Zhang Fan, Han Yan, Mao Yonghua, Li Wenjian
Changzhou Clinical College, Xuzhou Medical University, Changzhou, 213001, China.
Department of Endocrinology, Changzhou Third People's Hospital, Changzhou, 213001, China.
Diabetol Metab Syndr. 2024 Nov 24;16(1):282. doi: 10.1186/s13098-024-01536-0.
This study investigated the correlation between the systemic immune-inflammation index (SII) and the systemic inflammation response index (SIRI) and all-cause, cardiovascular, and kidney disease mortality in patients with diabetic nephropathy (DN). It aimed to provide a new predictive assessment tool for the clinic and a scientific basis for managing inflammation in DN.
The data utilized in this study were obtained from the National Health and Nutrition Examination Survey (NHANES) database, spanning 1999 to 2018. A total of 2641 patients diagnosed with DN were included in the analysis. The association between SII and SIRI levels and mortality in patients with DN was investigated using multivariate Cox proportional risk regression models. These relationships were further validated by Kaplan-Meier survival curves and restricted cubic spline (RCS) modeling, and subgroup analyses were performed to explore the heterogeneity among different characteristic subgroups.
The multivariate Cox regression analysis indicated that SII and SIRI levels were independently associated with all-cause mortality and cardiovascular mortality in patients with DN. SIRI levels were found to be an independently associated factor with kidney disease mortality in patients with DN. Patients in the highest quartile of SII and SIRI exhibited a 1.49-fold and 1.62-fold increased risk of all-cause mortality, respectively, compared to patients in the lowest quartile. The risk of cardiovascular mortality was 1.31 and 1.73 times higher than that in patients in the lowest quartile, respectively. The risk of kidney disease mortality in patients in the highest quartile of SIRI was 2.74 times higher than that in patients in the lowest quartile. Kaplan-Meier survival curve and RCS analyses further confirmed the positive association between SII and SIRI and mortality and a significant nonlinear relationship between SII and all-cause mortality. The SII and SIRI indices offer incremental value in model predictive power for mortality in patients with DN. Subgroup analyses demonstrated that the correlation between SII and SIRI and mortality risk was stable but heterogeneous across different subgroups.
SII and SIRI can be utilized as biomarkers for forecasting the likelihood of all-cause and cardiovascular mortality in patients with DN.
本研究调查了糖尿病肾病（DN）患者的全身免疫炎症指数（SII）与全身炎症反应指数（SIRI）以及全因、心血管和肾脏疾病死亡率之间的相关性。其目的是为临床提供一种新的预测评估工具，并为DN炎症管理提供科学依据。
本研究使用的数据来自1999年至2018年的美国国家健康与营养检查调查（NHANES）数据库。共有2641例诊断为DN的患者纳入分析。使用多变量Cox比例风险回归模型研究DN患者中SII和SIRI水平与死亡率之间的关联。通过Kaplan-Meier生存曲线和受限立方样条（RCS）建模进一步验证了这些关系，并进行亚组分析以探索不同特征亚组之间的异质性。
多变量Cox回归分析表明，SII和SIRI水平与DN患者的全因死亡率和心血管死亡率独立相关。发现SIRI水平是DN患者肾脏疾病死亡率的独立相关因素。与最低四分位数的患者相比，SII和SIRI最高四分位数的患者全因死亡率风险分别增加1.49倍和1.62倍。心血管死亡率风险分别比最低四分位数的患者高1.31倍和1.73倍。SIRI最高四分位数的患者肾脏疾病死亡率风险比最低四分位数的患者高2.74倍。Kaplan-Meier生存曲线和RCS分析进一步证实了SII和SIRI与死亡率之间的正相关以及SII与全因死亡率之间的显著非线性关系。SII和SIRI指数在DN患者死亡率的模型预测能力方面具有增量价值。亚组分析表明，SII和SIRI与死亡风险之间的相关性在不同亚组中稳定但存在异质性。
SII和SIRI可作为预测DN患者全因和心血管死亡率可能性的生物标志物。
