Impact of systemic immune inflammation index and systemic inflammation response index on all-cause and cardiovascular mortality in cardiovascular-kidney-metabolic syndrome
Year: 2025
Type: article
Abstract: BACKGROUND: The cardiovascular-kidney-metabolic (CKM) syndrome is a systemic condition defined by multifaceted interactions among metabolic risk factors, chronic kidney disorder, and cardiovascular diseases. Inflammation is essential in the pathogenesis and progression of CKM syndrome. Inflammatory markers, including the systemic immune inflammation index (SII) and the systemic inflammation response index (SIRI), function as composite indicators for assessing immune-related inflammatory status. This study seeks to address the associations between SII/SIRI and death outcomes in individuals with CKM syndrome using outcomes from the National Health and Nutrition Examination Survey (NHANES, 1999-2018). METHODS: This cross-sectional investigation comprised 18,452 individuals (≥ 20 years) with CKM syndrome, utilizing outcomes from ten cycles of NHANES (1999-2018). Participants were divided into higher and lower SII and SIRI groups according to cut-off values established by the optimally chosen rank statistics approach. Kaplan-Meier analysis and Cox proportional hazards and Fine-Gray competing risk regression models were utilized to evaluate the links between SII/SIRI and death outcomes in CKM individuals. Stratified and subgroup analyses were performed to further corroborate the results. Restricted cubic spline (RCS) analysis was utilized to examine potential non-linear links between SII/SIRI and death outcomes in this cohort. Ultimately, time-dependent receiver operating characteristic (ROC) analysis was employed to evaluate the prediction precision of SII and SIRI regarding death outcomes in short- and long-term follow-ups. RESULTS: > 0.05). Time-dependent ROC analysis revealed that SII and SIRI illustrated moderate to excellent and constant prognostic efficacy for short-term and long-term mortality outcomes in individuals with CKM syndrome, with SIRI consistently outperforming SII at all assessed time intervals. CONCLUSIONS: Higher values of SII and SIRI are related to an elevated risk of ACM and CVM in U.S. adults with CKM syndrome. SIRI had moderate, stable predictive capacities for ACM and CVM, whereas SII exhibited moderate to poor predictive capacity for both outcomes, with SIRI consistently outperforming SII across all evaluated time points. These outcomes highlight these inflammatory markers' potential in forecasting adverse mortality outcomes in this population.
Authors: Yongwei Huang, Xiaoshuang Yin, Zongping Li
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,190
OpenAlex ID: W4412504917