Systemic Immune-inflammation Index Research Articles

A Comparative Study of the Aggregate Index of Systemic Inflammation (AISI) and C-Reactive Protein (CRP) in Predicting Odontogenic Abscesses Severity: A Novel Approach to Assessing Immunoinflammatory Response

Background/Objectives: Odontogenic abscesses are a common cause of emergency visits to oral and maxillofacial surgery departments and can lead to life-threatening complications if they are not recognized and treated promptly. The aim of this study was to evaluate the prognostic value of the Aggregate Index of Systemic Inflammation (AISI) in comparison to other systemic inflammatory indices, including the Systemic Immune Inflammation Index (SII), the Neutrophil-to-Lymphocyte Ratio (NLR), the Platelet-to-Lymphocyte Ratio (PLR), and the Lymphocyte-to-Monocyte Ratio (LMR), in predicting the severity of odontogenic abscesses. Methods: This retrospective study included 221 patients hospitalized for odontogenic abscesses at Dubrava University Hospital between January 2019 and December 2023. Clinical and laboratory data, including AISI, SII, NLR, PLR, and LMR, were collected. The severity of the abscesses was assessed using the Symptom Severity (SS) Score and patients were categorized into less severe and severe groups based on their scores. An ROC curve analysis was used to assess the predictive accuracy of each inflammatory index. Results: The AISI was identified as the most effective predictor of abscess severity and had the highest sensitivity (SE = 82.93) and specificity (SP = 81.63) among the indices analyzed. It outperformed C-reactive protein (CRP) in predicting severe abscesses with an AUC of 0.90 compared to 0.74 for CRP. In addition, AISI showed significant correlations with length of hospital stay and the occurrence of systemic inflammatory response syndrome (SIRS). Conclusions: The AISI index is a better predictor of odontogenic abscess severity compared to other systemic inflammatory markers and CRP. Its integration into clinical practice could improve the early detection of high-risk patients, leading to better treatment outcomes and lower risks of complications.

The value of the systemic immune-inflammation index in assessing disease severity in autoimmune encephalitis

Background Autoimmune encephalitis (AE) is a group of autoimmune diseases targeting the central nervous system, characterized by severe clinical symptoms and substantial consumption of medical resources. Neuroinflammation plays a crucial role in disease progression, and detecting inflammatory responses can provide insights into disease status and disease severity. The systemic immune-inflammation index (SII), a novel marker of inflammatory status, has been rarely studied in AE. Methods Retrospective analysis of data from AE patients admitted to the First Affiliated Hospital of Zhengzhou University between January 2019 and September 2023 was conducted. Univariate analysis and logistic regression were used to assess the association between SII and patient severity. Nomograms for predicting AE severity were established, and receiver operating characteristic (ROC) curves, concordance index (C-index), calibration curves, and decision curve analysis were employed to evaluate predictive accuracy. Additionally, the Clinical Assessment Scale in Autoimmune Encephalitis (CASE) score was used to assess patient severity. Results This study enrolled 157 patients, of whom 57 were classified as severe according to the CASE score. SII, cerebrospinal fluid (CSF) cell counts, disturbance of consciousness, and behavioural abnormalities independently associated with the occurrence of severe cases. The C-index of the nomograms was 0.87, indicating strong association with disease severity, as supported by the calibration. Additionally, SII levels were highest within seven days of onset and decreased after one month. In subgroup analyses of different antibodies, SII also associations with severe cases in NMDAR encephalitis. Conclusions Higher SII levels are associated with an increased likelihood of developing severe AE, peaking within 7 days of disease onset and decreasing thereafter, potentially offering a prognostic marker to assess disease progression early in its course.

Association between tooth loss and depression mediated by lifestyle and Inflammation- a cross-sectional investigation

