He Yangxuan, Hu Manling, Miao Xinlei, Xu Fei, Deng Jiayi, Song Ziping, Li Meng, Ming Yunxiang, Leng Song
Health Management Center, the Second Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
Department of Gastroenterology,the Second Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China.
J Inflamm Res. 2025 Apr 1;18:4595-4606. doi: 10.2147/JIR.S509814. eCollection 2025.
Previous research studies have linked the systemic immune inflammation index (SII), derived from a complete blood count, to metabolic dysfunction-associated steatotic liver disease (MASLD). However, evidence on the relationship between longitudinal changes in SII and MASLD remains limited. This study aimed to explore distinct SII trajectories and their association with MASLD incidence.
A longitudinal study analyzed 25,600 individuals who underwent periodic health assessments at a Dalian City hospital between 2014 and 2023. MASLD was diagnosed via ultrasound. The SII was calculated using the formula SII = (platelet count × neutrophil count) / lymphocyte count. Group-based trajectory modeling was used to identify SII trajectories, and restricted cubic spline (RCS) analysis was employed to assesse the dose-response relationship. Stratified analyses and sensitivity analyses were also conducted.
Three SII trajectories were identified: "low stable" (50.6%), "moderate stable" (35.1%), and "high stable" (8.9%). After adjustments, the hazard ratios () for MASLD incidence were 1.118 (95% : 1.057-1.182, <0.001) for the "moderate stable" group and 1.284 (95% : 1.172-1.408, <0.001) for the "high stable" group. These associations persisted after adjusting for lifestyle factors. A significant non-linear relationship between SII and MASLD risk was found in both the overall population and among different genders. Subgroup and sensitivity analyses consistently confirmed these findings.
Elevated SII levels are significantly associated with an increased risk of MASLD, particularly among individuals under 45 and women. Regular SII monitoring may improve risk stratification and facilitate targeted prevention strategies for those at higher risk of MASLD.
既往研究已将基于全血细胞计数得出的全身免疫炎症指数（SII）与代谢功能障碍相关脂肪性肝病（MASLD）联系起来。然而，关于SII的纵向变化与MASLD之间关系的证据仍然有限。本研究旨在探索不同的SII轨迹及其与MASLD发病率的关联。
一项纵向研究分析了2014年至2023年期间在大连市一家医院接受定期健康评估的25600名个体。通过超声诊断MASLD。使用公式SII =（血小板计数×中性粒细胞计数）/淋巴细胞计数来计算SII。基于组的轨迹模型用于识别SII轨迹，并采用受限立方样条（RCS）分析来评估剂量反应关系。还进行了分层分析和敏感性分析。
确定了三种SII轨迹：“低稳定”（50.6%）、“中稳定”（35.1%）和“高稳定”（8.9%）。调整后，“中稳定”组MASLD发病的风险比（HR）为1.118（95%CI：1.057 - 1.182，P<0.001），“高稳定”组为1.284（95%CI：1.172 - 1.408，P<0.001）。在调整生活方式因素后，这些关联仍然存在。在总体人群和不同性别中均发现SII与MASLD风险之间存在显著的非线性关系。亚组分析和敏感性分析一致证实了这些发现。
SII水平升高与MASLD风险增加显著相关，尤其是在45岁以下个体和女性中。定期监测SII可能会改善风险分层，并有助于为MASLD高风险人群制定有针对性的预防策略。
