The potentially risky effects of metabolites of phthalates (mPAEs) on inflammation and immune function have attracted much attention in recent years. However, direct studies on the relationship between these metabolites and the systemic immune inflammatory index (SII) and systemic inflammatory response index (SIRI) are limited.

This cross-sectional study used generalized linear regression models (GLM), restricted cubic splines (RCS), weighted quantile sum (WQS), and Bayesian kernel-machine regression (BKMR) to analyze data from 2,763 U.S. adults aged between 20 and 80 years, obtained from the U.S. National Health and Nutrition Examination Survey (NHANES) conducted between 2013 and 2018. The study aimed to investigate the relationship between urine samples of nine mPAEs and levels of SII/SIRI in a single, nonlinear, and mixed relationship and explored the robustness of the findings under single and mixed effects using two sensitivity analyses for completeness. In addition, the effects of six variables (age, sex, BMI, the percentage of total daily energy intake from ultra-processed foods (UPFs), total vegetable intake, and dietary supplements) on the association results were explored through subgroup analyses to identify potentially important confounders.

In single exposure analyses, mono-n-butyl phthalate (MnBP), mono-ethyl phthalate (MEP), and monobenzyl phthalate (MBzP) were positively associated with SII/SIRI. The findings from the two mixed exposure models demonstrated a positive association between the collective concentrations of mPAEs and levels of SII/SIRI, with MBzP being identified as a significant contributor to the urinary levels of mPAEs. The subgroup analysis results of the effects of single and mixed exposures show that the association between mPAEs and SII/SIRI is more significant in females, overweight/obese populations, young/middle-aged populations, and populations with high levels of intake of UPFs.

Positive associations were identified between mPAEs and SII/SIRI. MBzP was determined to have the most significant impact. The association between mPAEs and SII/SIRI is significantly influenced by female groups, young and middle-aged populations, overweight and obese individuals, as well as those with a higher intake of UPFs.

In patients with ST-elevation myocardial infarction (STEMI), pulmonary infection after successful primary percutaneous coronary intervention (PCI) is a severe complication that often results in death. It is not known whether there are any predictive markers for the onset of pneumonia in STEMI patients after successful PCI.

According to whether pneumonia occurred within two weeks of PCI, 619 STEMI patients were divided into pneumonia and nonpneumonia groups. The area under the receiver operating characteristic curve (AUC) was used to assess the predictive accuracy of the SIRI for pneumonia risk following successful PCI. Using a restricted cubic spline (RCS) and multivariate regression analysis, we investigated the relationship between the SIRI and PCI-induced pneumonia.

Patients in the pneumonia group had a significantly greater SIRI than did those in the nonpneumonia group at admission (7.81 ± 7.53 vs. 3.35 ± 3.08, p < 0.001). Patients in the SIRI ≥ 4.04 group exhibited greater vulnerability to pneumonia after successful PCI than did those in the SIRI < 4.04 group (OR: 5.20, 95% CI: 3.53-7.72, p < 0.001). According to the ROC curve, the SIRI is highly predictive of pneumonia after PCI for STEMI patients, with an AUC of 0.766 (95% CI: 0.724-0.808). As the SIRI increased, the pneumonia risk increased in the RCS model.

As a result of PCI for STEMI patients, the SIRI is a good indicator of pneumonia risk. The likelihood of pneumonia occurring in STEMI patients after PCI generally increases with increasing SIRI.

Erectile dysfunction (ED) is a common disorder that significantly impacts quality of life, and phosphodiesterase type 5 inhibitors (PDE5is) such as tadalafil are one of the primary treatments. However, some patients remain unresponsive, necessitating further investigation.

To investigate the association between systemic inflammatory response index (SIRI) and tadalafil unresponsiveness in erectile dysfunction patients.

A total of 106 male patients who applied to the Andrology outpatient clinic with ED complaints between January and June 2024 were included in the study. Patients were started on daily tadalafil 5 mg therapy, and response was assessed after one month using the International Index of Erectile Function Erectile Function domain (IIEF-EF). SIRI values, calculated using neutrophil, monocyte, and lymphocyte counts, were compared between tadalafil-responsive and unresponsive groups.

Tadalafil unresponsiveness was observed in 48.1% of patients. Non-responders had significantly higher mean age(57.44 ± 12.52 vs. 47.22 ± 11.49, p < 0.001), BMI(27.22 ± 3.17 vs. 25.85 ± 2.92, p = 0.023), and SIRI values(1.33 ± 0.82 vs. 1.02 ± 0.40, p = 0.016) compared to responders. Multivariate analysis identified age(OR = 1,641, p = 0.001) and SIRI(OR = 2.420, p = 0.014) as independent predictors of tadalafil failure. ROC curve analysis revealed a SIRI cutoff of 1.03 (AUC = 0.617) with 69.1% sensitivity and 61.2% specificity.

Findings suggest that systemic inflammation plays a key role in ED pathophysiology and may impair PDE5i efficacy.

Objective: This study aimed to investigate the prognostic value of two novel systemic inflammatory indices-the Aggregate Systemic Inflammation Index (AISI) and the Systemic Inflammatory Response Index (SIRI)-in predicting preterm delivery and associated neonatal outcomes. Methods: A retrospective, descriptive, cross-sectional study was conducted using the electronic health records of 1056 pregnant women admitted to a tertiary university hospital between 2020 and 2025. Pregnancies were classified into preterm (n = 528) and term (n = 528) groups. Demographic, obstetric, neonatal, and laboratory data were analyzed. Results: The AISI and SIRI values in the first trimester and at admission were significantly higher in the preterm delivery group than in the term delivery group (p < 0.001). Elevated AISI and SIRI levels correlated with lower 1st- and 5th-minute APGAR scores (p < 0.001) and higher neonatal intensive care unit (NICU) admission rates (35.8% vs. 4.5%; p < 0.001). The AISI cut-offs were 399.2 for preterm delivery (59.7% sensitivity, 59.8% specificity), 558.8 for NICU admission (79.3% sensitivity, 79.2% specificity), 694.0 for RDS (87.8% sensitivity, 87.8% specificity), 602.1 for sepsis (79.6% sensitivity, 79.2% specificity), and 753.8 for congenital pneumonia (81.6% sensitivity, 81.9% specificity). The SIRI cut-offs were 1.7 for preterm delivery (59.1% sensitivity, 58.9% specificity), 2.4 for NICU admission (81.7% sensitivity, 81.6% specificity), 3.1 for RDS (89.0% sensitivity, 89.5% specificity), 3.0 for sepsis (85.8% sensitivity, 85.7% specificity), and 3.4 for congenital pneumonia (85.7% sensitivity, 83.8% specificity). Conclusions: The AISI and SIRI showed significant predictive utility for neonatal morbidity in preterm delivery. The use of these markers in clinical practice may improve neonatal outcomes by enhancing the early diagnosis and management of high-risk pregnancies.

This study aimed to investigate the effects of the systemic inflammatory response index (SIRI) on the long-term prognosis of patients with acute coronary syndrome (ACS) and obstructive sleep apnea (OSA).

This prospective cohort study enrolled patients with ACS and OSA at the Beijing Anzhen Hospital between June 2015 and January 2020. The SIRI was calculated at admission for all patients. Patients with SIRI ≥ 1.16 × 109/L were classified into the high SIRI group based on the optimal cutoff value for predicting major adverse cardiovascular and cerebrovascular events (MACCE) determined by the receiver operating characteristic (ROC) curve of our cohort study. The other patients were categorized into the low SIRI group. The primary endpoint was a composite of MACCE, including cardiovascular death, recurrent myocardial infarction (MI), stroke, and ischemia-driven revascularization.