BackgroundDepression and tooth loss are associated with the occurrence of systemic disease or the progression of multi-factorial disease, and both are considered important public health issues by World Health Organization (WHO). Previous research just suggested that tooth loss can generate psychological stress, low self-esteem, anxiety and other emotional disturbances. However, the precise correlation and underlying mechanisms between depression and tooth loss remains poorly understood. ​Consequently, we aim to explore the association between depression and tooth loss through a cross-sectional study, as well as investigate potential pathways of influence.MethodsWe analyzed data from the National Health and Nutrition Examination Survey (NHANES). Logistic regression models were employed to examine the relationship between depression and tooth loss, as well as the associations among healthy lifestyle, systemic immune-inflammation index (SII), depression and tooth loss. Through the mediating effect analysis by bootstrapping analysis, we evaluated the mediating effects of healthy lifestyle and SII between depression and tooth loss.ResultsDepressed patients were more likely to be toothless, and at the same time showed a tendency to have more missing teeth, with odds ratio (OR) = 1.305 (1.098, 1.551), p = 0.003 for 1–7 missing teeth, OR = 1.557 (1.166, 2.079), p = 0.003 for 8–14 missing teeth, and OR = 1.960 (1.476, 2.603), p<0.001 for 15–28 missing teeth. Lower healthy lifestyle scores and higher SII were both associated with more tooth loss. Healthy lifestyle and SII played a partial mediating role in this relationship, with a mediating effect ratio of 41.691% and 3.289%, respectively.Conclusions​Depression was positively associated with more severe tooth loss, which was partly mediated by lifestyle and SII. Therefore, attention should also be paid to the effects of depression as a mental disorder on physical health, such as depression and tooth loss. Adopting a healthier lifestyle and controlling systemic inflammation may be potential ways to reduce the impact of depression and tooth loss.

Predictive value of platelet-to-albumin ratio combined with the C2HEST score for New-Onset atrial fibrillation in elderly patients with acute ST-segment elevation myocardial infarction

BackgroundNew-onset atrial fibrillation (NOAF) is a common adverse outcome in acute ST-segment elevation myocardial infarction (STEMI) patients following percutaneous coronary intervention (PCI) and is associated with a worse prognosis. The platelet-to-albumin ratio (PAR) has been utilized to predict the severity and prognosis of cardiovascular diseases. This study aims to investigate the predictive value of PAR combined with the C2HEST score for NOAF in the elderly population with STEMI undergoing PCI.Methods445 elderly STEMI patients without a history of atrial fibrillation (AF) who underwent PCI were consecutively enrolled in this study. Multivariate logistic regression analysis was used to identify independent risk factors for NOAF after PCI.Results50 patients (11.2%) developed NOAF after PCI. Multivariate logistic regression analysis revealed that heart rate (HR), systemic immune-inflammation index (SII), uric acid (UA), PAR, and C2HEST score were independent risk factors for NOAF. The area under the curve (AUC) of the combined PAR and C2HEST score was 0.839, and Delong’s test indicated that the combined model had superior predictive value compared to individual markers (AUC of PAR: 0.738; AUC of C2HEST score: 0.752) (P < 0.05). The addition of PAR and C2HEST score to this model (HR, SII, and UA) significantly improved the reclassification and discrimination ability (IDI 0.175; NRI 0.734, both P < 0.001). During regular follow-up, the incidence of MACE was higher in the NOAF group compared to the non-NOAF group.ConclusionThe combination of PAR and the C2HEST score has a high predictive value for NOAF in elderly STEMI patients following PCI.

Preoperative monocyte-to-lymphocyte ratio as a prognosis predictor after curative hepatectomy for intrahepatic cholangiocarcinoma

BackgroundSeveral inflammatory indicators have been reported to have predictive value in many types of malignant cancer. This research was aimed to explore the ability of the monocyte-to-lymphocyte ratio (MLR) to predict prognosis in patients with intrahepatic cholangiocarcinoma (ICC) who subjected to curative hepatectomy.MethodsThis retrospective analysis included 196 patients with ICC who underwent curative hepatectomy between May 2018 and April 2023. The predictive abilities of the preoperative MLR in assessing overall survival (OS) and disease-free survival (DFS) in those patients were compared with other inflammation-based scores, including monocyte-to-white ratio, neutrophil-to-lymphocyte ratio, neutrophil-to-white ratio, platelet-to-lymphocyte ratio, platelet-to-white ratio, and systemic immune-inflammation index, as well as tumor markers, like carcinoembryonic antigen (CEA) and carbohydrate antigen 19 − 9 (CA19-9).ResultsThe area under the time-dependent receiver operating characteristic curve indicated that the preoperative MLR had higher predictive efficiency in contrast with other inflammation-based scores and tumor markers in assessing OS and DFS. Stratifying patients according to the optimal cut-off value for the preoperative MLR, the data showed that both OS and DFS in the high MLR group were significantly worse than those in the low MLR group (p < 0.05 for all). Univariable and multivariable Cox analyses revealed that the preoperative MLR was an independent risk factor for OS and DFS in patients with ICC. In addition to predicting OS in patients with high CEA levels and predicting DFS in patients with high CA19-9 levels, patients with different CEA and CA19-9 levels were divided into completely different OS and DFS subgroups based on the risk stratification of the preoperative MLR.ConclusionsOur results demonstrated that the preoperative MLR was a good prognosis indicator to predict DFS and OS following curative hepatectomy in patients with ICC.

