Systemic Inflammation Response Index Research Articles

Systemic inflammation response index as a predictor of 3-month functional outcomes in acute ischemic stroke patients following intravenous thrombolysis.

Systemic inflammation response index as a predictor of 3-month functional outcomes in acute ischemic stroke patients following intravenous thrombolysis.

SIRI as a biomarker for bladder neoplasm: Utilizing decision curve analysis to evaluate clinical net benefit.

SIRI as a biomarker for bladder neoplasm: Utilizing decision curve analysis to evaluate clinical net benefit.

Epigenetic age acceleration mediates the association between low-grade systemic inflammation and cardiovascular diseases: insight from the NHANES 1999–2002

BackgroundCurrently, with the global aging of the population, inflammation, recognized as a hallmark in age-related diseases, has been studied and linked to cardiovascular diseases (CVD). However, limited evidence on whether inflammation modifies epigenetic aging and affects CVD risk.MethodsThis study included 404 CVD patients and 1941 non-CVD individuals from the 1999–2002 National Health and Nutrition Examination Survey cross-sectional data. Low-grade systemic inflammation was assessed using C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and systemic inflammation response index (SIRI). Epigenetic age accelerations (EAAs) were calculated as the residuals between chronological and epigenetic ages: Horvath age acceleration (AgeAccel), AgeAccelHannum, and AgeAccelPheno. Weighted linear and logistic regression analyzed the associations between exposures and outcomes, with mediating effects assessed using the Sobel test.ResultsAfter adjusting confoundings, the log-transformed NLR and SIRI were positively associated with CVD risk, and the odds ratio (OR) ranges from 1.260 to 1.354 (all P < 0.05). Furthermore, the ln-transformed CRP was positively associated with AgeAccelHannum and AgeAccelPheno, and the coefficient (β) ranges from 0.505 to 1.304 (all P < 0.05); the ln-transformed NLR and SIRI were positively associated with all three EAAs, and the β ranges from 0.392 to 2.212 (all P < 0.005). Additionally, 1-unit increase in AgeAccelHannum and AgeAccelPheno was associated with 2.8% (OR: 1.028, 95% CI 1.007–1.049, P = 0.011) and 3.5% (OR: 1.035, 95% CI 1.014–1.056, P = 0.002) increase in CVD risk, respectively. After adjusting confoundings, mediation analysis showed that AgeAccelHannum mediates 10.44% (P = 0.046) of the association between NLR and CVD risk; and AgeAccelPheno mediates 24.03% (P = 0.009) and 18.16% (P = 0.015) of the NLR-CVD and SIRI-CVD risk associations, respectively.ConclusionOur results demonstrate that EAAs mediate the association between systemic inflammation and CVD risk, highlighting the potential of a multi-target approach to inflammation and epigenetic modifications for personalized management to reduce CVD risk.Graphical abstract

Association between systemic Immune-inflammation index, systemic inflammation response index and adult osteoarthritis: national health and nutrition examination survey

BackgroundOsteoarthritis (OA) is a degenerative and inflammatory joint disease caused by multiple factors, the underlying mechanisms of which are not fully understood. The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) are both novel biomarkers and predictors of inflammation. Thus, this study aimed to evaluate the relationship between SII, SIRI and OA in adult.ObjectiveThe ultimate goal is to gain a deeper understanding of how SII, SIRI influences OA and the implications of this relationship.Materials and methodsWe analyzed data from 7204 participants aged 20 and older from the NHANES surveys conducted in 1999–2020, all of whom provided comprehensive data for this study. Standardized surveys assessed the presence of osteoarthritis and SII, SIRI. To thoroughly understand their relationship, we employed statistical techniques including multivariable logistic regression, stratified analysis with interaction, restricted cubic splines (RCS), and threshold effect analysis.ResultsA total of 7204 adult participants were enrolled, composing of 2830 (39.3%) male and 4374 (60.7%) female with a median age of 62.2 ± 13.9 years, 2955 (41.0%) were diagnosed with OA. Accordingly, A linear relationship between SII and OA was discovered after adjusting for underlying confounders, (p > 0.05) in RCS, and the association between the SIRI and OA exhibited a nonlinear relationship (p = 0. 042) in RCS. In the threshold analysis, the OR of developing OA was 1.648 (95% CI: 1.144 ~ 2.374, p < 0.05) in participants with SIRI of < 0.99 103 cells/ml. There was no significantly association between the SIRI and OA when the SIRI was ≥ 0.99 103 cells/ml. Further sensitivity analyses provided confidence that the results are robust and not likely to be substantially influenced by unmeasured confounding factors.ConclusionsThis cross-sectional study demonstrated that a linear relationship between SII and OA, and the association between the SIRI and OA was found to be nonlinear.Clinical trial numberNot applicable.

