can serve as a reliable prognostic indicator for ES-SCLC patients receiving immunotherapy. Higher SII-PNI scores imply a worse prognosis.

High level of systemic immune inflammation index elevates delirium risk among patients in intensive care unit

Evidence regarding the effect of systemic immune-inflammation index on delirium occurrence is limited. This study aimed to investigate the association between SII and delirium in intensive care unit (ICU) patients. Methods: Information was extracted from Medical Information Mart for Intensive Care-IV. Four logistic regression model was established and incorporated with subgroup analysis and restricted cubic spline (RCS). The cutoff value of SII was acquired from receiver operator characteristic curve (ROC), and propensity score matching (PSM) was utilized to attenuate the confounding effect. Survival analysis was utilized to evaluate the relationship between SII and 30-day or 90-day all-cause mortality. Results: Among the 7,518 participants, 1,685 cases of delirium occurred. Individuals in the highest quartile of SII exhibited a heightened delirium risk, with a significant multivariable-adjusted odds ratio (OR) of 3.12(2.24,4.33). Tendency analysis, subgroup analysis and PSM together confirmed the positive relationship. Results of Cox regression displayed the risk of both 30-day and 90-day mortality increased about 50% in the higher-SII group. Conclusion: Higher levels of SII is positively associated with the occurrence of delirium and increased all-cause mortality risk.

Neutrophil but not lymphocyte response to matched interval and continuous running differs between protocols and sex.

When considering the acute effects of different modalities of endurance training on cellular immune components, the matching of duration and mean intensity and the consideration of sex-dependent differences have received less attention so far. The aim of the study was to compare the effects of interval running (IR) vs. continuous running (CR) on circulating immune cells and cellular immune inflammation markers. Additionally, we analyze sex-dependent differences in these effects. In a cross-over study design, 24 recreational runners completed a mean intensity and duration-matched session of IR and CR. Blood samples were taken immediately before, after, and 1h after exercise cessation for cell counts and cortisol level quantification. Neutrophil counts showed a sustained increase after both exercise modalities with significantly greater values after IR compared to CR at 1h after exercise and greater increases in females. Neutrophil-to-lymphocyte ratio and systemic immune-inflammation index increased 1h after exercise with significantly higher values after IR compared to CR with greater values in females. Platelet-to-lymphocyte ratio decreased in both immediately after IR and 1h after exercise in both sexes and modalities. The cortisol level shows a lower value immediately after CR compared to IR with no sex-dependent differences. The IR protocol induces greater immune cell mobilizations in comparison to CR, which is primarily based on a systemic increase in neutrophil counts. Neutrophil-to-lymphocyte ratio and systemic immune-inflammation index are suitable to distinguish this effect between training modalities. Sex-dependent differences confirm that biological sex influences the immune cells response to acute exercise. Protocol registration:German Clinical Trials Register,DRKS00017686,Date of registration: 11.02.2020.

The Effect of Systemic Immune-Inflammatory Index (SII) and Prognostic Nutritional Index (PNI) in Early Gastric Cancer.

In recent years, the systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI) have been considered potential predictors of survival outcomes in various solid tumors, including gastric cancer. However, there is a notable lack of research focusing on their prognostic implications specifically in the early stage of gastric cancer. This study aims to investigate the prognostic indicators of early gastric cancer (EGC), including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), SII, PNI, and lymph node metastasis (LNM). In this retrospective analysis, we examined 490 patients diagnosed with EGC (pT1Nx). The peripheral blood indices of interest were SII, PNI, PLR, and NLR. The receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC) were used to determine optimal cutoff values and prognostic efficacy for each parameter. Additionally, Kaplan-Meier survival curves and multivariate Cox regression models were utilized to delineate independent prognostic factors. The optimal cutoff values for SII and PNI were determined as 613.05 and 42.21, respectively. Patients in the low SII (SII-L) group demonstrated significantly higher 5-year Disease-Free Survival (DFS) and Overall Survival (OS) rates of 94.7% and 96.2%, compared to the high SII (SII-H) group (DFS: 78.7%; OS: 81.9%), with both differences proving statistically significant (P < 0.001, P < 0.001). Similarly, patients in the high PNI (PNI-H) group showed superior 5-year DFS (93.3%) and OS rates (95.1%) versus the low PNI (PNI-L) group (DFS: 71.4%; OS: 74.3%), also demonstrating statistical significance (P < 0.001, P < 0.001). Multivariate analysis identified SII, PNI, and LNM as independent prognostic factors for EGC. A combined analysis of SII, PNI, and LNM yielded a C-index of 0.723 (P = 0.008). SII, PNI, and LNM are effective markers for predicting the survival outcomes of patients undergoing radical gastrectomy for EGC.

