Associations of Inflammatory Prognosis Index With All-Cause and Cardiovascular Mortality Among Individuals With...

The systemic immune-inflammatory index (SII) and the systemic inflammatory response index (SIRI) have shown prognostic value in diabetes mellitus (DM). However, the impact of the inflammatory prognosis index (IPI) remains unexamined. This retrospective cohort study investigates the predictive value of IPI, along with SIRI and SII, on all-cause and cardiovascular disease (CVD) mortality in individuals with DM and prediabetes mellitus (pre-DM).

We analyzed DM and pre-DM individuals from the National Health and Nutrition Examination Survey (NHANES) (1999-2018), with follow-up conducted until December 31, 2019. Cox models assessed the correlation of IPI, SIRI, and SII with mortalities, yielding hazard ratios (HRs) and 95% confidence intervals (CIs). We also utilized restricted cubic spline (RCS) analysis, Kaplan-Meier curves, and subgroup analyses.

The final analysis included 10,049 individuals with DM and pre-DM. Over a mean follow-up of 9 years, 2233 all-cause mortalities occurred, with 612 attributed to CVD. Fully adjusted Cox regression analysis revealed a significant correlation between continuous and higher tertiles (T3) of IPI, SIRI, and SII and increased risk of all-cause and CVD mortality across all models (all p  < 0.05). Kaplan-Meier curves showed higher IPI, SIRI, and SII associated with elevated mortality risk (all log-rank p  < 0.001). RCS analysis demonstrated a nonlinear correlation between IPI and all-cause and CVD mortality, as well as between SII and all-cause mortality (nonlinear p  < 0.001). However, SIRI exhibited a linear association with both all-cause and CVD mortality.

Elevated IPI, along with SIRI and SII, is linked to increased all-cause and CVD-related mortality in DM and pre-DM, suggesting that incorporating IPI in routine screening could help identify high-risk individuals for earlier interventions.