Prognostic significance of C-reactive protein (CRP) and albumin-based biomarker in patients with breast cancer receiving chemotherapy.

Breast cancer patients with similar clinicopathologic characteristics may experience varied outcomes. This urges an increased effort to investigate other prognostic factors. C-reactive protein (CRP)-to-albumin ratio (CAR) is an inflammatory and nutritional biomarker that has been well studied and reported to have an impact on the survival of patients with diverse types of cancer, but limitedly in breast cancer. Therefore, this study aimed to investigate the prognostic significance of CAR in local patients with breast cancer. This study included 202 stage I-IV breast cancer patients receiving first-line chemotherapy. We calculated inflammatory and nutritional biomarkers including CAR, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), pan-immune-inflammation value (PIV), and prognostic nutrition index (PNI) before treatment. The Kaplan-Meier with log-rank test and Cox proportional hazard regression were used to analyze the prognostic role of clinicopathologic factors and biomarkers on disease-free survival (DFS), progression-free survival (PFS), and overall survival (OS). The median follow-up period was 46 months (1-77 months). The 3-year DFS and 3-year OS in patients with high CAR (CAR > 1.5) were significantly lower than those with low CAR (CAR ≤ 1.5) (47.0% vs 68.9%, P=0.022 and 59.5% vs 78.6%, P=0.009, respectively). Multivariate analysis showed high CAR as prognostic factors for poor DFS (HR 2.10, 95% confidence interval/CI [1.10-3.99], P=0.023) and OS (HR 2.16, 95% CI [1.27-3.68], P=0.005), but not for PFS (HR 1.43, 95% CI [0.73-2.80], P=0.293). In addition, more advanced stage and HER2 positive were correlated with unfavorable DFS and OS, older age predicted poor DFS, and stage was the only prognostic factor of PFS (all P values < 0.05). Besides age, stage, and molecular subtypes that have been widely observed to have impact on the survival of breast cancer patients, CAR was demonstrated as a promising prognostic marker in our local patients. A high CAR at diagnosis was associated with unfavorable DFS and OS, which can aid in identifying patients at risk and guide personalized treatment planning.

Association of red blood cell count, hemoglobin concentration, and inflammatory indices with cognitive impairment severity in Alzheimer’s disease

Some studies have found that patients with Alzheimer’s disease (AD) have changes in levels of red blood cell (RBC) and hemoglobin (HB), and some inflammatory indexes are increased. However, the results of relevant studies are not uniform. The aim of this study is to investigate the changes of RBC, HB, and commonly used inflammatory indexes in patients with AD and their correlation with the severity of cognitive impairment. A total of 225 subjects with AD and 2000 healthy controls were included. Dementia severity was evaluated by Mini-Mental State Examination (MMSE). The RBC count and HB concentration of subjects were detected, and inflammatory indexes including neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR), systemic immune inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV) were calculated. RBC count, HB concentration, NLR, PLR, MLR were independent influencing factors for AD. RBC count and HB concentration are significantly associated with the severity of cognitive impairment in AD patients. RBC count has a significant effect on the severity of cognitive impairment without considering the education level, but their effects on the severity of cognitive impairment are no longer significant when the education level is considered. The RBC count and HB concentration of AD patients are decreased, and are correlated with the severity of cognitive impairment. In addition, some inflammatory indexes are associated with the risk of AD.

Sex-Specific Impact of Inflammation and Nutritional Indices on AVF Blood Flow and Maturation: A Retrospective Analysis.

