Department of General Pediatric, Duzce University Faculty of Medicine, Duzce, Türkiye.
Department of Cardiology, Duzce University Faculty of Medicine, Duzce, Türkiye.
J Pediatr Endocrinol Metab. 2024 Jun 3;37(7):635-643. doi: 10.1515/jpem-2024-0043. Print 2024 Jul 26.
In this study, the systemic proinflammatory status was assessed using the systemic immune-inflammation index (SII) and SIRI systemic immune-inflammatory response index (SIRI) in children and adolescents with type 1 diabetes mellitus (T1DM).
The study involved 159 patients aged between 6 and 16 years. The SII and SIRI values were calculated based on the complete blood count. Basic blood biochemistry evaluated, and carotid intima-media thickness (cIMT) was measured and recorded. The cumulative glycemic exposure was calculated by multiplying the value above the normal reference range of the HbA value. The sum of all these values obtained from the time of diagnosis to obtain the cumulative glycemic exposure. All findings were compared statistically. All statistically significant parameters were evaluated in the multivariate logistic regression analysis.
The analysis revealed that only cIMT (Exp(B)/OR: 0.769, 95 % CI: 0.694-0.853, p<0.001), high-density lipoprotein (Exp(B)/OR: 3.924, 95 % CI: 2.335-6.596, p<0.001), monocyte count (Exp(B)/OR: 1.650, 95 % CI: 1.257-2.178, p<0.001), hematocrit (Exp(B)/OR: 0.675, 95 % CI: 0.523-0.870, p<0.001), and SIRI (Exp(B)/OR: 1.005, 95 % CI: 1.002-1.008, p<0.001) were significantly associated with T1DM. A statistically significant positive association was found between cumulative glycemic exposure and SIRI only (r=0.213, p=0.032). To our knowledge, this is the first study to evaluate SII and SIRI in children with type 1 diabetes.
These findings indicate that SIRI could serve as a potential biomarker for detecting early-onset proatherosclerotic processes in diabetic children. However, further clinical studies are required to confirm this.
本研究通过测定系统性免疫炎症指数(SII)和 SIRI 系统免疫炎症反应指数,评估 1 型糖尿病(T1DM)患儿的全身促炎状态。
该研究纳入了 159 名 6-16 岁的患者。SII 和 SIRI 值根据全血细胞计数计算得出。评估基本血液生化指标,测量并记录颈动脉内膜中层厚度(cIMT)。将糖化血红蛋白值高于正常参考范围的乘积计算为累积血糖暴露值。将从诊断开始获得的所有这些值相加,得到累积血糖暴露值。对所有发现进行统计学比较。在多变量逻辑回归分析中评估所有有统计学意义的参数。
分析表明,只有 cIMT(Exp(B)/OR:0.769,95%CI:0.694-0.853,p<0.001)、高密度脂蛋白(Exp(B)/OR:3.924,95%CI:2.335-6.596,p<0.001)、单核细胞计数(Exp(B)/OR:1.650,95%CI:1.257-2.178,p<0.001)、红细胞压积(Exp(B)/OR:0.675,95%CI:0.523-0.870,p<0.001)和 SIRI(Exp(B)/OR:1.005,95%CI:1.002-1.008,p<0.001)与 T1DM 显著相关。仅在累积血糖暴露与 SIRI 之间存在统计学显著的正相关(r=0.213,p=0.032)。据我们所知,这是第一项评估 1 型糖尿病儿童 SII 和 SIRI 的研究。
这些发现表明,SIRI 可能成为检测儿童糖尿病早期动脉粥样硬化过程的潜在生物标志物。然而,需要进一步的临床研究来证实这一点。