Association of systemic immune inflammatory index with all-cause and cause-specific mortality in hypertensive individuals: Results from NHANES - PubMed (original) (raw)

Association of systemic immune inflammatory index with all-cause and cause-specific mortality in hypertensive individuals: Results from NHANES

Yang Cao et al. Front Immunol. 2023.

Abstract

Background: The relationship between the systemic immune inflammatory index (SII) and the prognosis of hypertensive patients is unclear. This study aims to explore the association of SII with all-cause and cause-specific mortality in patients with hypertension.

Methods: This study included 8524 adults with hypertension from the National Health and Nutritional Examination Surveys (NHANES) 2011-2018, and followed for survival through December 31, 2019. Cox proportional hazards models were used to investigate the associations between SII and mortality from all causes, cardiovascular disease (CVD), and cancer. Restricted cubic spline, piecewise linear regression, subgroup and sensitivity analyses were also used.

Results: During a median follow-up of 4.58 years, 872 all-cause deaths occurred. After adjusting for covariates, higher SII was significantly associated with an elevated risk of CVD mortality. There was a 102% increased risk of CVD mortality per one-unit increment in natural log-transformed SII (lnSII) (P < 0.001). Consistent results were also observed when SII was examined as categorical variable (quartiles). The associations of SII with all-cause and cancer mortality were detected as U-shaped with threshold values of 5.97 and 6.18 for lnSII respectively. Below thresholds, higher SII was significantly associated with lower all-cause mortality (HR=0.79, 95%CI=0.64-0.97) and cancer mortality (HR=0.73, 95%CI=0.53-1.00). Above thresholds, SII was significantly positive associated with all-cause mortality (HR=1.93, 95%CI=1.55-2.40) and cancer mortality (HR=1.93, 95%CI=1.22-3.05). The results were robust in subgroup and sensitivity analyses.

Conclusion: Higher SII (either as a continuous or categorical variable) were significantly associated with a higher risk of CVD mortality. The U-shaped associations were observed between SII and all-cause and cancer mortality.

Keywords: NHANES; cross-sectional study; hypertension; population-based study; systemic immune-inflammation index.

Copyright © 2023 Cao, Li, Zhang, Qiu, Li, Ma, Yan, Li and Han.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1

Figure 1

Flow diagram of the selection of eligible participants.

Figure 2

Figure 2

Restricted cubic spline fitting for the association between SII with mortality. Association of SII levels with the all-cause (A), CVD mortality (B) and cancer mortality (C).

Figure 3

Figure 3

Forest plot for subgroup analysis of association between lnSII and all-cause mortality. Hazard ratios (HRs) were calculated using multivariate Cox regression models adjusted for the variables listed in the fully adjusted model except for the variable used for stratification.

References

    1. Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol (2020) 16(4):223–37. doi: 10.1038/s41581-019-0244-2 - DOI - PMC - PubMed
    1. Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the interheart study): Case-control study. Lancet (2004) 364(9438):937–52. doi: 10.1016/S0140-6736(04)17018-9 - DOI - PubMed
    1. O'Donnell MJ, Chin SL, Rangarajan S, Xavier D, Liu L, Zhang H, et al. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (Interstroke): A case-control study. Lancet (2016) 388(10046):761–75. doi: 10.1016/S0140-6736(16)30506-2 - DOI - PubMed
    1. Hu B, Yang XR, Xu Y, Sun YF, Sun C, Guo W, et al. Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma. Clin Cancer Res (2014) 20(23):6212–22. doi: 10.1158/1078-0432.Ccr-14-0442 - DOI - PubMed
    1. Yoon J, Jung J, Ahn Y, Oh J. Systemic immune-inflammation index predicted short-term outcomes in patients undergoing isolated tricuspid valve surgery. J Clin Med (2021) 10(18):4147. doi: 10.3390/jcm10184147 - DOI - PMC - PubMed

Publication types

MeSH terms

LinkOut - more resources