Background: Arteriovenous fistula (AVF) failure rates are consistently higher in females, although the underlying mechanisms remain incompletely understood. Inflammatory processes play a key role in AVF remodeling and venous arterialization, yet their influence may differ by sex. This study aimed to evaluate the impact of inflammatory indices on AVF blood flow and maturation, with a focus on sex-specific differences. Methods: This retrospective analytical study included 110 patients (50 females, 60 males) undergoing initial surgical AVF creation. Postoperative assessments occurred at the fourth and sixth weeks. Patients demonstrating insufficient maturation (blood flow < 600 mL/min) at the fourth week were re-evaluated after two weeks without any intervening procedures or additional interventions. Results: Intraoperative Transit-Time Flow Measurement (TTFM) revealed significantly higher median AVF blood flow in males compared to females (289 mL/min vs. 200 mL/min; p < 0.001). Doppler ultrasonography (DUS) findings confirmed these sex-related differences, demonstrating consistently lower blood flow rates in female patients. An elevated neutrophil-to-lymphocyte ratio (NLR) was associated with approximately a 31% reduction in AVF blood flow among females, whereas an increased C-reactive protein-to-albumin ratio (CrA) correlated with an approximate 9% decline. In males, an elevated systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) were significantly associated with decreased AVF blood flow. Conversely, a higher prognostic nutritional index (PNI) positively correlated with AVF blood flow in both sexes. Risk factors associated with inadequate AVF maturation (<600 mL/min at sixth week) included female sex, advanced age, obesity, smoking, anemia, low vitamin D levels, and elevated inflammatory indices (NLR, SII, and SIRI). Conclusions: Inflammatory and nutritional indices derived from routine laboratory tests may assist in estimating AVF maturation likelihood. While DUS reliably assesses AVF blood flow, complementary evaluation methods may be required to assess the broader vascular status. Further research is needed to clarify sex-specific inflammatory mechanisms influencing AVF outcomes and to guide individualized management strategies.

Association between systemic inflammatory response index and eczema among children and adolescents: a cross-sectional study based on NHANES database

BackgroundIn previous studies, the systemic inflammatory response index (SIRI) might be a predictor for chronic inflammation, but the relationship between SIRI and eczema continues to be ambiguous. The objective of the study was to clarify the connection between the level of SIRI and eczema prevalence among children and adolescents.MethodsThe National Health and Nutrition Examination Survey (NHANES) was the database from which we accessed information, comprising participants aged 3–19 years. Furthermore, the investigation of the association between SIRI and eczema was carried out by using logistic regression, and restricted cubic spline models were used to explore nonlinear relationships.ResultsA total of 3,397 subjects, featuring a median age of 11.97 ± 4.87 years, were selected, and 368 (10.83%) were diagnosed with eczema among these participants. Statistically significant differences were observed in the baseline SIRI characteristics for age, race, and BMI quartiles (p &amp;lt; 0.001). In adjusted logistic regression models, the negative association between SIRI and eczema was indicated (OR: 0.83; 95% CI: 0.69–1.00, p &amp;lt; 0.05), suggesting that a one-unit increase in SIRI corresponds to a 17.17% decline in the odds of eczema prevalence. Meanwhile, a nonlinear relationship was revealed by the restricted cubic spline (RCS) between SIRI and eczema prevalence among children and adolescents. The findings of subgroup analysis suggested that there were no significant effects of any covariates on this relationship (all p for interaction &amp;gt; 0.05).ConclusionThe association between SIRI and eczema prevalence in children and adolescents is negative, indicating that elevated SIRI exhibits a protective effect against eczema in children and adolescents, whereas those with low SIRI may require closer monitoring for eczema development.

Integrating Dynamic Red Blood Cell Distribution Width Monitoring and β-Blocker Therapy for Mortality Prediction in Intensive Care Unit Cardiomyopathy Patients: A Bayesian Multivariate Joint Model and Machine Learning Study.

Background/Objective: Cardiomyopathy is a key cause of cardiovascular mortality in critically ill patients. Although red blood cell distribution width (RDW) is recognized as a potential prognostic biomarker, its variations during ICU admission and its interaction with treatments such as β-blockers are not well understood across different cardiomyopathy subtypes. To assess the prognostic significance of RDW dynamics and their interaction with β-blocker therapy in predicting 365-day mortality among ICU patients with dilated, hypertrophic, and restrictive cardiomyopathy, utilizing longitudinal data and advanced modeling techniques. Methods: A retrospective analysis was conducted on 317 cardiomyopathy patients from the MIMIC-IV database. Their RDW dynamics were assessed over their ICU stay. Cox regression (including time-dependent Cox models) and logistic regression identified independent mortality risk factors. Key predictors were identified using Least absolute shrinkage and selection operator (LASSO) regression and the Boruta algorithm. Restricted cubic splines (RCSs) were used to examine nonlinear relationships. Machine learning models were used to evaluate predictive performance, with SHapley Additive Explanations (SHAP) and tree-based feature selection identifying influential variables. Repeated-measures ANOVA was used to analyze RDW trends and β-blocker associations. A Bayesian multivariate joint model (BMJM) integrated RDW dynamics and β-blocker therapy, incorporating repeated measures and survival outcomes. Results: RDW was an independent predictor of 365-day mortality (HR = 1.14, 95% CI: 1.01-1.29, p = 0.03), alongside the systemic immune-inflammation index (SII) (HR = 1.01, 95% CI: 1.00-1.01, p = 0.03), whereas β-blockers significantly reduced mortality risk (HR = 0.2, 95% CI: 0.1-0.39, p < 0.001). Comparative analysis demonstrated that RDW exhibited greater predictive value over the aggregate index of systemic inflammation (AISI), systemic inflammation response index (SIRI), and SII. Machine learning identified logistic classification as the best predictive model (AUC = 0.811), with SHAP and tree-based selection confirming RDW and β-blockers as key predictors. A repeated-measures ANOVA revealed a significant interaction between RDW and β-blocker use (F = 6.65, p < 0.0001), with β-blockers lowering RDW levels. The BMJM demonstrated strong predictive performance (AUC = 0.80). The patient-specific BMJM indicated that discontinuing β-blockers increased the risk of mortality, while initiating β-blockers reduced it. Conclusions: This study highlights dynamic RDW monitoring and β-blocker therapy as strong predictors of 365-day mortality in ICU-admitted cardiomyopathy patients. The BMJM enables personalized risk assessment by integrating longitudinal biomarker data. These findings support RDW as a dynamic biomarker and advocate for its integration into personalized treatment strategies.

