The prognostic value of the systemic immunity–inflammation index for cardiovascular and all-cause mortality in cardiovascular disease patients with diabetes or prediabetes

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Investigation Pub Date : 2024-12-24 DOI:10.1111/jdi.14383

Zhengyi Long, Jingyun Du, Jie Hu, Yang Xiao, Can Hou

{"title":"The prognostic value of the systemic immunity–inflammation index for cardiovascular and all-cause mortality in cardiovascular disease patients with diabetes or prediabetes","authors":"Zhengyi Long, Jingyun Du, Jie Hu, Yang Xiao, Can Hou","doi":"10.1111/jdi.14383","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>The relationship between the systemic immune–inflammatory index (SII) and the prognosis of cardiovascular disease (CVD) patients with diabetes or prediabetes remains uncertain. This study investigated the association between baseline SII and all-cause and cardiovascular mortality in American adults with CVD and diabetes or prediabetes.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Our survey included 4,060 adults with cardiovascular disease and diabetes or prediabetes from the National Health and Nutrition Examination Survey (1998–2020). Using restricted cubic splines (RCS) based on Cox regression models and a two-piecewise Cox proportional hazards model for both sides of the inflection point, we elucidated the nonlinear relationship between baseline SII and mortality. Mediation analysis was used to explore the indirect impact of SII on mortality through eGFR.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>In the median 129 months of follow-up, 620 people died from cardiovascular causes and 1,800 from all causes. In the CVD population with diabetes or prediabetes, SII showed a U-shaped relationship with all-cause mortality. The association between SII and CVD mortality was nonlinear and J-shaped. Stratified and interaction analysis confirmed the stability of the core results. Notably, eGFR partially mediated the association between SII and both all-cause and cardiovascular mortality by 9.4% and 6.9%, respectively.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>SII revealed a U-shaped relationship with all-cause mortality (inflection point: lnSII = 6) and a J-shaped association with CVD mortality (inflection point: lnSII = 5.73) in CVD patients with diabetes or prediabetes among American patients. Thus, assessing the SII index may offer valuable insights into risk assessment and prognosis in patients with CVD who are diabetic or prediabetic.</p>\n </section>\n </div>","PeriodicalId":51250,"journal":{"name":"Journal of Diabetes Investigation","volume":"16 3","pages":"510-520"},"PeriodicalIF":3.1000,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jdi.14383","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Diabetes Investigation","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jdi.14383","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Background

The relationship between the systemic immune–inflammatory index (SII) and the prognosis of cardiovascular disease (CVD) patients with diabetes or prediabetes remains uncertain. This study investigated the association between baseline SII and all-cause and cardiovascular mortality in American adults with CVD and diabetes or prediabetes.

Methods

Our survey included 4,060 adults with cardiovascular disease and diabetes or prediabetes from the National Health and Nutrition Examination Survey (1998–2020). Using restricted cubic splines (RCS) based on Cox regression models and a two-piecewise Cox proportional hazards model for both sides of the inflection point, we elucidated the nonlinear relationship between baseline SII and mortality. Mediation analysis was used to explore the indirect impact of SII on mortality through eGFR.

Results

In the median 129 months of follow-up, 620 people died from cardiovascular causes and 1,800 from all causes. In the CVD population with diabetes or prediabetes, SII showed a U-shaped relationship with all-cause mortality. The association between SII and CVD mortality was nonlinear and J-shaped. Stratified and interaction analysis confirmed the stability of the core results. Notably, eGFR partially mediated the association between SII and both all-cause and cardiovascular mortality by 9.4% and 6.9%, respectively.

Conclusions

SII revealed a U-shaped relationship with all-cause mortality (inflection point: lnSII = 6) and a J-shaped association with CVD mortality (inflection point: lnSII = 5.73) in CVD patients with diabetes or prediabetes among American patients. Thus, assessing the SII index may offer valuable insights into risk assessment and prognosis in patients with CVD who are diabetic or prediabetic.

Abstract Image

查看原文本刊更多论文

全身免疫炎症指数对心血管疾病合并糖尿病或前驱糖尿病患者心血管及全因死亡率的预测价值

背景：系统免疫炎症指数（SII）与心血管疾病（CVD）合并糖尿病或前驱糖尿病患者预后的关系尚不确定。本研究调查了基线SII与美国心血管疾病合并糖尿病或前驱糖尿病的成人全因死亡率和心血管死亡率之间的关系。方法：我们的调查包括来自1998-2020年全国健康与营养调查的4060名心血管疾病和糖尿病或前驱糖尿病的成年人。利用基于Cox回归模型的限制性三次样条（RCS）和拐点两侧的两分段Cox比例风险模型，我们阐明了基线SII与死亡率之间的非线性关系。采用中介分析，通过eGFR探讨SII对死亡率的间接影响。结果：在平均129个月的随访中，620人死于心血管疾病，1800人死于各种原因。在伴有糖尿病或前驱糖尿病的CVD人群中，SII与全因死亡率呈u型关系。SII与CVD死亡率呈非线性j型关系。分层和相互作用分析证实了核心结果的稳定性。值得注意的是，eGFR在SII与全因死亡率和心血管死亡率之间分别介导了9.4%和6.9%的关联。结论：在美国糖尿病或前驱糖尿病的CVD患者中，SII与全因死亡率呈u型关系（拐点lnSII = 6），与CVD死亡率呈j型关系（拐点lnSII = 5.73）。因此，评估SII指数可能为糖尿病或糖尿病前期CVD患者的风险评估和预后提供有价值的见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Diabetes Investigation ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

9.40%

发文量

218

审稿时长

6-12 weeks

期刊介绍： Journal of Diabetes Investigation is your core diabetes journal from Asia; the official journal of the Asian Association for the Study of Diabetes (AASD). The journal publishes original research, country reports, commentaries, reviews, mini-reviews, case reports, letters, as well as editorials and news. Embracing clinical and experimental research in diabetes and related areas, the Journal of Diabetes Investigation includes aspects of prevention, treatment, as well as molecular aspects and pathophysiology. Translational research focused on the exchange of ideas between clinicians and researchers is also welcome. Journal of Diabetes Investigation is indexed by Science Citation Index Expanded (SCIE).