Hu Bing, Liu Tong, Sun Yanxiang, Sun Jie, Feng Li, Li Fei
Department of Cardiology, Zhongshan City People's Hospital, Zhongshan, Guangdong, China.
Department of Cardiology, Zhongshan City People's Hospital, Zhongshan, Guangdong, China.
Clinics (Sao Paulo). 2025 Aug 6;80:100739. doi: 10.1016/j.clinsp.2025.100739.
The Systemic Immune-Inflammation Index (SII) is widely studied for its role in evaluating Cardiovascular Disease (CVD) and mortality. However, its association with all-cause and CVD mortality in non-elderly diabetic adults remains unclear. This study aims to explore the relationship between SII and both all-cause and CVD mortality in non-elderly diabetic adults in the United States.
Cox proportional hazards models and subgroup analyses were used to assess the link between SII and mortality. Restricted Cubic Splines (RCS) examined the nonlinear association between SII and mortality.
Data from 4680 participants in NHANES (2001‒2018) were analyzed. Over an average follow-up of 98.3 months, there were 625 all-cause deaths and 162 CVD-related deaths. Participants were categorized into two SII groups (higher: > 947.625, lower: ≤ 947.625). Multivariable-adjusted models showed that higher SII levels were significantly associated with an increased risk of both CVD mortality (HR = 3.05; 95 % CI 1.85, 5.01) and all-cause mortality (HR = 1.97; 95 % CI 1.50, 2.58). Subgroup analyses confirmed the consistency of these associations. RCS analysis revealed a nonlinear relationship between SII and all-cause mortality, while the association with CVD mortality was linear.
Higher SII levels in non-elderly diabetic adults in the U.S. are linked to an increased risk of both CVD and all-cause mortality.
系统性免疫炎症指数（SII）因其在评估心血管疾病（CVD）和死亡率方面的作用而得到广泛研究。然而，其与非老年糖尿病成年人全因死亡率和心血管疾病死亡率之间的关联仍不明确。本研究旨在探讨美国非老年糖尿病成年人中SII与全因死亡率和心血管疾病死亡率之间的关系。
采用Cox比例风险模型和亚组分析来评估SII与死亡率之间的关联。受限立方样条（RCS）分析用于检验SII与死亡率之间的非线性关联。
对美国国家健康与营养检查调查（NHANES，2001 - 2018年）中4680名参与者的数据进行了分析。平均随访98.3个月期间，有625例全因死亡和162例心血管疾病相关死亡。参与者被分为两个SII组（较高组：> 947.625，较低组：≤ 947.625）。多变量调整模型显示，较高的SII水平与心血管疾病死亡率（HR = 3.05；95% CI 1.85，5.01）和全因死亡率（HR = 1.97；95% CI 1.50，2.58）风险增加显著相关。亚组分析证实了这些关联的一致性。RCS分析显示SII与全因死亡率之间存在非线性关系，而与心血管疾病死亡率的关联是线性的。
美国非老年糖尿病成年人中较高的SII水平与心血管疾病和全因死亡率风险增加有关。