Systemic Inflammation Mediates the Association Between Blood Trihalomethane Concentrations and Cardiovascular Disease in U.S. Individuals Over 45: Insights from NHANES 2005-2012.

Trihalomethanes (THMs), the major byproducts of water chlorination which are associated with various adverse health outcomes. However, the relationship of THMs with cardiovascular disease (CVD) in aging populations remains underexplored. We analyzed data from 5,400 participants in the National Health and Nutrition Examination Survey (NHANES) 2005-2012. Associations between blood THM concentrations and CVD were evaluated using weighted multivariable logistic regression. Weighted quantile sum (WQS) regression was applied to identify the most relevant THM components. We also performed mediation analysis to evaluate the role of inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), white blood cell count (WBC), and systemic inflammation response index (SIRI). Network toxicology analysis was used to explore the biological pathways linking THM exposure, CVD, and aging. Elevated blood concentrations of THMs, particularly chloroform (TCM) and total THMs (TTHMs), were significantly associated with increased odds of CVD. Stratified analyses revealed stronger associations among older adults, males, individuals with higher BMI, and those with hypertension. WQS regression identified TCM as the predominant contributor to the THM-CVD association, accounting for 58.0% of the mixture's effect. Mediation analysis showed that NLR partially mediated the association between TTHMs and CVD, explaining 7.12% of the total effect. Network toxicology analysis highlighted inflammation-related pathways, including the IL-17 signaling pathway, as key mechanisms linking THM exposure, CVD, and aging. Our study revealed elevated blood TCM and TTHM concentrations are associated with increased prevalence of CVD among U.S. adults aged 45years and older. Network toxicology and mediation analysis suggest that systemic inflammation may play a mediating role in this relationship.

Evaluation of Acute Pancreatitis Severity and Prognosis Using the Aggregate Systemic Inflammation Index (AISI) as a New Marker: A Comparison with Other Inflammatory Indices.