A total of 1011 patients with ACS and OSA were enrolled, 435 of whom (43%) were in the high SIRI group. Over a median follow-up of 2.8 (1.4-3.6) years, 179 patients experienced MACCE. Kaplan-Meier survival analysis showed a higher cumulative incidence of MACCE in the high-SIRI group (log-rank P < 0.001). A restricted cubic spline analysis also showed a monotonic increase with a greater SIRI value for MACCE (P = 0.011). After adjusting for clinically relevant confounders, a high SIRI was independently associated with elevated MACCE risk (adjusted HR = 1.44, 95% CI 1.02-2.05, P = 0.039).

A high SIRI was associated with poorer clinical outcomes during long-term follow-up in patients with ACS and OSA.

This analysis aimed to evaluate the clinical relevance of the presurgical systemic inflammation response index (SIRI) in individuals undergoing radical cystectomy (RC).

In this retrospective study, 228 were categorized into 2 cohorts depending on their SIRI levels using the best cut-off determined by the Youden Index. The association between SIRI and lymph node metastasis (N), advanced pT stage (pT3/pT4), and loco-regional extended state were analyzed at the time of surgery. Multivariate Cox regression analysis was performed to evaluate the impact of SIRI on time to relapse, tumor-specific survival, and survival rates. The additional medical advantage was evaluated through decision curve analysis (DCA).

High and low SIRI group was obtained using the best cut-off value (1.71×109/l). On multivariate logistic regression analysis, elevated SIRI was significantly associated with advanced pT stage (P = 0.003) and loco-regional extended state (P = 0.003). On multivariable Cox regression models based on presurgical clinicopathological factors, an augmented SIRI was linked to poorer relapse-free survival (RFS) (P = 0.035), with the improvement of the concordance index just for RFS. In DCAs, incorporating SIRI yielded results equal to or better than those of the model without SIRI for all outcomes models. It demonstrated improvements in net benefit at probability thresholds up to 50% for the model adjusted with preoperative factors for RFS and for postoperative factors in CSS and OS.

SIRI is an innovative prognostic indicator and a potential biomarker that can enhance conventional medical pathological evaluation and improve the personalization of clinical treatment strategies for bladder cancer patients following RC.

Background/Objectives: To assess the pretreatment and posttreatment clinical factors associated with the rate of survival at 1, 3, and 5 years in stage IV nasopharyngeal carcinoma (NPC) patients. Methods: Clinicopathological characteristics of 61 Stage IV NPC patients diagnosed between 2008 and 2022 in a single tertiary medical center were retrospectively reviewed. Univariate and multivariate analyses were performed to evaluate the prognostic factors associated with overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS). A nomogram was developed to forecast DSS. Results: The OS at 1-year, 3-year, and 5-year were 93%, 70%, and 57%, while the DSS at 1-year, 3-year, and 5-year were 93%, 73%, and 58%, whereas the DFS at 1-year, 3-year, and 5-year were 51%, 44%, and 41%, respectively. In multivariate analyses, posttreatment body mass index (BMI) < 21.6 kg/m2 (hazard ratio [HR] 2.717, 95% confidence interval [CI] 1.248-5.917, p = 0.012) was an independent indicator for worsened OS. Posttreatment BMI < 21.6 kg/m2 (HR 3.003, 95% CI 1.340-6.757, p = 0.008) and pretreatment systemic inflammation response index (SIRI) ≥ 125 (HR 2.841, 95% CI 1.256-6.429, p = 0.012) were independent indicators for worsened DSS. Posttreatment BMI < 21.6 kg/m2 (HR 3.650, 95% CI 1.757-7.576, p = 0.001), change in BMI < -1.93 kg/m2 (HR 3.731, 95% CI 1.642-8.475, p = 0.002), and pretreatment SIRI ≥ 125 (HR 3.541, 95% CI 1.717-7.304, p = 0.001) were independent indicators for worsened DFS. A nomogram was created to predict DSS using posttreatment BMI and pretreatment SIRI. Conclusions: Associations with survival were observed between posttreatment BMI and OS, DSS, and DFS; pretreatment SIRI and DSS/DFS; and changes in BMI and DFS among patients with stage IV NPC. The developed nomogram aids in survival prediction.

This study aimed to assess the link between inflammatory biomarkers (like the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammatory index (SII), and systemic inflammation response index (SIRI)) and gallstones in American individuals aged under 50 years.

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) covering 2017 to 2020, centering on individuals under 50 years with comprehensive data on NLR, SII, SIRI, and gallstones. It employed a weighted multiple logistic regression approach to investigate the link between inflammatory biomarkers and gallstones. Furthermore, dose-response relationships and threshold effects were evaluated utilizing restricted cubic spline (RCS) methods and segmented linear regression models. Subgroup examinations and interaction assessments were conducted, too.

The investigation encompassed a total of 3,295 individuals. Upon comprehensive adjustment for variables, multivariate logistic regression revealed a positive relationship between inflammatory biomarkers and gallstones: ln-NLR (OR = 1.68, 95% CI: 1.06-2.66, p = 0.033), ln-SII (OR = 1.79, 95% CI: 1.08-2.98, p = 0.032), and ln-SIRI (OR = 1.46, 95% CI: 1.07-1.99, p = 0.025). A non-linear association, shaped like an inverse "U", was noted between ln-SIRI and gallstones. To the left of the inflection point (ln-SIRI = 0.35, SIRI = 1.42), a positive link existed between ln-SIRI and gallstones (OR = 2.45, 95% CI: 1.20-5.03); whereas, to the right of the inflection point, the association was statistically insignificant (OR = 0.60, 95% CI: 0.21-1.73).

ln-NLR and ln-SII exhibited a linear and positive relationship with the likelihood of developing gallstones. ln-SIRI demonstrated a nonlinear dose-response relationship with gallstone risk, characterized by an inverted "U" shape.

Study DesignCross-sectional study.ObjectiveTo examine the association between SIRI and spinal BMD and assess the influence of age, hypertension, and diabetes.MethodsWe analyzed data from 13,950 participants aged ≥20 years. SIRI was calculated using neutrophil, monocyte, and lymphocyte counts, and spinal BMD was measured by DXA. Linear regression, generalized additive models, and segmented regression were used, with subgroup analyses based on age, hypertension, and diabetes.ResultsA threshold effect was observed at SIRI = 0.68. Below this threshold, SIRI negatively correlated with spinal BMD (β = -0.0412, P = 0.0494), while above it, a positive correlation was found (β = 0.0079, P < 0.0001). Subgroup analyses showed stronger positive associations in older adults (≥65 years, β = 0.0136, P < 0.0001), and those with hypertension (β = 0.0089, P = 0.0004) and diabetes (β = 0.0187, P < 0.001).ConclusionA segmented nonlinear relationship exists between SIRI and spinal BMD, with age, hypertension, and diabetes as significant modifiers. SIRI may serve as a biomarker for osteoporosis risk.

Neoadjuvant chemoimmunotherapy (nCIT) has shown promise in treating early-stage triple-negative breast cancer (eTNBC), but predictive biomarkers for pathological response and prognosis remain poorly defined.

This study aimed to explore pathological complete response and prognostic predictive factors in eTNBC patients treated with nCIT.

We retrospectively analyzed 112 eTNBC patients who underwent surgery after nCIT at Sun Yat-sen University Cancer Center between June 2019 and June 2023. Pathological response was assessed using Miller-Payne grade. Clinicopathological features and hematologic markers were analyzed with univariate and multivariate logistic regression or Cox regression, as well as Kaplan-Meier survival curves. Objective response rate (ORR), pathological complete response (pCR), and disease-free survival (DFS) were evaluated. Nomograms predicting pCR and DFS were constructed based on significant risk factors and the systemic inflammatory response index (SIRI).