Evaluation of the immature granulocyte count in idiopathic sudden sensorineural hearing loss

Aims: The purpose of our study was to show whether the immature granulocyte count (IGC) can be used as a prognostic marker in idiopathic sudden sensorineural hearing loss (ISSNHL). Methods: This study is a retrospective case-control clinical study. Patients presenting to our clinic between June 2019 and June 2022, diagnosed with ISSNHL, and receiving the same treatment protocol were investigated. Preoperative complete blood count values of 40 normal individuals with normal hearing who presented to our clinic due to nasal septum deviation were adopted as the control group. Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) (platelet × neutrophil / lymphocyte) values were calculated in addition to IGC values in complete blood counts from the patient and control groups. The patient group was classified into treatment-responsive and non-responsive subgroups according to the results of audiological examinations performed after one month based on Siegel’s criteria. IGC, SII, NRL, and PLT values were compared between all groups. Results: Comparison of the patient and control group’s complete blood count data revealed higher leukocyte and neutrophil counts, IGC and also NLR, PLR, and SII values in the patient group compared to the control group. However, lymphocyte counts were lower in the patient group. None of the parameters previously emerging as significant in the data of patients with healing and non-healing idiopathic sudden hearing loss were statistically significant, and IGC is of no prognostic value in ISSNHL. Conclusion: IGC may be a novel and inexpensive indicator of ISSNHL and one easily determined with complete blood count, but it is of no prognostic value in the disease.

Single and Joint Associations Between Blood Cell-Based Inflammatory Indicator in Early Pregnancy and Risk of Gestational Diabetes Mellitus (GDM): A Prospective Cohort Study.

This study aims to introduce the Bayesian kernel machine regression (BKMR) model to explore the single and joint associations between exposure to blood cell-based inflammatory in early pregnant women and gestational diabetes mellitus (GDM). The study included 536 singleton pregnant women from the Zunyi Birth Cohort. Logistic regression, restricted cubic spline regression, and BKMR were used to investigate single, nonlinear, and combined associations. In this study, the adjusted odds ratio (OR) of white blood cell (WBC), neutrophil (NEUT), monocyte (MONO), platelet (PLT), neutrophil-to-lymphocyte ratio (NLR), and systemic immune inflammation index (SII) were 2.20 (95% confidence interval [CI]: 1.43-3.37), 2.27 (95% CI: 1.48-3.48), 1.67 (95% CI: 1.09-2.57), 1.66 (95% CI: 1.07-2.58), 1.65 (95% CI: 1.08-2.54), and 1.89 (95% CI: 1.23-2.91), respectively. Nonlinear associations of WBC (cutoff level: 7.91×109/L) and NEUT (cutoff level: 5.52×109/L) with GDM were also observed. Furthermore, BKMR analysis showed that the risk of GDM was linked with increased levels of blood cell-based inflammatory indicators. In early pregnancy, multiple blood cell-based inflammatory indicators are significantly positively correlated with the risk of GDM. Specifically, WBC and NEUT counts exhibit the most prominent association with GDM risk. Therefore, more attention should be paid to the inflammation levels of early pregnant women.

Predictive Value of Pan-Immune Inflammation Value and Systemic Immune-Inflammation Index for Identifying Coronary Vulnerable Plaques: New Insights from Optical Coherence Tomography in Acute Coronary Syndrome Patients.

