System inflammation response index: a novel inflammatory indicator to predict all-cause and cardiovascular disease mortality in the obese population

Fanliang Kong; Junhao Huang; Chunhua Xu; Tingyuan Huang; Grace Wen; Wenke Cheng

doi:10.1186/s13098-023-01178-8

System inflammation response index: a novel inflammatory indicator to predict all-cause and cardiovascular disease mortality in the obese population

Diabetol Metab Syndr. 2023 Oct 11;15(1):195. doi: 10.1186/s13098-023-01178-8.

Authors

Fanliang Kong^#¹, Junhao Huang^#^{2

3

4}, Chunhua Xu⁵, Tingyuan Huang⁶, Grace Wen¹, Wenke Cheng⁷

Affiliations

¹ University Medical Center of Göttingen, Georg-August University, Göttingen, Germany.
² Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.
³ Department of Plastic Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.
⁴ Department of Gastrointestinal Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China.
⁵ Department of Recuperation, Lintong Rehabilitation, and Recuperation Center, Xian, Shaanxi, China.
⁶ Department of Oncology, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China.
⁷ Medical Faculty, University of Leipzig, Leipzig, Germany. cwk2517@163.com.

^# Contributed equally.

Abstract

Aim: This study aims to investigate the relationship between two novel inflammatory markers, namely, the Systemic Inflammatory Response Index (SIRI) and the Systemic Immune Inflammatory Index (SII), as well as the all-cause and cardiovascular disease (CVD) mortality in the obese population.

Materials and methods: We conducted a prospective cohort study based on the data of 13,026 obese adults (age ≥ 18 years) from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2014 and followed until December 2019. SIRI was calculated by the formula: (neutrophil count × monocyte count) / lymphocyte count, while that of SII was: (platelet count × neutrophil count)/lymphocyte count. The association of SIRI and SII with all-cause and CVD mortality was evaluated using Cox regression. In addition, the nomogram was performed to predict 10-year survival probability.

Results: During a median follow-up of 137 months, 1959 and 553 all-cause and CVD deaths were recorded, respectively. Spearman correlation analysis indicated that SIRI and SII were unrelated to almost all baseline characteristics (r < 0.15). Multivariate Cox regression models displayed that each standard deviation (SD) increase in SIRI was associated with a 16% (HR 1.16; 95% CI 1.09-1.24) and 22% (HR 1.22; 95% CI 1.10-1.36) increase in the risk of all-cause and CVD mortality, respectively. Likewise, every SD increase in SII was correlated with a 9% (HR 1.09; 95% CI 1.02-1.16) and 14% (HR 1.14; 95% CI 1.04-1.26) increase in the risk of all-cause and CVD mortality, respectively. The predictive value of SIRI for all-cause and CVD mortality (AUC = 0.601 and 0.624) exceeded that of SII (AUC = 0.528 and 0.539). Moreover, the nomogram displayed a substantial predictive value for 10-year survival (AUC = 0.847) with sensitivity and specificity exceeding 75%.

Conclusions: In the obese population, SIRI and SII are independent risk factors for all-cause and CVD mortality. Notably, the predictive ability of SIRI for both all-cause and CVD mortality significantly outperforms that of SII, suggesting that SIRI is a more valuable marker of inflammation.

Keywords: All-cause mortality; Cardiovascular disease; Inflammation; Mortality; System inflammation response index; Systemic immune inflammatory index.