Higher baseline lymphocyte counts (P=0.004) were independently associated with a higher pCR rate, while elevated monocyte counts (P=0.006), neutrophil-to-lymphocyte ratio (P=0.005), platelet-to-lymphocyte ratio (p = 0.005), SIRI (P=0.037), systemic immune-inflammation index (P=0.029), and preoperative SIRI (P=0.010) were associated with a lower pCR rate. Higher baseline SIRI (P= 0.009) was correlated with shorter DFS, while higher preoperative lymphocyte counts (P=0.019) predicted longer DFS. Nomograms incorporating SIRI showed high accuracy in predicting pCR and DFS.

Hematologic inflammatory markers, particularly SIRI, are cost-effective and reliable predictors of prognosis and treatment efficacy in eTNBC patients undergoing nCIT, helping clinicians develop personalized treatment strategies.

https://www.medicalresearch.org.cn/, identifier MR-44-24-046099.

Although the systemic inflammation response index (SIRI) is often associated with prognostic significance in esophageal cancer (EC) patients, the results continue to be conflicting. We focused on identifying SIRI's precise role in forecasting EC prognosis through performing this meta-analysis.

This work searched PubMed, Web of Science, Embase, Cochrane Library, and CNKI till November 16, 2024, and determined pooled hazard ratios (HRs) and 95% confidence intervals (CIs) for evaluating EC prognosis forecasting efficiency of SIRI. The inclusion criteria: (1) pathologic confirmation of EC; (2) those reporting associations of SIRI with EC survival outcomes; (3) those reporting HRs and 95% CIs; (4) those with an available cut-off value of SIRI; and (5) no restriction in language. The exclusion criteria: (1) case reports, reviews, meeting abstracts, comments and letters; (2) those enrolling duplicate cases; and (3) animal studies.

We enrolled six studies comprising 2176 cases into the present work. Based on our combined findings, elevated SIRI showed significant relation to dismal overall survival (OS) (HR = 1.43, 95%CI = 1.20-1.71, p < 0.001; I2 = 48.8%, p = 0.098) and shortened progression-free survival (PFS) (HR = 2.00, 95%CI = 1.35-2.98, p = 0.001; I2 = 0, p = 0.409) in EC. Moreover, high SIRI exhibited obvious relation to male gender (OR = 1.86, 95%CI = 1.07-3.22, p = 0.027; I2 = 69.4%, p = 0.020), TNM stage of III-IV (OR = 1.52, 95%CI = 1.18-1.94, p = 0.001; I2 = 24.3%, p = 0.265), T3-T4 stage (OR = 1.73, 95%CI = 1.12-2.69, p = 0.014; I2 = 61.0%, p = 0.053), and lymph node metastasis (OR = 1.29, 95%CI = 1.02-1.64, p = 0.036; I2 = 42.7%, p = 0.155). However, SIRI was not markedly related to age, tumor location, tumor differentiation, or smoking history.

In summary, high SIRI is significantly related to dismal OS and shortened PFS of EC cases, together with advanced tumor stage, T3-T4 stage, and lymph node metastasis of EC. Due to some limitations, large prospective studies that utilize standardized threshold SIRI should be conducted to validate our results in the future.

Neuroinflammation is linked to cognitive function. However, epidemiological research on two emerging inflammation markers-the systemic immune-inflammation index (SII) and the systemic inflammation response index (SIRI)-remains limited in the context of cognitive performance. This study investigates the relationship between SII, SIRI, and cognitive performance in older adults.

This cross-sectional analysis included 2,194 participants from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) who met eligibility criteria. Logistic regression, subgroup analysis, and restricted cubic spline modeling were used to assess the associations between cognitive performance and inflammation markers, specifically SII and SIRI.

After adjusting for population weights, participants with low cognitive function had an SII of 541.54 (95% CI: 360.00-796.50, p = 0.037) and an SIRI of 1.28 (95% CI: 0.82-2.18, p = 0.031). In fully adjusted models, higher levels of both SII (OR = 0.858, 95% CI: 0.856-0.859) and SIRI (OR = 0.891, 95% CI: 0.889-0.892) were significantly associated with lower odds of normal cognitive function, indicating an increased risk of cognitive impairment. Neutrophil-related markers (NC, NLR, SIRI) exhibited the strongest inverse associations. Subgroup analysis showed more consistent associations for SIRI across demographic and behavioral factors, while SII displayed fewer. RCS analysis indicated a stronger non-linear relationship for SIRI (p = 0.005) compared to SII (p = 0.018) after full adjustment.

This study suggests a positive association between SII, SIRI, and cognitive function, with a more pronounced relationship for SIRI. These findings highlight the potential of SIRI as a novel, accessible marker for predicting cognitive impairment risk.

Objective: Preterm delivery is a leading cause of neonatal morbidity and mortality globally, with inflammation playing a crucial role in its pathophysiology. This study aimed to evaluate the predictive value of systemic inflammatory response indices in identifying pregnant women at risk of preterm delivery. Methods: This retrospective study analyzed data from 1128 pregnant women admitted to a tertiary care hospital between 2020 and 2025. Patients were classified into two groups: preterm delivery (n = 528) and term delivery (n = 600). Demographic characteristics, obstetric history, neonatal outcomes, and inflammatory indices were compared. Results: The preterm delivery group showed a significantly higher systemic inflammatory response index (SIRI) (p < 0.001), systemic immune-inflammation index (SII) (p < 0.001), neutrophil/lymphocyte ratio (NLR) (p < 0.001), and monocyte/lymphocyte ratio (MLR) (p < 0.001) than the term delivery group, while platelet/lymphocyte ratio (PLR) levels were significantly lower (p = 0.002). Inflammatory indices were higher in early preterm delivery cases (p < 0.001) than in middle and late preterm cases. Multivariate logistic regression identified the SIRI (p = 0.015) and NLR (p < 0.001) as independent predictors of preterm delivery, while the PLR showed an inverse association (p = 0.002). Higher inflammatory indices correlated with lower 1st and 5th minute APGAR scores (p < 0.001) and increased neonatal intensive care unit (NICU) admission rates (p < 0.001). NICU stay was prolonged in neonates born to mothers with elevated SIRI and NLR levels (p < 0.001). Conclusions: Integrating these inflammatory indices into obstetric risk assessment may enhance early detection and intervention strategies, potentially improving maternal and neonatal prognosis.

Background: The inflammatory response is critically important in ST-segment elevation myocardial infarction (STEMI). The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI), novel inflammatory biomarkers, have been linked to the determination of outcomes in various diseases. The aim of the current study was to examine the relation of the SII and SIRI with contrast-induced acute kidney injury (CI-AKI) in elderly subjects with STEMI undergoing primary percutaneous coronary intervention (pPCI). Methods: All patients diagnosed with STEMI between November 2020 and September 2024 were screened, and patients aged over 70 were retrospectively analyzed in the present study. The patients were divided into two groups according to CI-AKI development. The SII and SIRI were calculated based on the peripheral blood counts. A receiver operating characteristic (ROC) curve analysis was performed to determine the sensitivity and specificity of the SII and SIRI in predicting CI-AKI. Additionally, multivariable logistic regression models were employed to investigate the associations between inflammatory indices and the incidence of CI-AKI in elderly patients with STEMI. Results: A total of 263 participants were included (mean age 77.67 ± 6.20, 56% women). Both the SII and SIRI were higher in the CI-AKI group than in the non-CI-AKI group (3252 ± 2257, 1097 ± 991 p < 0.001 for SII; 12.1 ± 4.54, 4.86 ± 2.42 p < 0.006 for SIRI). In the receiver operating characteristic analysis, the SII and SIRI showed the highest area under curve (AUC) compared with other inflammatory parameters. The AUC of the SII and SIRI were 0.903 and 0.867 (p < 0.001). In multivariate logistic regression analysis, the SII and SIRI were found as independent predictors of CI-AKI. Conclusions: The SII and SIRI were found to be important markers for predicting post-procedural CI-AKI in elderly patients with STEMI.