The prognostic impact of the pan-immune-inflammation value (PIV) on the efficacy of treatment and clinical outcomes in patients with extensive-stage small cell lung cancer (ES-SCLC)

Aims: This study aimed to assess the prognostic and predictive implications of pre-treatment pan-immune-inflammation value (PIV) on treatment efficacy and clinical outcomes in patients with extensive-stage small-cell lung cancer (ES-SCLC), comparing it with established indices such as the systemic immune-inflammation index (SII) and neutrophil to lymphocyte ratio (NLR). Methods: A retrospective cohort study included 70 patients diagnosed with ES-SCLC treated with standard chemotherapy with or without immune checkpoint inhibitors. PIV was calculated as PIV=(neutrophils×platelets×monocytes)÷lymphocytes. Patients were categorized into low PIV (

The Model for End-Stage Liver Disease (MELD) Score Predicting Mortality Due to SARS-CoV-2 in Mexican Patients.

Background/Objectives: Coronavirus Disease 2019 (COVID-19) can cause liver injury and a deterioration of hepatic function. The Model for End-Stage Liver Disease (MELD) score is a good predictor for poor prognosis of hospitalized COVID-19 patients in the United States, Egypt and Turkey. Nevertheless, the best cut-off value for the MELD score to predict mortality in the Mexican population has yet to be established. Methods: A total of 234 patients with COVID-19 were studied in a tertiary-level hospital. Patients were stratified into survivors (n = 139) and non-survivors (n = 95). Receiver operating characteristic curves, Cox proportional hazard models, Kaplan-Meier method, and Bonferroni corrections were performed to identify the predictors of COVID-19 mortality. Results: MELD score had an area under the curve of 0.62 (95% CI: 0.56-0.68; p = 0.0009), sensitivity = 53.68%, and specificity = 73.38%. Univariate Cox proportional hazard regression analysis suggested that the leukocytes > 10.6, neutrophils > 8.42, neutrophil-to-lymphocyte ratio (NLR) > 8.69, systemic immune-inflammation index (SII) > 1809.21, MELD score > 9, and leukocyte glucose index (LGI) > 2.41 were predictors for mortality. However, the multivariate Cox proportional hazard model revealed that only the MELD score >9 (Hazard Ratio [HR] = 1.83; 95% confidence interval [CI]: 1.2-2.8; Pcorrected = 0.03) was an independent predictor for mortality of COVID-19. Conclusions: Although the MELD score is used for liver transplantation, we suggest that a MELD score >9 could be an accurate predictor for COVID-19 mortality at admission to ICU requiring mechanical ventilation.

Association of systemic immune-inflammation index with body mass index, waist circumference and prevalence of obesity in US adults

This study aims to investigate the potential relationships between the systemic immune-inflammation index (SII) and body mass index (BMI), waist circumference, and the prevalence of obesity. A cross-sectional analysis was conducted on 7,645 individuals aged 20 and above from the NHANES 2017–2020. Multivariate linear regression analyses were conducted to evaluate the association of the logarithmically transformed SII (lgSII) with BMI and waist circumference. Additionally, multivariable logistic regression was utilized to explore the relationship between lgSII and the prevalence of obesity. Fitted smoothing curves and threshold-effect analysis were applied to elucidate nonlinear relationships. In the fully adjusted model, a positive relationship was observed between lgSII and BMI, waist circumference, and obesity prevalence (β = 3.13, 95% CI 2.10–4.16; β = 7.81, 95% CI 5.50–10.13; OR = 1.44, 95% CI 1.12–1.86). The variables of gender, age, race, education, marital status, poverty income ratio (PIR), energy intake, sleep disorder, smoking status, and alcohol use did not significantly modify the positive association between lgSII and obesity. However, physical activity appeared to influence the positive correlation between lgSII and obesity. Using a two-segment linear regression model, an inverted U-shaped relationship was observed between lgSII and both BMI and waist circumference. Furthermore, lgSII demonstrated a linear positive correlation with obesity prevalence. When stratified by physical activity, lgSII showed a non-significant negative correlation with obesity in the physically active group. Our findings underscore a robust association between the logarithmically transformed SII and BMI, waist circumference, and the prevalence of obesity.

