Department of Hepatobiliary Surgery, People's Hospital of Longhua, Shenzhen, China.
Department of General Medicine, People's Hospital of Longhua, Shenzhen, China.
PLoS One. 2024 Jul 25;19(7):e0303398. doi: 10.1371/journal.pone.0303398. eCollection 2024.
A novel indicator of inflammation is the systemic immune-inflammation index (SII), and liver dysfunction is linked to the advancement of inflammation. In light of this, this study aims to look into any potential connections between SII and markers of liver injury.
A cross-sectional study was conducted using the National Health and Nutrition Examination (NHANES) dataset for 2017-2020. The linear relationship between SII and markers of liver injury was examined using multiple linear regression models. Examining threshold effects and fitted smoothed curves were utilized to describe nonlinear connections.
A total of 8213 adults aged 18-80 years participated in this population-based study. In the fully adjusted model, SII maintained a negative association with ALT(β = -0.003, 95%CI:-0.005, -0.002, P<0.00001), AST(β = -0.004, 95% CI:-0.005, -0.002, P<0.00001), and GGT(β = -0.004, 95% CI:-0.007, -0.000, P = 0.03791) and a positive association with ALP (β = 0.005, 95% CI:0.003, 0.007, P<0.00001). In subgroup analyses, it was found that SII remained negatively correlated with ALT, AST and GGT in gender, age and body mass index. SII was positively correlated with ALP at BMI≥25(kg/m2)(β = 0.005, 95% CI:0.003, 0.008, P = 0.00001), and was negatively correlated with ALT(β = -0.004, 95% CI:-0.005, -0.002, P<0.00001), AST(β = -0.004, 95% CI:-0.005, -0.003, P<0.00001) and GGT(β = -0.004, 95% CI:-0.008, -0.000, P = 0.02703) at BMI≥25, whereas no significant correlation was observed at BMI<25 (all P-values>0.05). Furthermore, the association between SII and markers of liver injury was nonlinear. By using a two-stage linear regression model for analysis, a U-shaped relationship was found to exist between SII and ALT with a turning point of 818.40(1,000 cells/μl). The inflection points of SII with AST and GGT were 451.20 (1,000 cells/μl) and 443.33 (1,000 cells/μl), respectively, and no significant inflection point with ALP was observed. Interaction tests demonstrated that SII correlation with ALT, AST, ALP, and GGT was not significantly different between strata (all p for interaction>0.05).
The research findings suggested that there was a negative correlation between SII and ALT, AST and GGT, and a positive correlation with ALP. However, larger prospective investigations are still greatly needed to confirm the findings.
炎症的一个新指标是全身免疫炎症指数（SII），而肝功能障碍与炎症的进展有关。鉴于此，本研究旨在研究 SII 与肝损伤标志物之间的潜在联系。
使用 2017-2020 年国家健康和营养检查（NHANES）数据集进行横断面研究。使用多元线性回归模型检查 SII 与肝损伤标志物之间的线性关系。使用阈值效应和拟合平滑曲线来描述非线性关系。
共有 8213 名 18-80 岁的成年人参与了这项基于人群的研究。在完全调整模型中，SII 与 ALT（β=-0.003，95%CI：-0.005，-0.002，P<0.00001）、AST（β=-0.004，95%CI：-0.005，-0.002，P<0.00001）和 GGT（β=-0.004，95%CI：-0.007，-0.000，P=0.03791）呈负相关，与 ALP（β=0.005，95%CI：0.003，0.007，P<0.00001）呈正相关。在亚组分析中，发现 SII 在性别、年龄和体重指数方面与 ALT、AST 和 GGT 仍然呈负相关。SII 在 BMI≥25（kg/m2）（β=0.005，95%CI：0.003，0.008，P=0.00001）时与 ALP 呈正相关，而与 ALT（β=-0.004，95%CI：-0.005，-0.002，P<0.00001）、AST（β=-0.004，95%CI：-0.005，-0.003，P<0.00001）和 GGT（β=-0.004，95%CI：-0.008，-0.000，P=0.02703）呈负相关，而在 BMI<25 时则没有显著相关性（所有 P 值>0.05）。此外，SII 与肝损伤标志物之间的关联是非线性的。通过使用两阶段线性回归模型进行分析，发现 SII 与 ALT 之间存在 U 形关系，转折点为 818.40（1,000 个细胞/μl）。SII 与 AST 和 GGT 的拐点分别为 451.20（1,000 个细胞/μl）和 443.33（1,000 个细胞/μl），而与 ALP 则没有明显的拐点。交互检验表明，SII 与 ALT、AST、ALP 和 GGT 的相关性在各分层之间没有显著差异（所有交互检验 P 值>0.05）。
研究结果表明，SII 与 ALT、AST 和 GGT 呈负相关，与 ALP 呈正相关。然而，仍需要更大规模的前瞻性研究来证实这些发现。