To assess the prognosis of young patients (≤40 years old) with head and neck squamous cell carcinoma (HNSCC), focusing on the preoperative Systemic Inflammation Response Index (SIRI).

Between January 2007 and February 2017, 175 young patients with HNSCC (≤40 years old) who underwent radical surgery were retrospectively enrolled in this study. The patients were randomly divided into a training cohort (N = 131) and a validation cohort (N = 44). The SIRI is defined as the absolute neutrophil count (×10⁹/L) multiplied by the absolute monocyte count (×10⁹/L), divided by the absolute lymphocyte count (×10⁹/L) in peripheral blood, all measured within one week prior to radical surgery. Univariate and multivariate Cox regression analyses were conducted to identify variables associated with survival outcomes, which were then used to construct and evaluate a predictive nomogram.

In both the training and validation cohorts, patients were classified into low- and high-SIRI groups based on a cutoff value of 0.87, which was determined by receiver operating characteristic analysis. This SIRI cutoff effectively stratified patients into two distinct prognostic groups with significant survival differences. Multivariable Cox analysis identified the presence of lymphovascular invasion and the high preoperative SIRI as significant independent prognostic factors associated with poorer cancer-specific survival (CSS) in young patients with HNSCC. Using these variables, a predictive model for 5 year CSS was constructed and visualized as a nomogram. The model demonstrated strong predictive performance, with a C-index of 0.744 [95% CI (0.643-0.845)] in the training cohort and 0.839 [95% CI (0.740-0.938)] in the validation cohort.

Data from preoperative SIRI assessment, coupled with the presence of pathological adverse features, serve as valuable references for risk stratification in young patients with HNSCC.

It is known that preoperative Prognostic Nutritional Index (PNI) is useful in predicting prognosis in gastrointestinal diseases and that preoperative improvement of nutritional status improves prognosis. However, there have been few large-scale reports examining the prognostic value of PNI in soft tissue sarcomas. Therefore, the aim of this study is to investigate whether the PNI can be useful for predicting overall survival in soft tissue sarcoma.

Between January 2006 and March 2022 at our hospital, 111 patients with pathologically diagnosed soft tissue sarcoma were included, retrospectively. Several nutritional or inflammatory biomarkers such as PNI were calculated from the pretreatment blood sample results. The patients were classified into two groups (low and high groups) based on the median value of each parameter. Overall survival was analyzed by the Kaplan‒Meier method and log-rank test. Univariate and multivariate analyses using the Cox proportional hazards model were used to investigate prognostic factors for overall survival.

The median overall survival was 24.3 months (mean 37.3 months), and the high PNI group had a significantly longer overall survival than the low PNI group (p < 0.0001). PNI was the most significant univariate factor for overall survival among other nutritional and inflammatory parameters (HR: 5.64, 95% CI: 2.26-14.12, p = 0.0002). The multivariate proportional hazards model was built using variables with prognostic potential as suggested by previous analysis with respect to patient characteristics and PNI. As potential confounding factors, we included PNI, stage, age, and tumor location. PNI was also an independent prognostic factor in multivariate analysis (HR: 7.02, CI: 2.52-19.40, p = 0.0002).

PNI is a useful prognostic factor among various parameters for overall survival in patients with soft tissue sarcoma.

Sepsis is a severe systemic inflammatory response syndrome in which matrix metalloproteinase 9 (MMP9) plays a key role in inflammatory response and cell migration. In this study, we analyzed different sepsis phenotypes to explore the role of MMP9 in promoting the progression of sepsis, especially how it affects the inflammatory index and related pathogenic cell programs. A standardized cecal ligation puncture (CLP) model was used to evaluate the inflammatory response in sepsis. The experiments followed animal ethical principles and extracted proteins and performed SDS-PAGE analysis for mass spectrometry identification. The samples were separated using filter-assisted sample preparation (FASP) and peptide digestion techniques, and the peptides were separated by ultra-high performance liquid chromatography (UHPLC). Subsequently, proteomic analysis, RNA extraction and differential expression analysis were performed on the data, and bioinformatics and machine learning methods were combined to evaluate the inflammatory index of both in vivo and in vitro samples. Through the integration of admission parameters, different sepsis endotypes and their clinical phenotypes were identified. Significantly, elevated MMP9 expression was found to be strongly associated with inflammatory indices such as NLR and PLR in patients with sepsis, suggesting that MMP9 may be involved in the proliferation of immune cells and the activation of their pro-inflammatory and hypoxic programs. Experimental CLP models validate the pathogenic cellular programs associated with NLR and PLR, demonstrating the critical role of MMP9 in the dynamic progression of sepsis.

To assess the prognostic value of the preoperative neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic immune-inflammation response index (SIRI) in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU).

One hundred seven patients were retrospectively enrolled. Chi-square (χ²) tests were adopted to assess the association of the inflammatory ratios and indexes to clinical risk factors. Overall survival (OS), metastasis-free survival (MFS), local, lymph node, and contralateral recurrence-free survival (RFS) were estimated by the Kaplan-Meier method and the corresponding curves were compared using log-rank test. Univariate and multivariate survival analysis were performed using general linear models to identify risk factors for prognosis.

NLR, MLR, PLR, SII, and SIRI were predictive of OS (p=0.024, p=0.025, p=0.004, p=0.006, and p=0.03, respectively). Besides, PLR was predictive of local (p<0.001) and lymph node RFS (p=0.014) and SII was associated to lymph node and contralateral RFS prediction (p=0.034 and p=0.023, respectively). All candidate markers adding high NLR+high MLR+high PLR combination were independent risk factors of OS. PLR was an independent risk factor of local and lymph node RFS whereas the above cited combination and NLR were independent prognosticators of local and contralateral RFS respectively. All markers were correlated to poor postoperative clinical characteristics mainly pathological grade (p<0.05).

Preoperative NLR, MLR, PLR, SII, and SIRI were associated with higher pathologic features and worse oncological outcomes in patients treated with RNU for UTUC.

Acute rhinosinusitis (ARS) is a common pediatric disorder. When complications occur, it can lead to various morbidities. Therefore, easily accessible and inexpensive markers are needed to predict the development of complications, treatment, and clinical course of acute rhinosinusitis. We aimed to investigate the predictive ability of the various inflammatory markers in pediatric complicated ARS patients.

The data of 79 pediatric patients with complicated ARS and 116 pediatric patients with uncomplicated ARS were analyzed retrospectively. The complete blood count and C-reactive protein (CRP) test results at the time of diagnosis were recorded. Also, a receiver operating characteristic (ROC) analysis was performed.

