Wu Fei, Yang Jiantong, Liu Yinchuan, Zhang Yipei
Department of Gynecology, Jiangxi Maternal and Child Health Hospital, Nanchang, Jiangxi, 330006, People's Republic of China.
Department of Gynecology, Nanchang Hongdu Hospital of Traditional Chinese Medicine, Nanchang, Jiangxi, 330008, People's Republic of China.
Int J Womens Health. 2025 May 20;17:1457-1468. doi: 10.2147/IJWH.S504664. eCollection 2025.
The systemic immune inflammation (SII) index provides a comprehensive assessment of inflammatory and immune status in patients with different diseases. However, it remains unclear whether the SII can be considered a valuable prognostic risk factor of all-cause mortality for postmenopausal women.
We analyzed data from 1882 postmenopausal women enrolled in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. The Systemic Immune-Inflammation Index (SII) was calculated using peripheral blood cell counts and categorized into quartiles. Multivariable Cox proportional hazards models and restricted cubic spline analyses were employed to assess the association between SII and mortality outcomes.
Over a median follow-up period of 8 years, 13.5% individuals died, with 4% deaths attributed to CVD. Patients with extremely high SII levels experienced significantly higher all-cause and CVD mortality. Compared to the low SII group (Q1), the hazard ratio (HR) and 95% confidence interval (CI) for all-cause mortality risk were 0.96 (0.87, 1.07), 0.97 (0.88, 1.08), and 1.28 (1.16, 1.41) for Q2, Q3, and Q4, respectively. Similarly, the HR (95% CI) for CVD mortality in Q2, Q3, and Q4 were 1.02 (0.83, 1.24), 1.11 (0.92, 1.34), and 1.32 (1.10, 1.58), respectively. Including SII in addition to traditional risk factors resulted in a slight enhancement in mortality prediction capability.
Among postmenopausal women, extremely high SII levels were identified as an independent risk factor for all-cause and CVD mortality.
全身免疫炎症（SII）指数可全面评估不同疾病患者的炎症和免疫状态。然而，SII是否可被视为绝经后女性全因死亡率的有价值预后风险因素仍不明确。
我们分析了1999年至2018年参加美国国家健康与营养检查调查（NHANES）的1882名绝经后女性的数据。使用外周血细胞计数计算全身免疫炎症指数（SII），并将其分为四分位数。采用多变量Cox比例风险模型和限制性立方样条分析来评估SII与死亡结局之间的关联。
在中位随访期8年期间，13.5%的个体死亡，4%的死亡归因于心血管疾病（CVD）。SII水平极高的患者全因死亡率和CVD死亡率显著更高。与低SII组（Q1）相比，Q2、Q3和Q4的全因死亡风险的风险比（HR）及95%置信区间（CI）分别为0.96（0.87，1.07）、0.97（0.88，1.08）和1.28（1.16，1.41）。同样，Q2、Q3和Q4的CVD死亡的HR（95%CI）分别为1.02（0.83，1.24）、1.11（0.92，1.34）和1.32（1.10，1.58）。除传统风险因素外纳入SII可使死亡率预测能力略有提高。
在绝经后女性中，极高的SII水平被确定为全因死亡率和CVD死亡率的独立风险因素。