Prognostic role of systemic immune-inflammation index versus other cardiac markers in acute myocarditis in young adults.

Aim: Myocarditis, an inflammatory disease of the myocardium, can range from asymptomatic cases to severe forms such as fulminant myocarditis. The systemic immune-inflammation index (SII) has emerged as a potential biomarker for various inflammatory diseases. This study aimed to determine the effect of SII on the prognosis of young adults with acute myocarditis and compare it with other cardiac markers.Methods: We retrospectively analyzed patients aged 18-40years who were admitted to the emergency department with a diagnosis of acute myocarditis between January 2014 and January 2024. Patients were divided into non-fulminant and fulminant myocarditis groups based on diagnostic criteria.Results: SII, troponin I and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were significantly higher in the fulminant myocarditis group (p<0.001 for all). Logistic regression analysis identified SII and NT-proBNP as independent predictors of fulminant myocarditis but not for troponin I (p=0.064). The optimal cutoff value for SII in diagnosing fulminant myocarditis was 1020, with a sensitivity of 91% and specificity of 83%, outperforming troponin I. Patients with SII ≥1020 had a significantly higher risk of adverse outcomes.Conclusion: The SII enables early detection of adverse outcomes and is an independent predictor of prognosis in young adults with myocarditis.

Associations between neutrophil-percentage-to-albumin ratio level and all-cause mortality and cardiovascular disease-cause mortality in general population: evidence from NHANES 1999-2010.

Chronic inflammation is a recognized independent risk factor for cardiovascular disease (CVD), highlighting the need for reliable inflammatory indicator to predict CVDs. As an inflammatory indicator which has been proved to have predictive value for prognosis of CVDs, neutrophil percentage-to-albumin ratio (NPAR) has obtained increasing attention, but further research is needed to confirm the relationship with mortality in the general population. This prospective cohort study included 21,317 individuals who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010, where baseline characteristics and NPAR level were extracted. Data for CVD and all-cause mortality were acquired by linking the cohort database with the National Death Index through December 31, 2019. We employed restricted cubic spline analyses to examine the nonlinear association. Weighted Kaplan-Meier curves with log-rank tests were conducted to access cumulative survival differences across different NPAR results. Multivariable Cox proportional hazards regression models were used to compute hazard ratios and 95% CIs. Receiver Operating Characteristic (ROC) curves were used to compare predictive value of NPAR with systemic immune inflammation index (SII) and neutrophils percent. In this cohort study, during 270,014 person-years of follow-up, 4,074 all-cause deaths and 1,116 CVD-cause deaths were documented. NPAR levels exhibited significant nonlinear associations with both CVD-cause (P = 0.018 for nonlinearity) and all-cause mortality (P < 0.001 for nonlinearity). Participants in the highest NPAR tertile had a significantly increased risk of all-cause mortality (HR: 1.46, 95% CI: 1.33-1.61) and CVD-cause mortality (HR: 1.54, 95% CI: 1.32-1.80) compared to those in the lowest tertile in the fully adjusted model, while no association was detected for individuals in the middle tertile. Further ROC analysis confirmed that NPAR had higher predictive value than neutrophil percent segment and SII. Elevated NPAR level was significantly associated with an increased risk of all-cause and CVD-cause mortality in general population. The high predictive value of NPAR, combined with the easy-to-calculate property, suggests that its potential as a novel inflammatory indicator is worthy of further investigation.

The relationship between leukocyte-based inflammation indices and essential tremor

