Department of Pediatrics, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
Academician Workstation, Changsha Medical University, Changsha, Hunan, China.
Ann Med. 2023;55(2):2275148. doi: 10.1080/07853890.2023.2275148. Epub 2023 Oct 26.
BACKGROUND & OBJECTIVE: The systemic immune-inflammation indicator (SII) has been extensively employed in various diseases for course change, treatment efficacy, or prediction, whereas whether it applies to iron overload or iron deficiency remains unclear. This study aimed at investigating the correlation between SII and serum ferritin in people aged over 20 in the US.
The measurements of the systemic immune-inflammation indicator (SII = platelet count × neutrophil-to-lymphocyte ratio) and serum ferritin of 5491 participants in the NHANES database served as the independent and dependent variables for the present cross-sectional study, respectively. Moreover, the correlation was investigated through and used multiple linear regression, smooth curve fitting, and threshold effect.
After rigorous inclusion and exclusion of 19,225 participants, a grand total of 5,491 participants conforming to the requirements were covered for relevant analysis. SII showed a significant negative correlation with serum ferritin in unregulated ([β=-0.05, < 0.0001], micro-regulated [β=-0.02, = 0.0010], and fully regulated models[β=-0.03, < 0.0001]). In all participants, the negative correlation between SII and serum ferritin served as a non-linear relationship, as indicated by a smooth curve. Subsequently, in the subgroup analysis (stratified by age, sex, and race) fitted by the smooth curve, the above-mentioned negative correlation turned out to be nonlinear in the subgroups aged ≥40 years, Non-Hispanic Black and female, with U-shaped inflection points reaching 874.59, 930.22, and 615 for SII in the above-described subgroups, respectively. The correlation between SII and serum ferritin in Mexican American, Other Hispanic, Non-Hispanic White, and those aged less than 40 developed a linear negative correlation.
To the best of our knowledge, this study examined the correlation between SII and serum ferritin for the first time. The correlation between SII and serum ferritin was varied with sex, age and race in people aged 20 and older. Therefore, higher or lower SII may be relevant for identifying iron overload and iron deficiency.
系统免疫炎症指标（SII）已广泛应用于各种疾病的病程变化、治疗效果或预测中，但它是否适用于铁过载或铁缺乏尚不清楚。本研究旨在探讨 SII 与美国 20 岁以上人群血清铁蛋白之间的相关性。
本横断面研究分别以 NHANES 数据库中 5491 名参与者的系统免疫炎症指标（SII=血小板计数×中性粒细胞与淋巴细胞比值）和血清铁蛋白测量值为自变量和因变量。此外，通过多元线性回归、平滑曲线拟合和阈值效应来研究相关性。
在严格纳入和排除 19225 名参与者后，共有符合要求的 5491 名参与者进行了相关分析。SII 与未调节模型（[β=-0.05，<0.0001]、微调节模型[β=-0.02，=0.0010]和完全调节模型[β=-0.03，<0.0001]）中血清铁蛋白呈显著负相关。在所有参与者中，SII 与血清铁蛋白之间的负相关呈非线性关系，由平滑曲线表明。随后，在通过平滑曲线拟合的亚组分析（按年龄、性别和种族分层）中，在年龄≥40 岁、非西班牙裔黑人和女性亚组中，上述负相关呈非线性，拐点分别为 874.59、930.22 和 615 的 SII。墨西哥裔美国人、其他西班牙裔、非西班牙裔白人和年龄小于 40 岁的人群中 SII 与血清铁蛋白之间呈线性负相关。
据我们所知，本研究首次探讨了 SII 与血清铁蛋白之间的相关性。SII 与血清铁蛋白的相关性因性别、年龄和种族而异，适用于 20 岁以上人群。因此，较高或较低的 SII 可能与识别铁过载和铁缺乏有关。
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