Background/Objectives: Acute pancreatitis (AP) remains a pressing clinical challenge, largely due to its potential to lead to life-threatening complications and increased mortality. Over the years, numerous tools have been proposed to evaluate the intensity of AP and estimate likely health outcomes. Despite their usefulness, many of these assessment models are complex and rely on a wide array of clinical inputs, making them less practical in everyday healthcare settings. In contrast, the Aggregate Systemic Inflammation Index (AISI), which is calculated using routine blood count parameters, provides a simpler and more inclusive approach to measuring systemic inflammation. This research focuses on examining how effectively AISI can be used to gauge disease severity and project clinical trajectories in individuals affected by pancreatitis. Methods: This retrospective study reviewed the medical records of 412 individuals diagnosed with acute pancreatitis, all of whom received care at the Internal Medicine Clinic of Ankara Bilkent City Hospital between 1 April 2019 and 1 September 2024. The investigation encompassed a thorough analysis of patients' demographic characteristics, lab parameters, and clinical findings, with special attention given to inflammatory markers, including the Aggregate Systemic Inflammation Index (AISI), its revised version, the Platelet-to-Lymphocyte Ratio (PLR), the Neutrophil-to-Lymphocyte Ratio (NLR), and the Systemic Inflammatory Response Index (SIRI). Comparative analyses between groups were performed using independent sample t-tests and one-way ANOVA, complemented by Tukey's post hoc tests where appropriate. Correlations among continuous variables were determined through Pearson's analysis, and the prognostic accuracy of both AISI and its modified form was assessed using Receiver Operating Characteristic (ROC) curve methodology. Results: The mean age among participants was 63.47 ± 17.92 years, while the average AISI value was calculated as 1183.89 ± 1067.42. Both the original and modified versions of the AISI index showed strong positive correlations with several key clinical measures, including prolonged hospitalization, a Glasgow score of 2 or above, BISAP, Ranson scoring, the revised Atlanta classification, and APACHE II. AISI was also significantly linked to the presence of complications and overall mortality (p < 0.01). Analysis through ROC curves demonstrated that an AISI level above 236.626 effectively predicted hospital stays exceeding 10 days, with a sensitivity of 94.40% and a specificity of 91.00%. Moreover, both AISI and its modified form reliably distinguished patients who had a Ranson score of zero, with high diagnostic accuracy. Conclusions: AISI and its modified version demonstrate a strong association with both the intensity and clinical course of acute pancreatitis. Thanks to their simplicity, low cost, and broad usability in healthcare settings, these indices hold considerable promise as practical and dependable tools for assessing the severity and likely outcomes of this increasingly prevalent disease.

Pathological complete response and prognostic predictive factors of neoadjuvant chemoimmunotherapy in early stage triple-negative breast cancer.

Neoadjuvant chemoimmunotherapy (nCIT) has shown promise in treating early-stage triple-negative breast cancer (eTNBC), but predictive biomarkers for pathological response and prognosis remain poorly defined. This study aimed to explore pathological complete response and prognostic predictive factors in eTNBC patients treated with nCIT. We retrospectively analyzed 112 eTNBC patients who underwent surgery after nCIT at Sun Yat-sen University Cancer Center between June 2019 and June 2023. Pathological response was assessed using Miller-Payne grade. Clinicopathological features and hematologic markers were analyzed with univariate and multivariate logistic regression or Cox regression, as well as Kaplan-Meier survival curves. Objective response rate (ORR), pathological complete response (pCR), and disease-free survival (DFS) were evaluated. Nomograms predicting pCR and DFS were constructed based on significant risk factors and the systemic inflammatory response index (SIRI). Higher baseline lymphocyte counts (P=0.004) were independently associated with a higher pCR rate, while elevated monocyte counts (P=0.006), neutrophil-to-lymphocyte ratio (P=0.005), platelet-to-lymphocyte ratio (p = 0.005), SIRI (P=0.037), systemic immune-inflammation index (P=0.029), and preoperative SIRI (P=0.010) were associated with a lower pCR rate. Higher baseline SIRI (P= 0.009) was correlated with shorter DFS, while higher preoperative lymphocyte counts (P=0.019) predicted longer DFS. Nomograms incorporating SIRI showed high accuracy in predicting pCR and DFS. Hematologic inflammatory markers, particularly SIRI, are cost-effective and reliable predictors of prognosis and treatment efficacy in eTNBC patients undergoing nCIT, helping clinicians develop personalized treatment strategies. https://www.medicalresearch.org.cn/, identifier MR-44-24-046099.

Prognostic and clinicopathological impact of systemic inflammation response index (SIRI) on patients with esophageal cancer: a meta-analysis