Aim: Previous limited studies have indicated that pro-inflammatory cytokines are elevated in patients with essential tremor (ET). This elevation could lead to a more pronounced inflammatory response in these patients. Thus, this study aimed to investigate the relationship between leukocyte-based inflammatory indices and ET. Material and Methods: In this retrospective study, 103 patients diagnosed with ET between January 2021 and December 2023 were included, along with 103 healthy individuals who were matched by age and gender, participated in check-up programs, and had no other comorbidities. To evaluate tremor severity, the Fahn-Tolosa-Marin (FTM) tremor rating scale was utilized. The leukocyte-based inflammatory indices were calculated as follows: NLR= neutrophils / lymphocytes, PLR = platelets / lymphocytes, systemic immune-inflammation index (SII) = platelets × neutrophils / lymphocytes, and systemic inflammatory response index (SIRI) = neutrophils × monocytes / lymphocytes. Results: The ET group exhibited higher levels of leukocytes, their subtypes, CRP and leukocyte-based inflammatory indices compared to the control group. Increased CRP (OR= 3.71, p &lt; 0.001) and SIRI (OR= 11.73, p &lt; 0.001) levels were independent predictors of ET. In predicting ET. SIRI exhibited superior diagnostic performance compared to other inflammatory parameters. The threshold for SIRI levels was set at 7 and above, with a sensitivity of 85.4% and a specificity of 82.5%. There was a positive correlation between SIRI and FTM scores. Conclusion: Among the leukocyte-based inflammation indices, SIRI demonstrated superior diagnostic performance in predicting ET and was associated with higher tremor severity. This suggests that inflammation may play a potential role in the pathophysiology of ET.

A novel analysis of interoceptive underpinnings of anxious psychopathology in COVID-19 survivors

IntroductionSARS-CoV-2 affects brain, body, and their interchange. We investigated interoceptive mechanisms in COVID-19 survivors focusing on their potential link with psychopathology and inflammatory biomarkers. MethodsWe assessed interoceptive accuracy (IAc) and time-perceiving (TA) skills of 57 COVID-19 survivors one month after hospital discharge through, respectively, a heartbeats perception task and a time duration task. Each participant was assessed about his interoceptive awareness (IAw) through Multidimensional Assessment of Interoceptive Awareness questionnaire (MAIA) and then, screened for post-traumatic (Impact of Events Scale – IES-R), anxious (State-Trait Anxiety Inventory – STAI-Y1) and depressive (Zung Self-Rating Depression Scale - ZSDS; Beck Depression Inventory - BDI-13) symptoms.Biomarkers of inflammation (platelet count, PC; mean platelet volume, MPV and systemic immune-inflammation index, SII) were obtained in a subsample of 40 survivors by a blood sampling conducted at admission and discharge time from the hospital. Correlational, GLM, GLMZ, and mediation analyses were performed. ResultsIAc did not correlate with TA confirming the reliability of interoceptive measure. IAc positively predicts MAIA’s Trusting subscale and negatively predicts anxious psychopathology which fully mediates the effect of IAc on Trusting.PC at hospital admission predicts anxiety at one month after recovery. Again, a higher decrease of SII during hospitalization predicts higher IAc skill and lower anxiety state at one month. The link between SII change and anxiety is fully mediated by IAc. ConclusionsOur results unveil a potential key role of interoception and brain-body interchange in the exacerbation and maintenance of anxiety psychopathology in COVID-19 survivors.

Body Mass Index Combined With Inflammatory Factors Can Better Predict Varicocele.

Most patients with VC have no symptoms, so they are often discovered due to male infertility. Early identification of them is a matter of concern for clinicians. A retrospective analysis of clinical data from patients between January 1, 2021, and February 1, 2024, was conducted. Patients were divided into VC and non-VC groups. Propensity score matching (PSM) was performed at a ratio of 1:1, and two cohorts with homogeneous baseline status were selected. Multivariate binary logistic regression and receiver operating characteristic (ROC) curve were used to analyze independent risk factors and protective factors and to evaluate their diagnostic value individually and in combination. A p-value <0.05 was considered statistically significant. A total of 256 patients with similar clinical characteristics were further analyzed after PSM in a 1:1 ratio of the 423 patients included in the study. The two groups had statistically significant differences in systemic immune-inflammation index (SII), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and body mass index (BMI) (p<0.05). Multivariate binary logistic regression analysis showed that SII and NLR were independent risk factors for VC, while high BMI could reduce the prevalence of VC. The PLR differences were not significant. The ROC analysis showed that BMI, SII, and NLR could predict VC, with areas under the curve of 68.3% (cut-off value 22.32), 83.4% (cut-off value 357.57), and 83.2% (cut-off value 1.8), respectively. The combination of BMI and inflammatory factors was more accurate for predicting VC than BMI alone (87.5% vs. 68.3%, p=0.0001), SII (87.5% vs. 83.4%, p=0.0106), and NLR (87.5% vs 83.2%, p=0.0058). Both SII and NLR are independent risk factors for VC while BMI is an independent protective factor. The BMI, SII, and NLR values have the potential to predict VC. The BMI combined with these inflammatory factors can improve the accuracy of prediction.

