探讨血清总胆红素与全身免疫炎症指数之间的负相关关系：来自 NHANES 数据（2009-2018 年）的见解。
Exploring the inverse relationship between serum total bilirubin and systemic immune-inflammation index: insights from NHANES data (2009-2018).
机构信息
Department of Critical Care Medicine, Ningbo Medical Center Lihuili Hospital, Ningbo, 315100, China.
Zhejiang Key Laboratory of Geriatrics and Geriatrics Institute of Zhejiang Province, Zhejiang Hospital, Hangzhou, 310030, China.
出版信息
Eur J Med Res. 2024 Jul 12;29(1):362. doi: 10.1186/s40001-024-01963-9.
BACKGROUND
Bilirubin is known for its multifaceted attributes, including antioxidant, anti-inflammatory, immunomodulatory, and antiapoptotic properties. The systemic immune-inflammation index (SII) is a recent marker that reflects the balance between inflammation and immune response. Despite the wealth of information available on bilirubin's diverse functionalities, the potential correlation between the total bilirubin (TB) levels and SII has not been investigated so far.
METHODS
Leveraging data from the National Health and Nutrition Examination Survey spanning 2009-2018, the TB levels were categorized using tertiles. Employing the chi-squared test with Rao and Scott's second-order correction and Spearman's rank correlation analysis, the association between TB and SII was examined. The potential nonlinearities between TB and SII were evaluated using restricted cubic spline (RCS) analysis. Weighted linear regression, adjusted for covariates, was used to explore the correlation between TB and SII, with further subgroup analyses.
RESULTS
A total of 16,858 participants were included, and the findings revealed significant SII variations across TB tertiles (p < 0.001). The third tertile (Q3) exhibited the lowest SII level at 495.73 (295.00) 1000 cells/µL. Spearman rank correlation disclosed the negative association between TB and SII. RCS analysis exposed the lack of statistically significant variations in the nonlinear relationship (p > 0.05), thereby providing support for a linear relationship. Weighted linear regression analysis underscored the negative correlation between TB and SII (β 95% CI - 3.9 [- 5.0 to - 2.9], p < 0.001). The increase in the TB levels is associated with a significant linear trend toward decreasing SII. After controlling for relative covariates, this negative correlation increased (p < 0.001). Subgroup analysis confirmed the significant negative TB-SII association.
CONCLUSION
A notable negative correlation between TB and SII implies the potential protective effects of bilirubin in inflammation-related diseases.
背景
胆红素具有抗氧化、抗炎、免疫调节和抗凋亡等多方面的特性。全身性免疫炎症指数（SII）是一种新的标志物，反映了炎症和免疫反应之间的平衡。尽管胆红素的多种功能特性已有大量信息，但胆红素的总胆红素（TB）水平与 SII 之间的潜在相关性尚未得到研究。
方法
利用 2009-2018 年国家健康与营养调查的数据，将 TB 水平分为三分位。采用卡方检验（带有 Rao 和 Scott 二阶校正）和 Spearman 秩相关分析，研究 TB 与 SII 之间的关系。采用限制性立方样条（RCS）分析评估 TB 与 SII 之间的潜在非线性关系。采用加权线性回归，调整协变量，探讨 TB 与 SII 之间的相关性，并进行进一步的亚组分析。
结果
共纳入 16858 名参与者，结果显示 TB 三分位之间的 SII 存在显著差异（p<0.001）。第三分位（Q3）的 SII 水平最低，为 495.73（295.00）1000 个细胞/µL。Spearman 秩相关显示 TB 与 SII 呈负相关。RCS 分析显示，TB 与 SII 之间的非线性关系无统计学意义（p>0.05），支持线性关系。加权线性回归分析强调了 TB 与 SII 之间的负相关（β95%CI-3.9[-5.0 至-2.9]，p<0.001）。TB 水平升高与 SII 显著线性下降相关。控制相关协变量后，这种负相关关系增强（p<0.001）。亚组分析证实了 TB-SII 之间显著的负相关关系。
结论
TB 与 SII 之间存在显著的负相关关系，这表明胆红素在炎症相关疾病中可能具有保护作用。
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