BackgroundAlthough the systemic inflammation response index (SIRI) is often associated with prognostic significance in esophageal cancer (EC) patients, the results continue to be conflicting. We focused on identifying SIRI’s precise role in forecasting EC prognosis through performing this meta-analysis.MethodsThis work searched PubMed, Web of Science, Embase, Cochrane Library, and CNKI till November 16, 2024, and determined pooled hazard ratios (HRs) and 95% confidence intervals (CIs) for evaluating EC prognosis forecasting efficiency of SIRI. The inclusion criteria: (1) pathologic confirmation of EC; (2) those reporting associations of SIRI with EC survival outcomes; (3) those reporting HRs and 95% CIs; (4) those with an available cut-off value of SIRI; and (5) no restriction in language. The exclusion criteria: (1) case reports, reviews, meeting abstracts, comments and letters; (2) those enrolling duplicate cases; and (3) animal studies.ResultsWe enrolled six studies comprising 2176 cases into the present work. Based on our combined findings, elevated SIRI showed significant relation to dismal overall survival (OS) (HR = 1.43, 95%CI = 1.20–1.71, p < 0.001; I2 = 48.8%, p = 0.098) and shortened progression-free survival (PFS) (HR = 2.00, 95%CI = 1.35–2.98, p = 0.001; I2 = 0, p = 0.409) in EC. Moreover, high SIRI exhibited obvious relation to male gender (OR = 1.86, 95%CI = 1.07–3.22, p = 0.027; I2 = 69.4%, p = 0.020), TNM stage of III-IV (OR = 1.52, 95%CI = 1.18–1.94, p = 0.001; I2 = 24.3%, p = 0.265), T3-T4 stage (OR = 1.73, 95%CI = 1.12–2.69, p = 0.014; I2 = 61.0%, p = 0.053), and lymph node metastasis (OR = 1.29, 95%CI = 1.02–1.64, p = 0.036; I2 = 42.7%, p = 0.155). However, SIRI was not markedly related to age, tumor location, tumor differentiation, or smoking history.ConclusionIn summary, high SIRI is significantly related to dismal OS and shortened PFS of EC cases, together with advanced tumor stage, T3-T4 stage, and lymph node metastasis of EC. Due to some limitations, large prospective studies that utilize standardized threshold SIRI should be conducted to validate our results in the future.

Can the PAN-Immune Inflammation Value Be Used as a Biomarker for Differentiating Epididymo-orchitis and Testicular Torsion in Children?

Aim: No study in the literature has investigated the role of the pan-immune inflammation value (PIV) in the differential diagnosis of epididymo-orchitis (EO) and testicular torsion (TT) in children. This study aims to evaluate the utility of PIV and other inflammatory indices in the differential diagnosis of EO and TT in children. Material and Method: A retrospective analysis was conducted on 258 children who presented with scrotal pain between January 2019 and December 2023. Patients were divided into EO (n=187) and TT (n=71) groups, with the TT group further classified into orchiectomy (n=24) and detorsion (n=47) subgroups. The diagnostic power of hematological parameters, including derived indices such as PIV, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI), in distinguishing TT from EO was investigated. Diagnostic performance was assessed using ROC analysis, and logistic regression models evaluated the predictive value of significant variables. Results: TT patients exhibited significantly higher levels of white blood cells (WBC), neutrophil count, NLR, SIRI, and PIV compared to the EO group. PIV values were found to be significantly higher in the testicular detorsion group compared to the orchiectomy group. ROC analysis demonstrated weak diagnostic performance for NLR (AUC=0.580), SII (AUC=0.568), SIRI (AUC=0.599), and PIV (AUC=0.585), while WBC (AUC=0.673) and neutrophil count (AUC=0.634) showed poor performance. Multivariate logistic regression identified WBC (OR=2.52) and NLR (OR=2.6) as significant predictors of TT, with NLR values &gt;3.39 associated with a 2.6-fold increased likelihood of TT. Conclusion: Our study demonstrates that NLR and WBC, with high specificity, can predict TT, while SIRI and SII have limited diagnostic performance. Although PIV shows potential as a biomarker with varying sensitivity and specificity across different thresholds, its contribution in multivariate models appears less significant. However, it may be effective in predicting testicular viability in TT. Larger sample sizes and multicenter studies are required to further validate the clinical utility of these biomarkers.

Comparative analysis of systemic inflammatory biomarkers on dipper and non-dipper hypertension phenotypes.

Circadian hypertension patterns, classified as dipper and non-dipper, influence cardiovascular risk and are linked to systemic inflammation. This study aimed to examine the relationship between hypertension phenotypes and inflammatory biomarkers. This retrospective cross-sectional study included 160 hypertensive patients with elevated office blood pressure (BP) who underwent 24-hour ambulatory BP monitoring and were categorized into dipper and non-dipper groups. Inclusion criteria comprised newly diagnosed, untreated individuals without hematological disorders, chronic inflammatory conditions, active infections, or moderate to severe chronic kidney disease. Inflammatory indices derived from complete blood counts were analyzed alongside demographic and clinical data. The cohort consisted of 79 dippers and 81 non-dippers, with a mean age of 46 ± 5 ± 11 ± 1 years. Non-dippers were more likely to be smokers (P = .006) and exhibited significantly higher 24-hour, awake, and sleep systolic BPs and sleep diastolic BPs than dippers (P = .001, P = .003, P < .001, and P < .001, respectively). Non-dippers also had elevated white blood cell counts, neutrophil (NEU) levels, neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) scores (P < .001, P < .001, P < .001, P < .001, P < .001, P = .002, P < .001, and P < .001, respectively), while dippers exhibited higher lymphocyte counts (P < .001). Logistic regression analyses indicated that NLR, dNLR, MLR, PLR, SII, and SIRI scores significantly predicted the inflammatory status of non-dipper hypertensive patients. Notably, dNLR demonstrated the highest specificity, sensitivity, and area under the curve values in the receiver operating characteristic analysis. This study identified significant differences in inflammatory status between dipper and non-dipper hypertensive groups, with inflammatory biomarkers strongly correlating with non-dipper hypertension. The dNLR score exhibited the strongest predictive value for non-dipper hypertension. Routine screening of inflammatory markers in clinical practice could facilitate early identification of at-risk patients and potentially improve treatment outcomes. However, further research is needed to validate these findings.