The complicated ARS group consisted of 65 (82.3%) patients with preseptal cellulitis, 4 (5.1%) with orbital cellulitis, 5 (6.3%) with subperiosteal abscess, and 5 (6.3%) with orbital abscess complications. At the time of initial diagnosis, there was a significant difference in WBC, NLR, CRP, %LUC, SII and SIRI values between complicated ARS and uncomplicated ARS patient groups (p < 0.05). In terms of predictive power, the area under the curve (AUC) was 0.805 (95% confidence interval (CI) 0.74-0.87, p < 0.001) for CRP, 0.62 (95% confidence interval (CI) 0.54-0.7, p = 0.004) for systemic immune-inflammatory index (SII) and 0.67 (95% confidence interval (CI) 0.6-0.75, p < 0.001) for systemic inflammatory response index (SIRI).

In conclusion, our study shows that inflammatory markers can be helpful in the evaluation of pediatric rhinosinusitis patients. CRP, SII and SIRI were adequate markers of inflammation to predict the development of complications in patients with pediatric rhinosinusitis.

Inflammatory responses play a critical regulatory role in the development and progression of cancer. As a novel inflammatory marker, the association between the systemic inflammation response index (SIRI) and mortality among cancer survivors remains unclear. This study aims to elucidate the relationship between the SIRI and all-cause mortality among cancer survivors in the United States. This study utilized continuous data from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2018, with follow-up data available through December 31, 2019. All patients were divided into four groups based on their SIRI values. Cox proportional-hazards regression models, Kaplan-Meier survival curves, and restricted cubic splines (RCS) combined with Cox proportional hazards models were applied to investigate the relationship between SIRI and cancer survival rates. Additionally, sensitivity and subgroup analyses were conducted to test the robustness of the results. A total of 3733 cancer survivors were included in this study. During a median follow-up period of 119 months, 1217 deaths occurred, resulting in an all-cause mortality rate of 32.57%. The results of the Cox proportional-hazards regression model showed that compared to the low SIRI group, the highest SIRI group had a higher risk of mortality (HR 1.52; 95% CI 1.28, 1.81). Additionally, the Kaplan-Meier curve indicated that participants with higher SIRI values had a higher all-cause mortality rate. The RCS model indicated a nonlinear positive correlation between SIRI values and all-cause mortality. The sensitivity analysis demonstrated that the study results remained consistent without significant changes after excluding participants who died within the first two years of follow-up. The subgroup analysis showed that SIRI was associated with all-cause mortality across different demographic characteristics (including gender, marital status, history of hypertension, and diabetes) as well as cancer types (lung cancer, breast cancer, colorectal cancer, skin cancer, and prostate cancer). In conclusion, our study reveals a significant association between SIRI and all-cause mortality among cancer survivors in the United States, which helps identify cancer survivors at higher risk of death and highlights its important prognostic value in oncology.

Body mass index (BMI) and sarcopenia are linked to osteoporosis, but the extent to which BMI influences osteoporosis through sarcopenia remains unclear. This study aims to assess the associations between BMI, sarcopenia, and osteoporosis, and to explore the predictive value of their combined biochemical markers for osteoporosis.

We retrospectively collected clinical data from 813 inpatients in the endocrinology department to explore the relationships between serum markers and skeletal muscle mass or BMI, and to evaluate the predictive value of BMI and sarcopenia for osteoporosis. Mediation analysis was employed to examine the associations among BMI, sarcopenia, and osteoporosis. Participants were randomly divided into training (n = 407) and testing (n = 406) sets (5:5). Independent risk factors were identified using least absolute shrinkage and selection operator and logistic regression, leading to the development of a nomogram model. Model evaluation was conducted through receiver operating characteristic curves, confusion matrices, calibration curves, decision curve analysis (DCA), and clinical impact curves (CIC).

BMI and skeletal muscle mass were negatively correlated with serum 25-hydroxyvitamin D and calcium levels. The "BMI < 28 and Non-Sarcopenia" emerged as a protective factor against osteoporosis. Sarcopenia significantly mediated the association between BMI and osteoporosis (46.88%). Gender, age, high-density lipoprotein, alkaline phosphatase, BMI, and sarcopenia emerged as independent predictors of osteoporosis. The area under the curve (AUC) for the training and testing sets was 0.859 and 0.866, respectively, with calibration curves indicating good consistency. DCA and CIC demonstrated clinical net benefits at risk thresholds of 0.02-0.82 and 0.02-0.67. Sankey diagrams and partial AUCs (1.00-0.75 sensitivity and specificity) illustrate the significant negative predictive value of BMI and sarcopenia.

Lower BMI and non-sarcopenia are negatively associated with the risk of osteoporosis. In addition, the nomogram demonstrates good predictive value, with a greater negative predictive value of the BMI and sarcopenia.

Peripheral blood-related inflammatory markers, including systemic immune inflammation index (SII), inflammatory response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR), have received increasing clinical attention over the years. This study aims to investigate the clinical significance of peripheral blood-related inflammatory markers in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). We hope that this study will provide guidance for clinical individualized treatment and management of AECOPD patients.

A total of 254 patients with AECOPD admitted between January 2021 and December 2022 were enrolled in this study and categorized into mild and moderate-to-severe groups. Univariate analysis, Spearman correlation analysis, and receiver operating characteristic curve (ROC) were performed to study the clinical value of peripheral blood-related inflammatory markers. Then, the relationship between the peripheral blood-related inflammatory markers and the risk of readmission owing to acute exacerbation during the first year after discharge was further studied through survival analysis and multivariate Cox regression.

The levels of peripheral blood-related inflammatory markers in patients with moderate-to-severe AECOPD were significantly higher than patients in the mild group, and the levels of peripheral blood-related inflammatory markers are positively correlated with the severity of disease. The highest diagnostic accuracy for moderate-to-severe AECOPD was achieved by combining five indexes, with a cut-off value of 0.38 and an AUC of 0.837 (95 % CI: 0.789-0.885). Higher levels of peripheral blood-related inflammatory markers may indicate a higher risk of readmission within one year of hospital discharge in patients with AECOPD, and SII (HR = 3.478, P < 0.001) was an independent risk factor. Besides, higher levels of peripheral blood-related inflammatory markers also suggest impaired pulmonary ventilation function and enlarged right ventricular diameter.

Peripheral blood-related inflammatory markers (SII, SIRI, NLR, PLR, MLR) can serve as a reference for identifying patients with moderate-to-severe AECOPD. Patients with higher levels of peripheral blood-related inflammatory markers are more susceptible to experiencing acute exacerbation and readmission events within one year after hospital discharge. Peripheral blood-related inflammatory markers can assist clinicians in evaluating the condition and predicting the risk of readmission in patients with AECOPD more scientifically and objectively.