Congential nasolacrimal duct obstruction: investigating the role of systemic inflammation through novel biomakers.

Congenital nasolacrimal duct obstruction (CNLDO) is a common lacrimal system anomaly in newborns and infants. We aimed to evaluate the role of inflammation in the pathogenesis of persistent CNLDO and its potential use in diagnosis and follow up, focusing on novel inflammatory biomarkers: Systemic Immune-Inflammation Index (SII), Neutrophil-to-lymphocyte ratio (NLR), Platelet-to-lymphocyte ratio (PLR), Red cell distribution width (RDW), and Mean platelet volume (MPV). A retrospective case-control study involving 76 CNLDO patients and 47 age-matched healthy controls was conducted. Complete blood count parameters were analyzed to calculate SII, NLR, PLR, RDW, and MPV. Receiver Operating Characteristic (ROC) analysis determined the diagnostic efficacy of these markers. SII, RDW, and neutrophil count were significantly elevated in the CNLDO group (p < 0.05). An elevated SII (cutoff > 200.9) demonstrated a sensitivity of 63.2% and a specificity of 63.8%. ROC analysis (AUC = 61.7%, p = 0.029) indicated that SII is a more significant marker for diagnosing CNLDO compared to NLR and PLR. Elevated SII, indicative of systemic inflammation may serve as a significant biomarker in the diagnosis of CNLDO that does not resolve spontaneously and requires probing. SII > 200.9 acts as a threshold that aids in the diagnosis of persistent CNLDO. Being a valuable biomarker, SII can be used in monitoring patients with CNLDO and in identifying those who will require advanced treatment like probing. Prospective studies are essential to validate these findings.

Inflammation indices in association with periodontitis and cancer.

Inflammation is a complex physiological process that plays a pivotal role in many if not all pathological conditions, including infectious as well as inflammatory diseases, like periodontitis and autoimmune disorders. Inflammatory response to periodontal biofilms and tissue destruction in periodontitis is associated with the release of inflammatory mediators. Chronic inflammation can promote the development of cancer. Persistence of inflammatory mediators plays a crucial role in this process. Quantification and monitoring of the severity of inflammation in relation to cancer is essential. Periodontitis is mainly quantified based on the severity and extent of attachment loss and/or pocket probing depth, in addition with bleeding on probing. In recent years, studies started to investigate inflammation indices in association with periodontal diseases. To date, only few reviews have been published focusing on the relationship between blood cell count, inflammation indices, and periodontitis. This review presents a comprehensive overview of different systemic inflammation indices, their methods of measurement, and the clinical applications in relation to periodontitis and cancer. This review outlines the physiological basis of inflammation and the underlying cellular and molecular mechanisms of the parameters described. Key inflammation indices are commonly utilized in periodontology such as the neutrophil to lymphocyte ratio. Inflammation indices like the platelet to lymphocyte ratio, platelet distribution width, plateletcrit, red blood cell distribution width, lymphocyte to monocyte ratio, delta neutrophil index, and the systemic immune inflammation index are also used in hospital settings and will be discussed. The clinical roles and limitations, relationship to systemic diseases as well as their association to periodontitis and treatment response are described.

Indices and ferritin level that predict organ involvement in adult-onset Still's disease.

Aim: The aim of the study is to evaluate whether C-reactive protein to albumin ratio (CAR), lactate dehydrogenase to albumin ratio (LAR), ferritin to erythrocyte sedimentation rate ratio (FER), systemic immune-inflammation index (SII), prognostic nutritional index (PNI) indices and ferritin level can predict organ involvement in adult-onset Still's disease (AOSD) patients.Methods: This study was planned as a cross-sectional study. Univariate and multivariate logistic regression analyses were performed to evaluate the usefulness of ferritin level and inflammatory indices in defining organ involvement.Results: Sixty-one patients diagnosed with AOSD were included in this study. Multivariate logistic regression analyzes showed that LAR (OR 1.028, 95% CI: 1.011-1.044) (p=0.001) index predicted lymphadenopathy involvement, CAR (OR 1.249, 95% CI: 1.087-1.435) (p=0.002) index predicted hepatomegaly involvement, ferritin level (OR 1.004, 95% CI: 1.001-1.008) (p=0.007) predicted splenomegaly involvement, FER (OR 1.085, 95% CI: 1.012-1.164) (p=0.021) and PNI (OR 0.271, 95% CI: 1.132-0.553) (p<0.001) index predicted the occurrence of serositis.Conclusion: This study showed that ferritin level, CAR, FER, PNI and LAR markers may predict organ involvement at diagnosis in AOSD patients.