Inflammatory Biomarkers Predicting Contrast-Induced Acute Kidney Injury in Elderly Patients with ST-Segment Elevation Myocardial Infarction.

Background: The inflammatory response is critically important in ST-segment elevation myocardial infarction (STEMI). The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), novel inflammatory biomarkers, have been linked to the determination of outcomes in various diseases. The aim of the current study was to examine the relation of the SII and SIRI with contrast-induced acute kidney injury (CI-AKI) in elderly subjects with STEMI undergoing primary percutaneous coronary intervention (pPCI). Methods: All patients diagnosed with STEMI between November 2020 and September 2024 were screened, and patients aged over 70 were retrospectively analyzed in the present study. The patients were divided into two groups according to CI-AKI development. The SII and SIRI were calculated based on the peripheral blood counts. A receiver operating characteristic (ROC) curve analysis was performed to determine the sensitivity and specificity of the SII and SIRI in predicting CI-AKI. Additionally, multivariable logistic regression models were employed to investigate the associations between inflammatory indices and the incidence of CI-AKI in elderly patients with STEMI. Results: A total of 263 participants were included (mean age 77.67 ± 6.20, 56% women). Both the SII and SIRI were higher in the CI-AKI group than in the non-CI-AKI group (3252 ± 2257, 1097 ± 991 p < 0.001 for SII; 12.1 ± 4.54, 4.86 ± 2.42 p < 0.006 for SIRI). In the receiver operating characteristic analysis, the SII and SIRI showed the highest area under curve (AUC) compared with other inflammatory parameters. The AUC of the SII and SIRI were 0.903 and 0.867 (p < 0.001). In multivariate logistic regression analysis, the SII and SIRI were found as independent predictors of CI-AKI. Conclusions: The SII and SIRI were found to be important markers for predicting post-procedural CI-AKI in elderly patients with STEMI.

Inflammatory Indices and Preterm Delivery: A New Horizon in Obstetric Risk Assessment.

Objective: Preterm delivery is a leading cause of neonatal morbidity and mortality globally, with inflammation playing a crucial role in its pathophysiology. This study aimed to evaluate the predictive value of systemic inflammatory response indices in identifying pregnant women at risk of preterm delivery. Methods: This retrospective study analyzed data from 1128 pregnant women admitted to a tertiary care hospital between 2020 and 2025. Patients were classified into two groups: preterm delivery (n = 528) and term delivery (n = 600). Demographic characteristics, obstetric history, neonatal outcomes, and inflammatory indices were compared. Results: The preterm delivery group showed a significantly higher systemic inflammatory response index (SIRI) (p < 0.001), systemic immune-inflammation index (SII) (p < 0.001), neutrophil/lymphocyte ratio (NLR) (p < 0.001), and monocyte/lymphocyte ratio (MLR) (p < 0.001) than the term delivery group, while platelet/lymphocyte ratio (PLR) levels were significantly lower (p = 0.002). Inflammatory indices were higher in early preterm delivery cases (p < 0.001) than in middle and late preterm cases. Multivariate logistic regression identified the SIRI (p = 0.015) and NLR (p < 0.001) as independent predictors of preterm delivery, while the PLR showed an inverse association (p = 0.002). Higher inflammatory indices correlated with lower 1st and 5th minute APGAR scores (p < 0.001) and increased neonatal intensive care unit (NICU) admission rates (p < 0.001). NICU stay was prolonged in neonates born to mothers with elevated SIRI and NLR levels (p < 0.001). Conclusions: Integrating these inflammatory indices into obstetric risk assessment may enhance early detection and intervention strategies, potentially improving maternal and neonatal prognosis.

Assessment of Preoperative Systemic Inflammation Response Index in Surgically Treated Young Head and Neck Cancer Patients Under 40.

