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Association between systemic immune-inflammation index and all-cause and CVD mortality in non-elderly diabetic adults

Bing Hu1, Tong Liu1, Yanxiang Sun1

  • 1Department of Cardiology, Zhongshan City People's Hospital, Zhongshan, Guangdong, China.

Clinics (Sao Paulo, Brazil)
|August 7, 2025
PubMed

Insights

Higher Systemic Immune-Inflammation Index (SII) levels indicate increased cardiovascular disease (CVD) and all-cause mortality risk in non-elderly diabetic adults. This finding highlights SII as a potential biomarker for mortality risk stratification in this population.

Area of Science:

  • Cardiovascular Medicine
  • Diabetes Research
  • Inflammation Biomarkers

Background:

  • The Systemic Immune-Inflammation Index (SII) is a known predictor of cardiovascular disease (CVD) and mortality.
  • Its specific association with all-cause and CVD mortality in non-elderly diabetic adults requires further investigation.

Purpose of the Study:

  • To investigate the relationship between SII and both all-cause and CVD mortality in non-elderly diabetic adults in the United States.
  • To explore potential nonlinear associations using Restricted Cubic Splines (RCS).

Main Methods:

  • Analysis of 4680 participants from the NHANES (2001–2018) dataset.
  • Utilized Cox proportional hazards models and subgroup analyses to assess mortality risk.
  • Employed RCS to examine nonlinear relationships between SII and mortality outcomes.

Main Results:

  • Higher SII levels were significantly associated with increased CVD mortality (HR = 3.05) and all-cause mortality (HR = 1.97).
  • Subgroup analyses confirmed the robustness of these associations.
  • RCS revealed a nonlinear association with all-cause mortality and a linear association with CVD mortality.

Conclusions:

  • Elevated SII levels are linked to a higher risk of both CVD and all-cause mortality in non-elderly diabetic adults.
  • SII may serve as a valuable prognostic marker for mortality in this demographic.
Abstract

Keywords:
Cardiovascular diseaseDiabetesMortalitySystemic immune-inflammation index

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