Huang Dongli, Wu Hang
Department of Nephrology, Bishan Hospital of Chongqing Medical University (Bishan Hospital of Chongqing), Chongqing, China.
Front Med (Lausanne). 2025 Mar 10;12:1506575. doi: 10.3389/fmed.2025.1506575. eCollection 2025.
We aimed to investigate the potential association between the aggregate index of systemic inflammation (AISI) and chronic kidney disease (CKD).
This study analyzed data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2018. CKD was defined as either an estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73 m or the presence of albuminuria, defined as a urine albumin-to-creatinine ratio (ACR) of 30 mg/g or higher. Low eGFR is an eGFR of less than 60 mL/min/1.73 m. Multivariate regression analysis, smoothed curve fitting, and subgroup analyses were conducted to investigate the relationship between the Inflammatory status index (AISI) and CKD. The receiver operating characteristic (ROC) curve analysis was used to evaluate its ability to identify CKD and low eGFR. The AISI was transformed using the natural logarithm (Ln) for statistical analysis.
Of the 50,768 recruits, 49.86% were male. The prevalence of CKD and low eGFR was 20.31% and 8.57%, respectively. Ln-AISI was positively associated with CKD (OR = 1.24; 95% CI: 1.19, 1.28) and low eGFR (OR = 1.17; 95% CI:1.11, 1.24). Smooth curve fitting revealed a positive association between AISI and CKD and low eGFR. Subgroup analysis and interaction tests indicated that stratifications did not significantly alter the association between AISI and CKD and low eGFR. Threshold effect analysis indicated that this relationship became more pronounced when Ln-AISI exceeded 5.2 (AISI > 181.27). The ROC analysis showed that AISI had better discrimination and accuracy for identifying CKD and low eGFR compared to other inflammatory indicators [lymphocyte count (LYM), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), and the product of platelet count and neutrophil count (PPN)].
AISI was significantly and positively correlated with the prevalence of CKD, and this relationship was more potent when AISI was greater than 181.27. Compared with other inflammatory indicators, AISI was more effective in identifying CKD.
我们旨在研究全身炎症综合指数（AISI）与慢性肾脏病（CKD）之间的潜在关联。
本研究分析了1999年至2018年美国国家健康与营养检查调查（NHANES）的数据。CKD的定义为估计肾小球滤过率（eGFR）低于60 mL/min/1.73 m²，或存在白蛋白尿，定义为尿白蛋白与肌酐比值（ACR）为30 mg/g或更高。低eGFR是指eGFR低于60 mL/min/1.73 m²。进行多变量回归分析、平滑曲线拟合和亚组分析，以研究炎症状态指数（AISI）与CKD之间的关系。采用受试者工作特征（ROC）曲线分析来评估其识别CKD和低eGFR的能力。对AISI进行自然对数（Ln）变换用于统计分析。
在50768名受试者中，49.86%为男性。CKD和低eGFR的患病率分别为20.31%和8.57%。Ln-AISI与CKD（OR = 1.24；95%CI：1.19，1.28）和低eGFR（OR = 1.17；95%CI：1.11，1.24）呈正相关。平滑曲线拟合显示AISI与CKD和低eGFR之间呈正相关。亚组分析和交互检验表明，分层并未显著改变AISI与CKD和低eGFR之间的关联。阈值效应分析表明，当Ln-AISI超过5.2（AISI > 181.27）时，这种关系变得更加明显。ROC分析表明，与其他炎症指标[淋巴细胞计数（LYM）、全身免疫炎症指数（SII）、血小板与淋巴细胞比值（PLR）以及血小板计数与中性粒细胞计数的乘积（PPN）]相比，AISI在识别CKD和低eGFR方面具有更好的辨别力和准确性。
AISI与CKD的患病率显著正相关，当AISI大于181.27时，这种关系更为显著。与其他炎症指标相比，AISI在识别CKD方面更有效。