The predictive value of PIV and SII in identifying vulnerable plaques among ACS patients remains poorly understood. This study represents the inaugural use of OCT to identify vulnerable plaques and establishes a predictive model incorporating PIV and SII, enhancing clinical treatment strategies. A total of 523 eligible ACS patients underwent coronary angiography and OCT. Clinical data were collected and analyzed. Multifactorial logistic regression was employed to identify factors influencing TCFA. Receiver operating characteristic (ROC) curves were constructed to assess the diagnostic accuracy of the PIV and SII for TCFA, with a calculation of the area under the ROC curve (AUC). The optimal cutoff values for PVI and SII were calculated. Compared to the non-TCFA group, the TCFA group exhibited significantly higher levels of hypersensitive C-reactive protein (hs-CRP), PIV, and SII (all P <0.05). Multifactorial logistic regression analysis revealed that PIV (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.35-2.06; P <0.001) and SII (OR, 1.52; 95% CI, 1.14-2.08; P <0.001) were independent risk factors for TCFA development. The optimal cutoff value for PIV was 490.7, achieving a diagnostic sensitivity and specificity of 75.44% and 89.32%, respectively. For SII, the optimal cutoff value was 802.9, with a diagnostic sensitivity and specificity of 67.54% and 79.61%, respectively. This study suggests that PIV and SII can serve as noninvasive, practical, and cost-effective biomarkers for evaluating plaque vulnerability in patients with ACS.

Strong Positive Correlations Between the Levels of Systemic Inflammation Markers and the Occurrence of Persistent Atrial Fibrillation.

In this study, a retrospective analysis was conducted to investigate the associations between systemic inflammation markers and persistent atrial fibrillation (pAF), intending to identify potential biomarkers for early detection of pAF.In the analysis, a total of 207 patients were included, with 109 in the pAF group and 98 in the non-pAF group. The associations between three systemic inflammation markers were investigated, namely, the systemic immune inflammation index (SII), system inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI), and pAF.The proportion of pAF showed a gradual increase with increasing logSII, logSIRI, and logAISI tertiles. Compared with those in the lowest tertiles, those in the highest logSII and logSIRI tertiles had 3.196- and 2.884-fold higher risks of developing pAF, respectively. Nonetheless, no significant correlation between logAISI and pAF risk was observed in the highest tertile of logAISI. The restricted cubic spline analysis revealed a nonlinear relationship between the elevation of systemic inflammation markers and the risk of pAF, with logSII ≥ 2.56, logSIRI ≥ -0.10, and logAISI ≥ 2.28 identified as significant predictors. The receiver operating characteristic analysis of logSII, logSIRI, and logAISI showed AUC values of 0.629, 0.721, and 0.646, respectively. It also presented favorable sensitivity and specificity of these systemic inflammation markers in detecting the presence of pAF.To conclude, our cross-sectional study shows significant positive correlations between the SII, SIRI, and AISI with the incidence of pAF.

Inflammation-related markers in COVID-19 infection and ST-segment elevation myocardial infarction.

The aim of this study is to investigate the association between inflammation-related markers in COVID-19 infection and ST-segment elevation myocardial infarction (STEMI). We conducted an observational, single-center, retrospective study between January 2020 and November 2022. A total of 149 patients aged between 34 and 90 years, 28.2% (N.=42) female and 71.8% (N.=107) male, were included in the study. Systemic immune-inflammation index (SII), systemic inflammation-response indexes (SIRI), platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) were calculated for each patient. The patients were divided into two groups based on their presence or absence of a confirmed SARS-CoV-2 infection. During the in-hospital follow-up, mortality occurred in 12% (N.=20) of patients. Among the COVID-19 (+) and STEMI group, the mortality rate was 24.3% (N.=10), while it was 5.6% (N.=6) in the COVID-19 (-) and STEMI group (P=0.001). In multivariate logistic regression analysis, SII ([HR] = 7.198 [1.423-36.411], P=0.017) and PLR ([HR] = 5.762 [1.783-18.619], P=0.003) remained significant risk factor for mortality. The SII, SIRI, NLR, and PLR are relatively new, simple, and effective inflammation-related markers that determine mortality risk in STEMI patients.

