Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.
Front Endocrinol (Lausanne). 2024 Feb 13;15:1334811. doi: 10.3389/fendo.2024.1334811. eCollection 2024.
It has been demonstrated that in diabetic patients, an elevated neutrophil-lymphocyte ratio (NLR) is independently connected with higher cardiovascular and all-cause mortality. It is unclear, however, if the systemic immune-inflammatory index (SII) and the mortality rate among diabetic patients are related. Investigating the linkage between SII and diabetes patients' risk of cardiovascular and all-cause death was the aim of the study.
4972 diabetics who were chosen from six rounds of the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2016 were the study's participants. The optimal SII threshold with the highest correlation with survival outcomes was identified by applying the Maximum Selection Ranking Statistical Method (MSRSM). To assess the relationship between SII and cardiovascular and all-cause mortality in diabetics, subgroup analysis and Cox regression modeling were employed. Furthermore, smoothed curve fitting was utilized to determine the nonlinear relationship of them.
Over the course of a median follow-up of 69 months (interquartile range [IQR], 54-123 months), 1,172 (23.6%) of the 4,972 diabetic patients passed away. These deaths included 332 (6.7%) cardiovascular deaths and 840 (16.9%) non-cardiovascular deaths. Individuals were categorized into higher (>983.5714) and lower (≤983.5714) SII groups according to MSRSM. In multi-variable adjusted models, subjects with higher SII had a significantly increased chance of dying from cardiovascular disease (HR 2.05; 95% confidence interval (CI):1.42,2.97) and from all causes (HR 1.60; 95% CI:1.22,1.99). Kplan-Meier curves showed similar results. Subgroup studies based on age, sex, BMI, drinking, smoking, and hypertension revealed that the connection maintained intact. The previously stated variables and SII did not significantly interact (p interaction > 0.05). In diabetic patients, smooth curve fitting revealed a nonlinear correlation between SII and mortality.
In diabetic patients, elevated SII is linked to higher cardiovascular and all-cause mortality.
已有研究表明，在糖尿病患者中，中性粒细胞与淋巴细胞比值（NLR）升高与更高的心血管和全因死亡率独立相关。然而，目前尚不清楚全身免疫炎症指数（SII）与糖尿病患者的死亡率之间是否存在关联。本研究旨在探讨 SII 与糖尿病患者发生心血管和全因死亡的风险之间的关系。
该研究的参与者是从 2005 年至 2016 年进行的六轮国家健康和营养检查调查（NHANES）中选择的 4972 名糖尿病患者。应用最大选择排名统计方法（MSRSM）确定与生存结局相关性最高的最佳 SII 阈值。采用亚组分析和 Cox 回归模型评估 SII 与糖尿病患者心血管和全因死亡率之间的关系。此外，还采用平滑曲线拟合来确定它们之间的非线性关系。
在中位随访 69 个月（四分位距 [IQR]，54-123 个月）期间，4972 名糖尿病患者中有 1172 人（23.6%）死亡。这些死亡包括 332 例（6.7%）心血管死亡和 840 例（16.9%）非心血管死亡。根据 MSRSM，将个体分为较高（>983.5714）和较低（≤983.5714）SII 组。在多变量调整模型中，SII 较高的患者发生心血管疾病死亡的风险显著增加（HR 2.05；95%置信区间 [CI]：1.42，2.97）和全因死亡风险（HR 1.60；95%CI：1.22，1.99）。Kplan-Meier 曲线显示了类似的结果。基于年龄、性别、BMI、饮酒、吸烟和高血压的亚组研究表明，这种联系仍然存在。上述变量与 SII 之间无显著交互作用（p 交互值>0.05）。在糖尿病患者中，平滑曲线拟合显示 SII 与死亡率之间存在非线性关系。
在糖尿病患者中，SII 升高与心血管和全因死亡率升高相关。
