Systemic Immune-Inflammation Index and Selected Immune-Based Scores in the Diagnosis and Monitoring of Celiac Disease

The aim of this study was to investigate the value and effectiveness of the systemic immune-inflammation index (SII) in the diagnosis and follow-up of celiac disease (CD) is an immune-mediated enteropathy that requires reliable non-invasive markers for monitoring.

This retrospective analysis included patients diagnosed with CD who were followed up and treated at the Gastroenterology Department between 2018 and 2022. Healthy individuals (n=133) were included as the control group (n=121). Comparative analyses were conducted on CD patients and control group. Demographic data, hemogram, biochemical parameters, SII, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume-to-platelet ratio (MPR) values were recorded. Measurements at the initiation of treatment and at the 6th and 12th months post treatment were evaluated for the CD group.

The SII, PLR, NLR, and MPR values were significantly higher in the CD group at diagnosis compared to the healthy group (P < .001). Receiver operating characteristic analysis showed that SII had a significantly higher discriminatory power in differentiating CD from healthy individuals (P < .001), with a sensitivity of 86% and specificity of 90% for the diagnosis of CD. The SII values showed a significant progressive decrease in the CD group at the 6th and 12th months after initiation of diet (P < .001), parallel to improvements in laboratory findings. Similar results were detected in PLR and NLR, but their sensitivities were lower with an AUC of 0.942.

Systemic immune-inflammation index may serve as an easily accessible, cost-effective, and promising biomarker for the diagnosis and follow-up of CD.