Nonlinear associations between the aggregate index of systemic inflammation and cardiovascular disease in adults:
Run Wang1, Ruoling Chen2, Weijun Tao1
1Department of Cardiology, The Third People's Hospital of Hefei (The Third Clinical College of Anhui Medical University), Hefei, Anhui, China.
Insights
Systemic inflammation, measured by the aggregate index of systemic inflammation (AISI), is strongly linked to cardiovascular disease (CVD) prevalence. Higher AISI levels indicate an increased risk of developing CVD in US adults.
Area of Science:
- Cardiovascular Medicine
- Inflammation Research
- Public Health Analytics
Background:
- The link between inflammation and cardiovascular disease (CVD) is established, but the role of the aggregate index of systemic inflammation (AISI) remains under-explored.
- AISI is calculated using neutrophil, monocyte, and platelet counts relative to lymphocyte count.
- Investigating AISI provides novel insights into cardiovascular disease mechanisms.
Purpose of the Study:
- To examine the association between the aggregate index of systemic inflammation (AISI) and cardiovascular disease (CVD) prevalence in US adults.
- To identify potential thresholds and nonlinear relationships between AISI and CVD.
- To assess the consistency of this association across diverse demographic and clinical subgroups.
Main Methods:
- Utilized data from 23,472 adults in the 2011-2020 National Health and Nutrition Examination Survey (NHANES) database.
- Employed weighted generalized linear models, subgroup analyses, and threshold effect analyses to evaluate the AISI-CVD relationship.
- Smoothed curve analyses were used to visualize nonlinear associations.
Main Results:
- CVD prevalence significantly increases with higher AISI levels (P < 0.001).
- Individuals in the highest quartile of AISI showed a 1.27-fold increased odds of CVD compared to the lowest quartile.
- A nonlinear relationship was observed, with a critical inflection point at AISI = 467; above this, each 100-unit increase in AISI correlated with a 3% rise in CVD prevalence (OR = 1.03).
- The association remained consistent across subgroups, independent of age, ethnicity, smoking, hyperlipidemia, hypertension, and diabetes.
Conclusions:
- This study provides robust evidence for a significant positive correlation between AISI and CVD prevalence.
- The findings underscore the potential of AISI as a biomarker for cardiovascular risk.
- Further prospective research is recommended to fully elucidate AISI's role in the etiology and progression of CVD.
Background:
Although the connection between inflammation and cardiovascular disease (CVD) is well-documented, the association involving the aggregate index of systemic inflammation (AISI)-a distinctive indicator derived from this formula (neutrophil count × monocyte count × platelet count)/lymphocyte count-has not been extensively explored. Addressing this research gap, our study leveraged the National Health and Nutrition Examination Survey (NHANES) database for investigating a correlation among AISI and CVD among adults in U.S. This investigation provides new insights into the inflammatory mechanisms underlying cardiovascular conditions and may have implications for preventive and therapeutic strategies in cardiovascular health.
Methods:
Our study included 23,472 adults from the 2011-2020 NHANES database. The relationship between AISI and CVD was examined using weighted generalized linear models, subgroup analyses, and threshold effects to estimate effect sizes and saturation effects. Nonlinear relationships between the AISI and CVD were further elucidated through smoothed curve analyses.
Results:
The prevalence of CVD increases with AISI(P < 0.001). Within weighted generalized linear models, individuals within Quartile 4 [OR = 1.27, 95%CI (1.00, 1.61)] exhibited a favorable correlation with CVD prevalence, in contrast to the figures observed during Quartile 1. Notably, this correlation was consistent across various subgroups, indicating its independence from factors such as age, ethnicity, smoking, hyperlipidemia, hypertension, and diabetes mellitus (P for interaction > 0.05). Additionally, using threshold effect analysis, we identified a nonlinear relationship across AISI and CVD, with a critical inflection point observed at an index value of 467. Above this threshold, every increment of 100 units within AISI was linked to a 3% elevated CVD prevalence [OR = 1.03, 95%CI (1.00, 1.07)].
Conclusion:
Our work substantiates robust evidence for a important positive correlation between AISI and CVD. However, it also highlights the importance of conducting additional prospective research to comprehensively explore the function of AISI in etiology and advancement of CVD.
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