Volatile organic compounds (VOC) metabolites in urine are associated with increased systemic inflammation levels, and smokers are identified as a vulnerable population

BackgroundPrevious studies indicated that exposure to VOCs was linked to increased systemic inflammation levels. However, the dose-response relationships between urine VOCs metabolites and systemic inflammation have not been established, and the key metabolite of the toxic compounds has not been identified. MethodsWe used data in 7007 US adults in the NHANES cycles (2011–2018) across 8 years. Urinary VOC metabolites were measured using ultra-performance liquid chromatography and electrospray tandem mass spectrometry (UPLC-ESI/MSMS). VOC metabolites were adjusted by urinary creatinine level before analysis. Systemic inflammation was assessed by systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) indices. Generalized linear models, restricted cubic splines (RCS), and weighted quantile sum (WQS) regression were applied to evaluate the associations, exposure-response (E-R) curve and identify the key contributor compound, adjusting for gender, age, race, BMI, marital condition, education level, smoking level, alcohol consumption and physical activity. Smoking status was assessed as an effect modifier. ResultsSignificant and robust positive correlations were found between 8 VOC metabolites and both SII and SIRI. They were N-Acetyl-S-(2-carboxyethyl)-L-cysteine (CEMA), N-Acetyl-S-(2-cyanoethyl)-L-cysteine (CYMA), N-Acetyl-S-(3,4-dihydroxybutyl)-L-cysteine (DHBMA), N-Acetyl-S-(3-hydroxypropyl)-L-cysteine (3HPMA), mandelic acid (MA), N-Acetyl-S-(4-hydroxy-2-butenyl)-L-cysteine (MHBMA3), phenylglyoxylic acid (PGA), and N-Acetyl-S-(3-hydroxypropyl-1-methyl)-L-cysteine (HPMMA). The RCS curves showed J-shaped or exponential shaped E-R relationships for most VOC metabolites. WQS regression found that exposure to the mixture of VOC metabolites was related to increased systemic inflammation, and MA was the key VOC metabolite contributing most to systemic inflammation levels. Smokers exhibited higher levels of urinary VOCs and larger susceptibility to VOC-related increases in SII and SIRI compared to non-smokers. ConclusionThis study demonstrated a strong link between urinary VOC metabolites and increased systemic inflammation, and smokers were more susceptible. Our findings highlighted the significance of reducing VOC exposure to mitigate the inflammation levels, particularly for smokers.

Systemic Immune Inflammation Index, Systemic Inflammation Response Index, Aggregate Index of Systemic Inflammation, and Follistatin-Like Protein-1 Levels in Children Diagnosed with Pneumonia.

Background: This study aims to evaluate systemic immune inflammation index, systemic inflammatory response index (SIRI), aggregate index of systemic inflammation (AISI), and follistatin-like protein-1 (FSTL-1) levels in children with pneumonia and healthy controls. Methods: The study was carried out at the Seydisehir State Hospital between February 1, 2024 and June 1, 2024. The patient group included 44 children diagnosed with pneumonia and the control group included 45 healthy children without any disease. Index values obtained from hemogram data. Enzyme-linked immunosorbent assay was used to measure FSTL-1 levels. Results: A total of 89 participants, 44 in the patient group and 45 in the healthy control group, were included in the study. White blood cells, monocyte, eosinophil, neutrophil, c-reactive protein, SIRI, and AISI levels were significantly higher in the patient group than in the control group. FSTL-1 levels were higher in the patient group, but did not differ statistically significant. The patient and control groups were compared in the receiver operating characteristics analysis, we found the highest area under curve (AUC) in the SIRI (AUC: 0.754) and AISI (AUC: 0.713) parameters. Conclusion: In conclusion, compared to healthy controls, SIRI and AISI levels were significantly higher in the patient group, and the highest AUC values belonged to these indices. Therefore, we believe that SIRI and AISI indices, which are inexpensive and simple tests, are useful for early diagnosis and treatment of pneumonia.