Association between systemic immune inflammation index and mortality risks in type 2 diabetes based on NHANES

Area of Science:

• Cardiovascular Research
• Endocrinology
• Immunology

Background:

• Systemic immune-inflammation index (SII) reflects inflammation and immune status.
• Limited evidence exists on SII's prognostic value in type 2 diabetes mellitus (T2DM).

Purpose of the Study:

• To investigate the association between SII and risks of all-cause and cardiovascular mortality in adults with T2DM.
• To evaluate SII as a potential biomarker for risk stratification in T2DM patients.

Main Methods:

• Utilized data from the National Health and Nutrition Examination Survey (1999-2018) with 6035 T2DM participants.
• Employed Kaplan-Meier survival analysis, multivariable Cox proportional hazards models, and restricted cubic spline (RCS) analyses.
• Analyzed SII as both a continuous variable and by quartiles, with subgroup analyses for robustness.

Main Results:

• A median follow-up of 82 months revealed 1808 all-cause deaths and 780 cardiovascular deaths.
• Elevated SII was significantly associated with increased all-cause (HR=1.15) and cardiovascular mortality (HR=1.16) per unit increase.
• The highest quartile of SII showed a 48% higher risk of all-cause and 41% higher risk of cardiovascular death compared to the lowest quartile.

Conclusions:

• Elevated SII is a significant predictor of increased all-cause and cardiovascular mortality in T2DM patients.
• SII may serve as a cost-effective biomarker for long-term risk stratification in T2DM.
• Further prospective studies are needed to confirm causality due to the observational nature of this research.