To assess the prognosis of young patients (≤40 years old) with head and neck squamous cell carcinoma (HNSCC), focusing on the preoperative Systemic Inflammation Response Index (SIRI). Between January 2007 and February 2017, 175 young patients with HNSCC (≤40 years old) who underwent radical surgery were retrospectively enrolled in this study. The patients were randomly divided into a training cohort (N = 131) and a validation cohort (N = 44). The SIRI is defined as the absolute neutrophil count (×10⁹/L) multiplied by the absolute monocyte count (×10⁹/L), divided by the absolute lymphocyte count (×10⁹/L) in peripheral blood, all measured within one week prior to radical surgery. Univariate and multivariate Cox regression analyses were conducted to identify variables associated with survival outcomes, which were then used to construct and evaluate a predictive nomogram. In both the training and validation cohorts, patients were classified into low- and high-SIRI groups based on a cutoff value of 0.87, which was determined by receiver operating characteristic analysis. This SIRI cutoff effectively stratified patients into two distinct prognostic groups with significant survival differences. Multivariable Cox analysis identified the presence of lymphovascular invasion and the high preoperative SIRI as significant independent prognostic factors associated with poorer cancer-specific survival (CSS) in young patients with HNSCC. Using these variables, a predictive model for 5 year CSS was constructed and visualized as a nomogram. The model demonstrated strong predictive performance, with a C-index of 0.744 [95% CI (0.643-0.845)] in the training cohort and 0.839 [95% CI (0.740-0.938)] in the validation cohort. Data from preoperative SIRI assessment, coupled with the presence of pathological adverse features, serve as valuable references for risk stratification in young patients with HNSCC.

Systemic inflammation as a mediator in the link between obesity and depression: Evidence from a nationwide cohort study

BackgroundObesity and depression are major public health issues with a complex, bidirectional relationship potentially involving systemic inflammation.MethodsUsing a diverse sample from the National Health and Nutrition Examination Survey (NHANES) (n = 11,324; weighted population = 456,457,366), we examined the associations between obesity, systemic inflammation, and depression. Obesity was classified by Body Mass Index (BMI), depressive symptoms were assessed with the Patient Health Questionnaire-9 (PHQ-9), and systemic inflammation was measured using markers like Neutrophil-to-Lymphocyte Ratio (NLR), Systemic Inflammation Response Index (SIRI), and Systemic Immune-Inflammation Index (SII). Weighted logistic regression models were used to assess relationships between obesity, inflammation, and depression. Linear regression evaluated BMI’s association with inflammation markers, and Restricted Cubic Spline (RCS) analysis explored their interrelationships. Subgroup analyses and interaction tests were conducted, and mediation analysis examined the role of inflammation markers in mediating the obesity-depression association.ResultsClass III obesity was associated with higher inflammatory marker levels and increased depression risk. Mediation analysis showed NLR, SIRI, and SII mediated 5.2%, 5.9%, and 6.1% of the obesity-depression relationship.ConclusionsSystemic inflammation partially mediates the relationship between obesity and depression.

Integrating adipsin with novel cardiometabolic and inflammatory indices for enhanced early prediction of gestational diabetes mellitus: a prospective cohort study

BackgroundEarly identification of individuals at risk for gestational diabetes mellitus (GDM) is essential for mitigating its adverse effects on both maternal and foetal health. This study aimed to evaluate the predictive value of the cardiometabolic index (CMI), systemic inflammation response index (SIRI), and serum adipsin levels for GDM.MethodsA total of 1660 pregnant women were enrolled in this study conducted in Suzhou, China. Baseline clinical data, including blood glucose levels, lipid profiles, and blood cell counts, were collected at 12 weeks of gestation. GDM was diagnosed between 24 and 28 weeks of gestation. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the associations and predictive performance of CMI, SIRI, and adipsin for GDM.ResultsCompared with non-GDM participants, those with GDM exhibited significantly higher CMI and SIRI values and lower serum adipsin levels at baseline. Increased CMI and SIRI, as well as reduced adipsin levels, were independently associated with a higher risk of GDM in both unadjusted and adjusted models (all P < 0.05). The composite model incorporating all three biomarkers achieved a higher area under the curve (AUC) of 0.918 compared with the individual models for CMI (AUC = 0.825), SIRI (AUC = 0.802), and adipsin (AUC = 0.724).ConclusionsCMI, SIRI, and serum adipsin are independently associated with GDM risk, and their combination provides a promising multi-biomarker strategy for early GDM prediction. Further studies are needed to validate these findings in diverse populations.Graphical