Zhang Xiaohong, Fang Yuan, Weng Mengjie, Chen Caiming, Xu Yanfang, Wan Jianxin
Department of Nephrology, Blood Purification Research Center, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China.
Fujian Clinical Research Center for Metabolic Chronic Kidney Disease, the First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China.
PeerJ. 2024 Nov 18;12:e18493. doi: 10.7717/peerj.18493. eCollection 2024.
Systemic immune-inflammation index (SII) was an indicator which could reflect immune response and systemic inflammation. We aim to explore the relationship between SII and diabetic nephropathy (DN).
SII was calculated as neutrophil count × platelet count/lymphocyte count. The receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnosis power of SII. Univariate and multivariate logistic analysis were conducted to assess SII as the risk factor for DN. A restricted cubic spline model was carried out to show the nonlinear association between SII and DN.
Two hundred participants were enrolled, with an average age of 56.6 ± 13.4 years; 54% participants were categorized as DN. Spearman association analysis showed SII was positive associated with increased urinary albumin to creatinine ratio and serum creatinine, while negative associated with eGFR and serum albumin. The ROC curve revealed that the maximum area under the curve (AUC) was 0.761 (95% , 0.694-0.828, < 0.001). After univariate and multivariate logistic analysis, SII (=1.004, = 0.002) and serum creatinine (=1.146, < 0.001) were risk factors for the occurrence of DN, while age (=0.920, = 0.011) and serum albumin (=0.708, < 0.001) were protective factors for the occurrence of DN. The restricted cubic spline model showed that there was a significant nonlinear association between DN incidence and continuous SII value when it exceeded 624*10 9/L.
SII is a novel diagnostic biomarker which is independently associated with DN. Further large-scale prospective studies are needed to validate our findings before SII can be considered a reliable diagnostic or prognostic tool for DN.
全身免疫炎症指数（SII）是一种可反映免疫反应和全身炎症的指标。我们旨在探讨SII与糖尿病肾病（DN）之间的关系。
SII的计算方法为中性粒细胞计数×血小板计数/淋巴细胞计数。采用受试者工作特征（ROC）曲线分析来评估SII的诊断效能。进行单因素和多因素逻辑回归分析以评估SII作为DN的危险因素。采用限制立方样条模型来显示SII与DN之间的非线性关联。
共纳入200名参与者，平均年龄为56.6±13.4岁；54%的参与者被归类为DN。Spearman相关性分析显示，SII与尿白蛋白肌酐比值升高和血清肌酐呈正相关，而与估算肾小球滤过率（eGFR）和血清白蛋白呈负相关。ROC曲线显示，曲线下最大面积（AUC）为0.761（95%可信区间，0.694 - 0.828，P < 0.001）。经过单因素和多因素逻辑回归分析，SII（β = 1.004，P = 0.002）和血清肌酐（β = 1.146，P < 0.001）是DN发生的危险因素，而年龄（β = 0.920，P = 0.011）和血清白蛋白（β = 0.708，P < 0.001）是DN发生的保护因素。限制立方样条模型显示，当SII连续值超过624×10⁹/L时，DN发病率与SII之间存在显著的非线性关联。
SII是一种新型诊断生物标志物，与DN独立相关。在SII可被视为DN的可靠诊断或预后工具之前，需要进一步的大规模前瞻性研究来验证我们的发现。
