Assessing the Relationship between Systemic Immune-Inflammation Index and Metabolic Syndrome in Children with Obesity

Abstract

Childhood obesity represents a worldwide concern as many countries have reported an increase in its incidence, with possible cardiovascular long-term implications. The mechanism that links cardiovascular disease to obesity is related to low-grade inflammation. We designed this study to investigate the diagnostic utility of inflammatory indices (NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; SII, systemic immune-inflammation index; SIRI, systemic inflammation response index) in obese children with metabolic syndrome (MetS) and their relationship with cardiometabolic risk biomarkers, such as the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), triglyceride-to-high-density lipoprotein cholesterol (TG:HDL-C), and non-high-density lipoprotein cholesterol (non-HDL-C). A total of 191 obese children from one large Romanian reference center was included in the study. Patients were classified in two groups according to the presence (MetS group) or absence (non-MetS group) of metabolic syndrome. According to our results, the SII index proved to have diagnostic value in distinguishing MetS patients among children with obesity (AUC = 0.843, a sensitivity of 0.83, and a specificity of 0.63). Furthermore, the SII was positively associated with cardiometabolic risk biomarkers (HOMA-IR, p < 0.001; TG:HDL-C, p = 0.002; non-HDL-C, p = 0.021), highlighting its possible role as an additional measure of cardiometabolic instability in obese children.

Relationship between SIRI and android and gynoid fat related to obesity and cardiovascular risk: a cross-sectional study of NHANES 2017–2018

“…Nicoară et al. 17 found that children with MetS have higher levels of inflammatory status (systemic immune-inflammation index and/or SIRI). Elevated inflammatory indices are significantly correlated with the presence and severity of MetS, which is consistent with the findings of the present study.…”

Association between Insulin Resistance and Pan-Immune-Inflammation Value (PIV): results from the National Health and Nutrition Examination Survey (NHANES) 2017–2020

“…Various complete blood count (CBC)-derived in ammatory indices such as neutrophil-lymphocyte ratio (NLR) (Lou et al, 2015), plateletlymphocyte ratio (PLR) (Atak et al, 2019), monocyte-lymphocyte ratio (MLR) (Alfhili et al, 2022), and systemic immune-in ammation index (SII) (Nicoară et al, 2023) have been used in estimating chronic low-grade in ammation in insulin resistance. The role of PIV has been wellelucidated in cancer as a biomarker to determine prognosis and survival outcomes (Fucà et al, 2020;Guven et al, 2022).…”

C-Reactive Protein as a Marker of Inflammation in Children and Adolescents with Metabolic Syndrome: A Systematic Review and Meta-Analysis

“…The different definitions used to diagnose MetS in children and adolescents create a flaw in our meta-analysis. There is no international general agreement regarding the defini-tion of this pathology, with recent evidence reporting over 40 definitions recommended by various organizations and authors deriving from criteria used in adults [4,68,69]. Even though the criteria are based on the same five components (obesity, raised triglycerides, low HDL-C, high systolic or diastolic blood pressure, and altered plasma glucose) [70], the slightly different cutoff points for each of them make it difficult to obtain highly relatable data.…”