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Association between blood inflammatory indices and heart failure: a cross-sectional study of NHANES 2009-2018
Yayun Zhang1, Lu Feng2, Zixiong Zhu1
1Department of Cardiovascular Medicine, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China.
Insights
Elevated levels of systemic inflammatory response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), and monocyte-to-lymphocyte ratio (MLR) are linked to a higher risk of heart failure (HF). These complete blood count-derived markers may indicate inflammation associated with HF development.
Area of Science:
- Cardiovascular Medicine
- Inflammation Research
- Hematology
Background:
- Inflammation is a key factor in the development of heart failure (HF).
- Complete blood count (CBC)-derived inflammatory biomarkers are increasingly recognized for their potential role in disease pathogenesis.
- Understanding the association between these biomarkers and HF risk is crucial for early detection and management.
Purpose of the Study:
- To investigate the association between specific CBC-derived inflammatory biomarkers and the presence of heart failure (HF).
- To evaluate the potential of systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) as indicators of HF risk.
- To explore the nature of the relationship between these inflammatory markers and HF.
Main Methods:
- Utilized data from the National Health and Nutrition Examination Survey (NHANES) 2009-2018, including 26,021 participants.
- Compared five CBC-derived inflammatory markers (SII, SIRI, NLR, PLR, MLR) between individuals with and without HF.
- Employed statistical analyses including smoothing curves, threshold effect analysis, Spearman correlation, and subgroup analyses after adjusting for confounding variables.
Main Results:
- After adjusting for confounders, SIRI, NLR, and MLR showed significant positive correlations with HF risk.
- Participants in the highest quarter of SIRI, NLR, and MLR exhibited an increased risk of HF compared to those in the lowest quarter.
- Subgroup and sensitivity analyses confirmed a stronger correlation between SIRI, NLR, MLR, and HF, with a nonlinear relationship observed.
Conclusions:
- Elevated levels of SIRI, NLR, and MLR are significantly associated with an increased risk of developing heart failure (HF).
- These CBC-derived inflammatory markers demonstrate potential utility as systemic inflammation hazard markers for HF.
- Further research may validate the clinical application of SIRI, NLR, and MLR in HF risk stratification.
Background:
Inflammation plays a pivotal role in the pathogenesis of heart failure (HF). This study was aimed to the potential association between complete blood cell count (CBC)-derived inflammatory biomarkers and HF.
Methods:
Data from the National Health and Nutrition Examination Survey (NHANES) 2009-2018 were utilised. We evaluated the associations between HF and five systemic inflammation markers derived from CBC: systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR). Demographic characteristics, physical examinations, and laboratory data were systematically collected for comparative analysis between HF and non-HF individuals. Fitted smoothing curves and threshold effect analysis delineated the relationship. In addition, Spearman correlation and subgroup analyses were further conducted.
Results:
A total of 26,021 participants were categorised into HF (n = 858) and non-HF (n = 25,163) groups. After adjusting for confounding variables, SIRI, NLR, and MLR had significant positive correlations with the risk of HF. Participants in the highest quarter groups of SIRI, NLR, and MLR showed a increased risk of developing HF compared to those in the lowest quarter group. Furthermore, subgroup and sensitivity analyses indicated that SIRI, NLR, and MLR had a stronger correlation to HF (all p < 0.05). Smoothing curve fitting highlighted a nonlinear relationship between CBC-derived inflammatory biomarkers and HF.
Conclusions:
Our results illustrated a significant association between elevated levels of SIRI, NLR, and MLR and an increased risk of HF. SIRI, NLR, and MLR could potentially serve as systemic inflammation hazard markers for HF.
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