Systemic immune-inflammation index is associated with high risk for prostate cancer among the U.S. elderly: Evidence from NHANES 2001-2010.

The Systemic Immuno-Inflammation Index (SII) is a crucial clinical measure of inflammation, and there is currently no solid evidence linking SII to an increased risk of prostate cancer (PCa). Through the analysis of serum total prostate-specific antigen (tPSA), free prostate-specific antigen (fPSA), and the tPSA/fPSA (fPSA%) ratio, this study sought to investigate the relationship between SII and PCa risk among the U.S. elderly. Elderly male participants were gathered from the NHANES database between 2001 and 2010.SII was calculated by platelet count * neutrophil count/lymphocyte count. High risk individuals for prostate cancer were defined as those with tPSA > 4 ng/ml and fPSA% < 16%. Multivariate logistic regression models, restricted cubic spline curves, and subgroup analyses were used to assess the relationship between SII and PCa risk. This research comprised 2664 people in total, 137 (5.14%) of whom were deemed to be at high risk of developing PCa. Multivariate logistic regression analysis, after controlling for variables, revealed a significant positive correlation between high PCa risk and an increase in SII (p = 0.009). The RCS suggested a turning point at 9.01. Restricted cubic spline curves revealed a non-linear U-shaped association between SII and high PCa risk (p for nonlinear = 0.028). Education level, marital status, PIR, alcohol status, smoking status, rheumatoid arthritis status, and heart problem were not significantly correlated with this positive connection, according to subgroup analyses and interaction tests. The results of this study suggest that inflammation represented by SII is associated with high PCa risk.

Metabolic Dysfunction-Associated Steatotic Liver Disease: The Associations between Inflammatory Markers, TLR4, and Cytokines IL-17A/F, and Their Connections to the Degree of Steatosis and the Risk of Fibrosis.

Background: The pathogenesis of MASLD (metabolic dysfunction-associated steatotic liver disease) is driven by environmental, genetic, metabolic, immune, and inflammatory factors. IL-17 and TLR4 determine hepatic steatosis, inflammation, and finally fibrosis. Objectives: To explore the associations between the plasma levels of inflammatory markers, TLR4, and the cytokines IL17A/F, as well as their connections with the degree of hepatic steatosis and the risk of hepatic fibrosis (defined by the FIB-4 score) in MASLD patients. Methods: The study cohort included 80 patients diagnosed with MASLD. The IL-17A/F and TLR4 serum concentrations were determined using the ELISA method. Results: We found a significant difference in the CAR levels (C-reactive protein to albumin ratio) when comparing MASLD patients with severe steatosis to those with mild/moderate steatosis (Student's t test, t (71) = 2.32, p = 0.023). The PIV (pan-immune inflammatory value) was positively correlated with the SII (systemic immune inflammation index), (r = 0.86, p < 0.0001) and the CAR (r = 0.41, p = 0.033) in MASLD patients with severe steatosis. In contrast, increased values of the LMR (lymphocyte to monocyte ratio) were significantly associated, with decreased levels of the SII (ρ = -0.38, p = 0.045). We also found a positive correlation between the CAR and the SII (r = 0.41, p = 0.028). In patients with mild/moderate steatosis, a significant positive correlation was observed between the SII and IL17A (r = 0.36, p = 0.010), the PIV and the CAR (r = 0.29, p = 0.011), the PIV and the SII (r = 0.87, p < 0.0001) and the PIV and IL17A (r = 0.3, p = 0.036). A negative correlation was observed between the LMR and the SII (r = -0.55, p < 0.0001) and the CAR and IL17F (r = -0.37, p = 0.011). Regarding the inflammatory markers, the PIV (336.4 vs. 228.63, p = 0.0107), and the SII (438.47 vs. 585.39, p = 0.0238) had significantly lower levels in patients with an intermediate-high risk of hepatic fibrosis as compared with the patients with a low risk of hepatic fibrosis. The PNI (prognostic nutritional index) (47.16 vs. 42.41, p = 0.0392) had significantly different levels in patients with the likelihood of hepatic fibrosis than those with a low risk of hepatic fibrosis. Conclusions: Regarding the inflammatory markers, the PIV and the SII hold promise as biomarkers for discriminating between MASLD patients with an intermediate-high risk and those with a low risk of hepatic fibrosis. Our findings underscore the role of IL-17A and its potential relationship with inflammatory markers in MASLD pathogenesis and the progression to hepatic fibrosis.

