Systemic inflammation markers independently associated with increased mortality in individuals with hyperuricemia: Results from the NHANES prospective cohort study

IF 3.1 4区医学 Q3 IMMUNOLOGY

Immunity, Inflammation and Disease Pub Date : 2024-10-01 DOI:10.1002/iid3.70032

Tian Ren, Erye Zhou, Jian Wu, Chao Wang, Yufeng Yin

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Abstract

Background

Hyperuricemia is associated with increased systemic inflammation. The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) are novel systemic inflammation markers and prognostic markers. However, no studies have evaluated the association between the SII/SIRI and mortality risk in individuals with hyperuricemia. This study aimed to investigate the predictive value of the SII and SIRI for all-cause and cardiovascular mortality in a large cohort of hyperuricemia patients.

Methods

We conducted a prospective cohort study using data from the National Health and Nutrition Examination Survey (NHANES) 2001-2020. Hyperuricemia was defined as serum uric acid (SUA) levels of ≥7 mg/dL in men and ≥6 mg/dL in women. The SII and SIRI were calculated based on complete blood count parameters. Associations with all-cause and cardiovascular mortality were analyzed using Cox proportional hazards models. Nonlinearity and effect modification were assessed using restricted cubic splines (RCS) and interaction analysis.

Results

Among the 6181 participants with hyperuricemia aged 20 years and older, over a total 181 months of follow-up, there were 936 all-cause deaths, of which 195 were cardiovascular mortality. In the fully adjusted models, the hazard ratios (HRs) were 1.73 (95% CI 1.42-2.13) for the SII and 2.18 (95% CI 1.82-2.62) for the SIRI with all-cause mortality. The adjusted HRs were 2.08 (95% CI 1.37-3.14) for the SII and 2.32 (95% CI 1.56-3.45) for the SIRI with cardiovascular mortality. Spline models identified nonlinear U-shaped (SII) and J-shaped (SIRI) relationships of inflammation markers with mortality.

Conclusions

Elevated SII and SIRI are independent predictors of mortality in hyperuricemia patients. These inflammatory biomarkers may improve risk stratification in this high-risk population. Further research should evaluate utility in guiding preventive interventions.

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全身炎症标志物与高尿酸血症患者死亡率升高密切相关：NHANES前瞻性队列研究的结果。

背景：高尿酸血症与全身炎症加剧有关。全身免疫炎症指数（SII）和全身炎症反应指数（SIRI）是新型的全身炎症标志物和预后标志物。然而，还没有研究评估过 SII/SIRI 与高尿酸血症患者死亡风险之间的关联。本研究旨在调查 SII 和 SIRI 对一大批高尿酸血症患者的全因死亡率和心血管死亡率的预测价值：我们利用美国国家健康与营养调查（NHANES）2001-2020 年的数据开展了一项前瞻性队列研究。高尿酸血症的定义是男性血清尿酸（SUA）水平≥7 mg/dL，女性≥6 mg/dL。SII和SIRI是根据全血细胞计数参数计算得出的。与全因死亡率和心血管死亡率的关系采用 Cox 比例危险模型进行分析。使用限制性立方样条（RCS）和交互分析评估了非线性和效应修正：在 6181 名年龄在 20 岁及以上的高尿酸血症患者中，在长达 181 个月的随访中，共有 936 人死于各种原因，其中 195 人死于心血管疾病。在完全调整模型中，SII 和 SIRI 与全因死亡率的危险比分别为 1.73（95% CI 1.42-2.13）和 2.18（95% CI 1.82-2.62）。SII和SIRI与心血管死亡率的调整HR分别为2.08（95% CI 1.37-3.14）和2.32（95% CI 1.56-3.45）。样条模型确定了炎症指标与死亡率之间的非线性U形（SII）和J形（SIRI）关系：结论：SII 和 SIRI 升高是高尿酸血症患者死亡率的独立预测指标。这些炎症生物标志物可改善这类高危人群的风险分层。进一步的研究应评估其在指导预防性干预措施方面的效用。

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来源期刊

Immunity, Inflammation and Disease Medicine-Immunology and Allergy

CiteScore

3.60

自引率

0.00%

发文量

146

审稿时长

8 weeks

期刊介绍： Immunity, Inflammation and Disease is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research across the broad field of immunology. Immunity, Inflammation and Disease gives rapid consideration to papers in all areas of clinical and basic research. The journal is indexed in Medline and the Science Citation Index Expanded (part of Web of Science), among others. It welcomes original work that enhances the understanding of immunology in areas including: • cellular and molecular immunology • clinical immunology • allergy • immunochemistry • immunogenetics • immune signalling • immune development • imaging • mathematical modelling • autoimmunity • transplantation immunology • cancer immunology