Abdominal aortic calcification (AAC) and the systemic inflammation response index (SIRI) have been linked to both all-cause and cardiovascular disease (CVD)-related mortality. Whether combining AAC and SIRI improves the predictive ability for adverse outcomes remains poorly unexplored. The present study aims to investigate the joint associations of AAC and SIRI with the risk of all-cause and CVD-related mortality in the general population. This prospective cohort study included participants with AAC and SIRI data from the 2013-2014 National Health and Nutrition Examination Survey (NHANES). Primary outcomes were death from any cause (all-cause mortality) and heart or cerebrovascular diseases (CVD-related mortality). AAC was categorized into three groups based on the AAC score: non-AAC (score = 0), low- moderate AAC (score > 0 and < 5), and severe AAC (score ≥ 5). SIRI ( x 109/L) was stratified by tertiles. Multivariable Cox regression analyses and competing risk models were employed to examine the individual associations of AAC and SIRI with the risk of all-cause and CVD-related mortality. Participants were further divided into four groups according to AAC (presence or absence) and SIRI (≤ or > median) to explore their joint association. A total of 2159 participants with a median age of 55 years were included in this study. 1031 (47.8%) were males and 1128 (52.2%) were females. For race, 317 (14.7%) were mexican american, 226 (10.5%) were other hispanic, 878 (40.7%) were white, 431 (20.0%) were black, and 307 (14.2%) were other race. During a median of 73 months follow-up, 119 deaths were recorded, 41 of which were CVD-related cases. AAC was presented in 553 participants (355 with low-moderate AAC and 198 with severe AAC), and the median SIRI was 1.05 × 109/L. After adjusting for potential confounding factors, AAC and SIRI were significantly associated with the risks of all-cause (AAC: HRsevere AAC vs. non-AAC = 2.903, 95% CI: 1.855 ~ 4.543, p for trend < 0.001; SIRI: HRtertile 3 vs. tertile 1 = 2.077, 95% CI: 1.264 ~ 3.411, p for trend = 0.001) and CVD-related death (AAC: HRsevere AAC vs. non-AAC = 4.579, 95% CI: 2.019 ~ 10.381, p for trend < 0.001; SIRI: HRtertile 3 vs. tertile 1 = 3.215, 95% CI: 1.253 ~ 8.246, p for trend = 0.006). These associations remained statistically significant even after mutual adjustment. Participants with both AAC presence and elevated SIRI had higher risk of adverse outcomes. Severe AAC and elevated SIRI were independently associated with an increased risk of all-cause and CVD-related mortality in the general population. Notably, individuals with both AAC presence and increased SIRI exhibited the greatest mortality risk. The combined assessment of AAC and SIRI may provide novel predictive value, offering a more comprehensive approach to identifying high-risk individuals and refining risk stratification strategies.

Objective: This research focuses on analyzing the link between the systemic inflammatory response index (SIRI) and all-cause mortality in individuals with atherosclerotic cardiovascular disease (ASCVD) . Methods: This research analyzed data from 4693 patients using nine cycles of the National Health and Nutrition Examination Survey (NHANES). The connection between SIRI and mortality was determined by employing survey-weighted Cox models, with hazard ratios (HRs) and 95% confidence intervals (CIs) being computed. Kaplan-Meier method illustrated survival differences across SIRI levels. Sensitivity analyses involved restricted cubic splines (RCS), stratified analysis, and E-value calculations. Landmark analysis assessed survival differences at multiple follow-up intervals, while time-dependent receiver operating characteristic curves evaluated SIRI's prognostic value. Mediation analysis identified potential intermediaries impacting the SIRI-mortality relationship. Results: Over 406,564 person-months, 1933 deaths occurred. Adjusted Cox models discovered that higher SIRI was connected with elevated overall mortality [HR 1.192, (95% CI 1.131-1.256), p < 0.001]. Higher SIRI consistently showed lower survival probabilities. RCS and stratified analysis confirmed the robustness of these findings. Survival probability at different follow-up periods was considerably lower in those with higher SIRI. Additionally, SIRI demonstrated a prognostic value of 0.66 for all-cause mortality at 1 year and 3 years, and 0.65 at 5 years. Notably, serum uric acid (6.2%) partially mediated the connection between SIRI and mortality from all causes. Conclusion: In ASCVD patients, SIRI was robustly correlated with all-cause mortality, partially mediated by serum uric acid.

Background/Objectives: Myocarditis is a major cause of morbidity and mortality in children and can lead to long-term heart failure, dilated cardiomyopathy, the need for heart transplantation, or death. New systemic inflammatory indices that combine lymphocyte, neutrophil, and platelet counts have been recently used as strong prognostic markers of some inflammatory diseases and adverse outcomes of neoplasms. This study aimed to investigate the use of new systemic indices as early predictive markers for adverse outcomes in patients with pediatric myocarditis. Methods: This study retrospectively examined patients between the ages of >1 month and <18 years who were monitored in our clinic with a diagnosis of myocarditis between 1 January 2022 and 31 December 2024. The cases were divided into two groups: fulminant myocarditis (requiring the use of inotropes or extracorporeal membrane oxygenation due to hemodynamic disturbance) and non-fulminant myocarditis. The systemic inflammatory index values of these groups (calculated in the first 6 h) were compared, and the results were statistically analyzed. Results: The study included 122 pediatric myocarditis cases treated during the study period (80 boys; median age: 11 (IQR: 8-14) years). Twenty-six of these patients (21.3%) developed fulminant myocarditis. The median systemic immune-inflammation index (SII) value in the group with fulminant myocarditis was 1300 (IQR: 1000-1600), while this value was 500 (IQR: 350-650) for the non-fulminant group (p < 0.05). The median systemic inflammatory response index (SIRI) values were 2.9 (IQR: 2.5-3.2) in the fulminant myocarditis group and 1.5 (IQR: 1.2-1.8) in the non-fulminant group (p < 0.05). The cut-off values for fulminant myocarditis were found to be 1050 for the SII, with an AUC value of 0.76 (95% confidence interval: 0.80-0.96; p < 0.001), and 1.9 for the SIRI, with an AUC value of 0.64. Conclusions: The SII and SIRI may independently predict adverse myocarditis prognoses in children. These new biomarkers are easy to calculate using routine blood parameters.

Stomach adenocarcinoma (STAD) is an aggressive malignant tumor. Herein, we characterized the prognosis based on inflammatory response-related features and evaluated their potential impact on survival and immune status of STAD patients.

Inflammation-related genes obtained from public databases were used to analyze the inflammatory response scores of STAD samples. The differentially expressed genes (DEGs) between STAD and adjacent gastric tissue were then analyzed using the "limma" package. Genes associated with STAD prognosis were obtained from the intersection of inflammation-related genes and DEGs. The key genes screened by last absolute shrinkage and selection operator (LASSO) Cox and stepwise regression analyses were used to construct prognostic models and nomograms. The tumor immune dysfunction exclusion (TIDE) algorithm was used to assess potential differences in immunotherapy response between high- and low-risk groups and to explore gene mutation signatures using the R software maftools package. In addition, GSEA was used to predict pathway characteristics between different subgroups. Finally, scratch and transwell assays were performed to explore the role of SERPINE1 in STAD cells.

We found that a high-inflammatory group was associated with poor prognosis in STAD patients. 14 inflammation-related DEGs out of 126 DEGs were identified to be associated with the prognosis of STAD patients, and the prognostic models and nomograms constructed from the subsequently identified key genes (SLC7A1, CD82, SERPINE1 ROS1 and SLC7A2) demonstrated a good predictive performance in terms of prognosis of STAD. Patients in the STAD high-risk group had higher StromalScore and TIDE scores. It was also found that patients in the STAD low-risk group may have a higher mutation burden. Enrichment analysis revealed significant enrichment of epithelial-mesenchymal transition, angiogenesis and KRAS pathways in the high-risk group. In-vitro experiments showed that down-regulation of SERPINE1 attenuated the migratory and invasive abilities of AGS cells.

This study provides new insights into prognostic prediction and immunotherapy for STAD from the perspective of the inflammatory response.

To evaluate the diagnostic value of platelet-to-neutrophil ratio (PNR) in the occurrence of diabetic macular edema (DME) in patients with diabetic retinopathy (DR).

This cross-sectional study included 366 participants categorized into four groups: DME group (n = 96), DR group (n = 90, DR without DME), diabetes mellitus (DM) group (n = 90, without DR), and healthy control group (n = 90). PNR was calculated by dividing the platelet count by the neutrophil count. Each subject was classified as one of three DME types according to the optical coherence tomography (OCT) features: diffuse retinal thickening (DRT), cystoid macular edema (CME), serous retinal detachment (SRD). The correlations between the PNR and the occurrence of DME, as well as the DME subtypes based on OCT were investigated. Multivariate logistic regression analysis was employed to determine the risk factors for DME. Receiver operating characteristic (ROC) curve analysis was conducted to assess the predictive value of PNR for DME.