Association between dust exposure and lung function levels in steelworkers: mediation analysis of inflammatory biomarkers.

This investigation aimed to examine the mediating effect of inflammatory biomarkers on the relationship between dust exposure and lung function levels among steelworkers. The study comprised 2,315 front-line workers employed at an iron and steel company in Tangshan, who underwent occupational health assessments through cluster sampling. Demographic and lifestyle data were collected via a self-administered questionnaire, while physical examinations measured parameters such as height and weight. Lung function was assessed using a portable pulmonary function tester (CHEST). Blood cell counts were uniformly analyzed using a Mindray fully automated biochemistry analyzer (BS-800). Inflammatory biomarkers, including leukocyte count, neutrophil count, lymphocyte count, and platelet count, were assessed, and the neutrophil-to-lymphocyte ratio and systemic immune inflammation index were computed. Generalized linear models and Spearman rank correlation analyses were employed to explore the interplay among dust exposure, inflammatory biomarkers, and alterations in lung function. A mediation analysis model was constructed to elucidate how inflammatory biomarkers mediate the relationship between dust exposure and lung function levels. After adjusting for covariates, dust exposure was significantly associated with reduced lung function levels, with statistically significant differences observed between dust-exposed and non-exposed groups across various lung function indicators (P < 0.001). In the dust-exposed group, inflammatory biomarkers were elevated, showing significant correlations with FVC and FEV1 (P < 0.05). However, the correlation between FEV1/FVC and various inflammatory biomarkers was insignificant (P > 0.05). Mediation analysis revealed that white blood cells and neutrophils partially mediated the association between dust exposure and FVC, with proportions of 1.75% and 1.09%, respectively. Similarly, white blood cells, neutrophils, and the systemic immune inflammation index partially mediated the association between dust exposure and FEV1, with proportions of 1.15%, 0.82%, and 0.82%, respectively. In conclusion, dust exposure poses a risk for decreased lung function levels. Inflammatory biomarkers derived from blood cells offer a valuable and easily obtainable means of identifying changes in lungfunction levels. Among these biomarkers, white blood cells, neutrophils, and the systemic immune inflammation index significantly mediate the association between dust exposure and lung function levels, although further exploration is needed to understand their underlying mechanisms.

Association between the systemic immune-inflammation index and hearing loss: A cross-sectional study of NHANES 2005 to 2018.

The relationship between systemic inflammation and hearing loss (HL) remains unclear. To investigate the association between the systemic immune-inflammation index (SII) and objective HL, this study was performed. Participants from the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2018 were analyzed. Two types of hearing loss were investigated: speech-frequency hearing loss (SFHL) and high-frequency hearing loss (HFHL). The SII score was constructed using the levels of peripheral neutrophil (N), lymphocyte (L), and platelet (P), and was defined as P multiplied by N/L (in units of 109/L). Weighted multivariable logistic regression and subgroup analysis were used to examine the relationship between HL and high-SII group (≥330 × 109/L). A total of 6428 participants were included in the study. This study found that the high-SII group was positively associated with a higher risk of HL (OR: 1.29, 95% CI: 1.05-1.57, P < .05) and HFHL (OR: 1.24, 95% CI: 1.05-1.46, P < .05), but not significant for SFHL (OR: 1.13, 95% CI: 0.94-1.37, P > .05). Subgroup analysis showed that this association was similar in different age groups. Finally, sensitivity analysis confirmed the robustness of the association. In the full model, increasing SII index per SD was associated with HL (OR: 1.17, 95% CI: 1.09-1.26, P < .001) and HFHL (OR: 1.13, 95% CI: 1.06-1.21, P < .001). The significance of SFHL was not detected with the increasing SII index (OR: 1.13, 95% CI: 0.94-1.37, P > .05). SII score was associated with HL and HFHL in the general adult population of the United States, but was not significantly correlated with SFHL.