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

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.

Association of systemic inflammation response index with mortality risk in older patients with hip fracture: a 10-year retrospective cohort study

“…Also, SIRI was found to be an independent predictor of in-hospital death in older patients with acute myocardial infarction (odds ratio [OR] = 3.948, 95% CI: 1.910–8.158) ( 23 ). In addition, this positive association between SIRI and mortality has been observed in other diseases (e.g., cancer, coronary artery disease, stroke, asthma, obesity) ( 20 – 22 , 25 – 28 ).…”

“…More recently, the system inflammation response index (SIRI) has been considered as a novel marker that comprehensively reflects the balance between host inflammatory and immune status ( 20 ). Emerging studies indicated that high SIRI level was closely associated with poor prognosis in many diseases, including cancer (e.g., liver cancer, prostate cancer) ( 20 , 21 ), cardiovascular disease (e.g., coronary artery disease, myocardial infarction) ( 22 – 24 ), cerebrovascular disease (e.g., stroke, intracerebral hemorrhage) ( 25 , 26 ), respiratory disease (e.g., asthma) ( 27 ), and obesity ( 28 ). The SIRI is calculated from peripheral neutrophil, monocyte and lymphocyte ( 20 ).…”

Systemic inflammatory biomarkers are novel predictors of all-cause and cardiovascular mortality in individuals with osteoarthritis: a prospective cohort study using data from the NHANES

“…Notably, the SIRI demonstrated better prognostic discrimination for adverse clinical outcomes than did the CRP [ 33 ]. An elevated SII/SIRI has also been associated with increased risks of all-cause or cardiovascular mortality in individuals with obesity [ 34 ], nonalcoholic fatty liver disease [ 35 ], diabetes [ 36 ], and ischemic stroke [ 17 ]. Research on the utility of the SII and SIRI in OA has been limited, with very few studies examining their potential roles as biomarkers in this population.…”

Construction of a nomogram model for deep vein thrombosis in patients with tibial plateau fracture based on the Systemic Inflammatory Response Index

“…Additionally, this study also collected laboratory data upon patient admission, including white blood cell count (WBC), red blood cell count (RBC), hemoglobin (HGB), mean corpuscular hemoglobin concentration (MCHC), mean corpuscular volume (MCV), neutrophils (NC), lymphocytes (LYM), monocytes (MONO), eosinophils (Eos), basophils (Baso), albumin (ALB), aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), creatinine (Cr), blood urea nitrogen (BUN), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), and other relevant data. The inflammatory factor validated in this study is calculated as the systemic inflammatory response index (SIRI) using the formula: SIRI = (neutrophil count × monocyte count)/lymphocyte count [ 19 ].…”