DME group exhibited significantly lower PNR level compared to the other three groups [50.73 (38.92, 65.20) in DME group, 95.63 (68.83, 120.19) in DR group, 92.39 (72.38, 130.61) in DM group, and 100.66 (75.26, 152.77) in healthy control group, respectively, p < 0.001], but did not differ across the DME subtypes based on OCT (p = 0.548). The ROC curve demonstrated that the PNR could better predict DME (area under the curve = 0.832, 95% confidence interval: 0.773 - 0.891, p < 0.001). When the cut-off value of the PNR was 68.51, the sensitivity was 80.2%, and the specificity was 75.6%. Multivariate regression analysis indicated that PNR ≤ 68.51 was an independent risk factor for DME occurrence in DR patients (Odds ratio = 12.05, 95% confidence interval: 5.93 - 24.47, p < 0.001).

PNR ≤ 68.51 was strongly associated with the development of DME in DR patients, while no significant differences in PNR levels were observed across the different OCT morphological groups. Hence, PNR may serve as a valuable diagnostic biomarker for identifying DME, thereby enhancing risk stratification and management strategies for patients with DR.

To investigate the value of the first-trimester aggregate index of systemic inflammation (AISI) and other combined inflammatory markers in the prediction of gestational diabetes mellitus (GDM) and related obstetric outcomes.

The data of pregnant women diagnosed with GDM between September 2021 and November 2024, as well as an equal number of control patients, were retrospectively analyzed. The patients' AISI, neutrophil lymphocyte ratio (NLR), systemic immune-inflammatory index (SII), and systemic inflammatory response index (SIRI) values were calculated from the hemogram parameters of the participants at 11-14 weeks of gestation. The clinical characteristics, laboratory results, combined inflammatory indices, obstetric outcomes, the need for neonatal intensive care unit (NICU) admission, and the presence of composite adverse perinatal outcome (CAPO) of the groups were then compared. Receiver operating characteristic (ROC) curve analyses were performed to investigate the value of the indices that reached statistical significance in predicting GDM.

The GDM group exhibited significantly higher SII and AISI values, rate of NICU admission, and CAPO compared to the control group (p = 0.036, p = 0.011, p < 0.01, and p < 0.01, respectively). The gestational age at birth was significantly lower in the GDM group compared to the control group, while the neonatal weight was higher (p < 0.01, p < 0.01, respectively). The ROC curve analyses yielded an area under the curve (AUC) of 0.566 and 0.581 for SII and AISI for GDM prediction, respectively (p = 0.036 and p = 0.011, respectively).

First-trimester AISI and SII may be useful markers for identifying pregnancies at high risk for developing GDM.

To develop and validate a nomogram based on systemic inflammation response index (SIRI) and clinical risk factors to predict short-term prognosis in very elderly patients with hypertensive intracerebral hemorrhage (HICH).

A total of 324 very elderly HICH patients from January 2017 to June 2024 were retrospectively enrolled and randomly divided into two cohorts for training (n = 227) and validation (n = 97) according to the ratio of 7:3. Independent predictors of poor prognosis were analyzed using univariate and multivariate logistic regression analyses. Furthermore, a nomogram prediction model was built. The area under the receiver operating characteristic curves (AUC), calibration plots and decision curve analysis (DCA) were used to evaluate the performance of the nomogram in predicting the prognosis of very elderly HICH.

By univariate and stepwise multivariate logistic regression analyses, GCS score (p < 0.001), hematoma expansion (p = 0.049), chronic obstructive pulmonary disease (p = 0.010), and SIRI (p = 0.005) were independent predictors for the prognosis in very elderly patients with HICH. The nomogram showed the highest predictive efficiency in the training cohort (AUC = 0.940, 95% CI: 0.909 to 0.971) and the validation cohort (AUC = 0.884, 95% CI: 0.813 to 0.954). The calibration curve indicated that the nomogram had good calibration. DCA showed that the nomogram had high applicability in clinical practice.

The nomogram incorporated with the SIRI and clinical risk factors has good potential in predicting the short-term prognosis of very elderly HICH.

Gut microbiota is reported to be related to the onset of insulin resistance (IR) and type 2 diabetes mellitus (T2DM). The dietary index for gut microbiota (DI-GM) is a novel index for reflecting gut microbiota diversity. We aimed to evaluate the association of DI-GM with T2DM and IR.

This cross-sectional research comprised 10,600 participants aged ≥20 from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. We employed weighted multivariable linear and logistic regression models to examine the correlation of DI-GM with T2DM and IR. Linear or nonlinear relationships were examined by restricted cubic spline (RCS) regression. Additionally, subgroup and sensitivity analyses were performed to ensure the reliability of the results. Mediation analysis explored the roles of body mass index (BMI) and inflammatory factors in these associations.

Higher DI-GM were inversely associated with T2DM (OR = 0.93, 95%CI: 0.89-0.98) and IR (OR = 0.95, 95%CI: 0.91-0.99) after adjusting for confounders. DI-GM ≥ 6 group showed significantly lower risks of T2DM (OR = 0.74, 95%CI: 0.60-0.91) and IR (OR = 0.77, 95%CI: 0.62-0.95). RCS demonstrated a linear relationship between DI-GM and T2DM, as well as IR. DI-GM was also inversely correlated with the risk markers of T2DM. Mediation analysis showed that BMI and the systemic inflammation response index partly mediated the association of DI-GM with T2DM and IR, while the systemic immune-inflammation index mediated only the association with T2DM.

DI-GM is inversely associated with T2DM and IR, with BMI and inflammatory markers partly mediating this association.

Acrylamide (AA) is a ubiquitous environmental contaminant linked to systemic inflammation and oxidative stress in animal studies; however, the epidemiological evidence is still lacking. This study aimed to evaluate the association of AA exposure with markers of systemic inflammation and serum concentrations of an anti-aging protein, α-klotho.

The study used data of 1,545 adults aged 40-79 years from the National Health and Nutrition Examination Survey (NHANES) 2013-2016. Internal AA exposure was assessed using hemoglobin adducts of acrylamide and glycidamide (HbAA and HbGA, respectively), the sum of HbAA and HbGA (HbAA + HbGA), and the ratio of HbGA and HbAA (HbGA/HbAA). Two novel indicators, systemic immune-inflammation index (SII) and system inflammation response index (SIRI), were calculated using the lymphocyte, platelet, neutrophil, and monocyte counts. The serum concentration of soluble α-klotho was measured using enzyme-linked immunosorbent assay. Multivariable linear regression models were used to estimate the associations of AA hemoglobin biomarkers with systemic inflammation indicators and serum concentration of α-klotho.

Each one-unit increase in ln-transformed HbAA, HbGA, and HbAA+HbGA was associated with an increase in SII in models adjusted for age, sex, and race/ethnicity [regression coefficient (β) = 32.16, 95% confidence interval (CI): 3.59, 60.73; β =36.37, 95% CI: 5.59, 67.15; and β = 37.17, 95% CI: 6.79, 67.55, respectively]. However, the associations were no longer significant after additional adjustment for lifestyle factors. Higher HbAA and HbAA+HbGA predicted lower serum α-klotho concentrations (β = -35.76 pg./mL, 95% CI: -63.27, -8.25; β = -33.82 pg./mL, 95% CI: -62.68, -4.96, respectively).

