Huang Suwen, Wang Yanchu, Zhu Jinrong, Li Shengqi, Lin Shenyi, Xie Wei, Chen Siyao, Wang Yukai, Wang Lingsheng, Jin Qiaoqiao, Weng Yiyun, Yang Dehao
Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, People's Republic of China.
J Inflamm Res. 2024 Apr 25;17:2563-2574. doi: 10.2147/JIR.S449324. eCollection 2024.
Myasthenia gravis (MG) is a chronic autoimmune disease caused by neuromuscular junction (NMJ) dysfunction. Our current understanding of MG's inflammatory component remains poor. The systemic inflammatory response index (SIRI) presents a promising yet unexplored biomarker for assessing MG severity. This study aimed to investigate the potential relationship between SIRI and MG disease severity.
We conducted a retrospective analysis of clinical data from 171 MG patients admitted between January 2016 and June 2021. Patients with incomplete data, other autoimmune diseases, or comorbidities were excluded. Disease severity was evaluated using the Myasthenia Gravis Foundation of America (MGFA) classification and Myasthenia Gravis Activities of Daily Living (MG-ADL) on admission. The association between SIRI and disease severity was assessed through logistic regression analysis, along with receiver operating characteristic (ROC) curve and decision curve analysis (DCA) comparisons with established inflammation indicators.
After exclusion, 143 patients were analyzed in our study. SIRI levels significantly differed between patients with higher and lower disease severity ( < 0.001). Univariate logistic regression showed that SIRI had a significant effect on high disease severity (OR = 1.376, 95% CI 1.138-1.664, = 0.001). This association remained significant even after adjusting for age, sex, disease duration, history of MG medication and thymoma (OR = 1.308, 95% CI 1.072-1.597, = 0.008). Additionally, a positive correlation between SIRI and MG-ADL was observed (r = 0.232, = 0.008). Significant interactions were observed between SIRI and immunosuppressor ( interaction = 0.001) and intravenous immunoglobulin ( interaction = 0.005). DCA demonstrated the superior net clinical benefit of SIRI compared to other markers when the threshold probability was around 0.2.
Our findings indicate a strong independent association between SIRI and disease severity in MG, suggesting SIRI's potential as a valuable biomarker for MG with superior clinical benefit to currently utilized markers.
重症肌无力（MG）是一种由神经肌肉接头（NMJ）功能障碍引起的慢性自身免疫性疾病。我们目前对MG炎症成分的了解仍然有限。全身炎症反应指数（SIRI）是一种有前景但尚未被探索的评估MG严重程度的生物标志物。本研究旨在探讨SIRI与MG疾病严重程度之间的潜在关系。
我们对2016年1月至2021年6月期间收治的171例MG患者的临床资料进行了回顾性分析。排除数据不完整、患有其他自身免疫性疾病或合并症的患者。入院时使用美国重症肌无力基金会（MGFA）分类和重症肌无力日常生活活动（MG-ADL）评估疾病严重程度。通过逻辑回归分析评估SIRI与疾病严重程度之间的关联，并与既定的炎症指标进行受试者操作特征（ROC）曲线和决策曲线分析（DCA）比较。
排除后，本研究共分析了143例患者。疾病严重程度较高和较低的患者之间SIRI水平存在显著差异（<0.001）。单因素逻辑回归显示，SIRI对高疾病严重程度有显著影响（OR = 1.376，95%CI 1.138 - 1.664，= 0.001）。即使在调整年龄、性别、病程、MG用药史和胸腺瘤后，这种关联仍然显著（OR = 1.308，95%CI 1.072 - 1.597，= 0.008）。此外，观察到SIRI与MG-ADL之间存在正相关（r = 0.232，= 0.008）。在SIRI与免疫抑制剂（交互作用 = 0.001）和静脉注射免疫球蛋白（交互作用 = 0.005）之间观察到显著的交互作用。当阈值概率约为0.2时，DCA显示SIRI与其他标志物相比具有更高的净临床效益。
我们的研究结果表明SIRI与MG疾病严重程度之间存在强烈的独立关联，提示SIRI作为一种有价值的生物标志物的潜力，其临床效益优于目前使用的标志物。