The hemoglobin adducts of AA parameters, as biomarkers of internal AA exposure, were associated with reduced serum concentrations of α-klotho among the United States population in their middle-late adulthood. The findings indicated that exposure to AA may have impacts on the molecular pathways of aging and related diseases by influencing α-klotho concentrations.

Sedentary behavior (SB), has been closely linked to numerous detrimental health effects. While the individual and combined impacts of such behaviors on immune-inflammatory responses remain ambiguous, innovative indices like the Systemic Immune-Inflammation Index (SII) and the Systemic Inflammation Response Index (SIRI) are considered as comprehensive tools to assess inflammation. This study endeavors to elucidate the potential correlations between SB, SII, and SIRI, thereby contributing to a deeper understanding of how lifestyle choices influence systemic inflammation profiles.

This research entailed a retrospective, cross-sectional examination of 39,156 adult participants sourced from 2011 to 2018 of the National Health and Nutrition Examination Survey (NHANES). SASB was used as the independent variable and SII and SIRI as dependent variables. Weighted linear regression was used to assess the correlation between the independent and dependent variables. Smoothed curve fitting and threshold effect analyses were also performed to determine to identify if there was a non-linear relationship between SII and SIRI and SASB. Subgroup analyses were then performed to identify sensitive populations.

A total of 15,789 individuals ≥18 years old were included. Elevated SB levels were correlated with a rise in SII levels in three models (p < 0.05). There was a positive correlation of SB and SII (as a continuous variable). At the same, higher SB was associated with increased SIRI level in three models (p < 0.05). However, there was a non-linear correlation between SB and SIRI with 485 min (min) being the inflection point.

Among US adults, SII and SIRI exhibited a positive correlation with heightened SB, underscoring the need for more extensive, prospective studies to further elucidate SB's impact on these inflammation indices.

Inflammatory biomarkers have shown prognostic value in Non-Small Cell Lung Cancer (NSCLC), but the inclusion of Adenocarcinoma In Situ (AIS) cases in previous studies may introduce bias. This study aims to evaluate the prognostic significance of inflammatory biomarkers in NSCLC while excluding AIS.

This study included patients who received surgery for lung carcinoma from August 2016 and August 2019. We collected demographic, clinical, laboratory, and outcome information. Inflammatory biomarkers were analyzed using receiver operating characteristic (ROC) curves, Kaplan-Meier survival analysis, and Cox regression to assess their prognostic value.

Higher levels of inflammatory biomarkers correlated with poorer survival, with significant differences in overall survival (OS) between high- and low-expression groups. However, multivariate Cox regression identified age, tumor stage, and differentiation as independent prognostic factors, while biomarkers were not independently predictive.

Inflammatory biomarkers have short-term prognostic value in invasive NSCLC, but traditional clinical and pathological factors remain key for long-term outcomes.

Diabetic foot ulcer (DFU) is a common complication of diabetes. It is often accompanied by infection and, in severe cases, necessitates amputation. Early diagnosis and monitoring are crucial for improving prognosis. Novel inflammatory biomarkers, such as the systemic inflammatory response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) are useful for the diagnosis and predicting prognosis of some diseases. This study aimed to clarify the association between SIRI, NLR, PLR and DFU and assess their utility for early diagnosis and monitoring of DFU. Cross-sectional data were extracted on individuals with diabetes who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 to 2004. DFU was diagnosed based on the presence of foot ulcers that had not healed within 4 weeks. Weighted multivariable regression, subgroup analysis, and smooth curve fitting were used to evaluate the relationships between the SIRI, NLR, and PLR with DFU.A total of 1204 participants were included in the analysis, of whom 112 had DFUs. Participants with DFUs had higher NLR, PLR, and SIRI values than those without DFUs. For each unit increase in SIRI, the prevalence of DFU increased by 27% . Subgroup analyses showed a consistent association between an elevated SIRI and the prevalence of DFUs.SIRI is a low-cost, readily accessible biomarker that can be used in conjunction with NLR and PLR to assess the severity and predict the prognosis of DFU. Continuous monitoring of these indicators could assist with early diagnosis and management of DFU.

Pancreatic cancer (PCa) is one of the malignant tumors with an extremely poor prognosis. Rare biomarkers exist for predicting the outcomes of PCa patients. This study aimed to develop a nomogram model based on serum microRNA-24 (miR-24) and clinicopathological factors to predict overall survival (OS) and treatment response to conventional adjuvant chemotherapy (ACT) in patients with PCa. This retrospective study included 296 patients with PCa who underwent radical resection and were followed up every three months. The serum levels of miR-24 were analyzed with real- time polymerase chain reaction, and the clinicopathological information relevant to the patients was extracted from the medical center. By combining miR-24 with some clinicopathological factors associated with prognosis, a nomogram model was developed to predict the OS of patients with PCa. Patients with elevated miR-24 levels exhibited significantly poorer OS compared to those at low risk (P < 0.0001). miR-24 was an independent predictor of OS regardless to the patients' age, gender, and clinical pathological characteristics. It demonstrated remarkable predictive power, with an AUC of 0.82, surpassing CA19-9 (AUC: 0.61), CA125 (AUC: 0.59), CA50 (AUC: 0.51) and CEA (0.56). When miR-24 was integrated with TNM stage, CA19-9 and CA125 in a nomogram, the prognostic accuracy was notably enhanced compared to individual factors. Furthermore, patients classified into the high-risk group who received post-operative ACT showed superior outcomes in both OS and two-year survival compared to those who did not receive ACT (P < 0.0001). A serum miR-24-based nomogram may serve as a powerful tool for predicting risk and prognosis in patients with resected pancreatic cancer, thus facilitating personalized clinical decision-making.

Chronic low-grade systemic inflammation plays a significant role in age-related macular degeneration (AMD) pathogenesis. The systemic inflammatory response index (SIRI), a novel inflammatory marker, may predict various diseases. However, data on the relationship between SIRI and AMD are limited. This study examines the relationship between SIRI and AMD and assesses its potential as a predictive biomarker.

A cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2008 was conducted on participants aged ≥40 years with SIRI and AMD status data. Multivariable logistic regression models adjusted for confounders were used to assess the association. Sensitivity and subgroup analyses, along with restricted cubic spline (RCS) curve analysis, were performed.

Among 5,365 participants, 425 (7.9%) had AMD. The median SIRI was higher in AMD patients (1.23 vs. 1.04, p < 0.001). Higher SIRI was independently associated with increased odds (adjusted OR: 1.18, 95% CI:1.07-1.29, p = 0.001). RCS analyses revealed a dose-response relationship (p = 0.002). Subgroup analyses showed a positive association in male participants, individuals with hypertension, individuals with obesity, and non-smokers. Higher SIRI levels were independently associated with increased AMD risk (adjusted OR: 1.27, 95% CI: 1.03-1.56, p = 0.023).

Elevated SIRI is independently associated with increased AMD risk in the U.S. population. SIRI may serve as a biomarker for identifying high-risk individuals, enabling early intervention. The cross-sectional design limits causal inference, and unmeasured confounders may affect the results. SIRI could potentially serve as a non-invasive biomarker for AMD risk, pending further validation through longitudinal studies.

Although the link between inflammation and chronic obstructive pulmonary disease (COPD) is increasingly recognized, the correlation between systemic immune response index (SIRI), a novel marker of inflammation, and COPD is unknown. This cross-sectional study used data from patients with complete lung function in NHANES 2007-2012 to explore the relationship between SIRI and COPD. We performed a series of statistical analyses on a total of 5056 participants, including multiple linear regression, smoothed curve fitting, ROC curve analysis, and subgroup analysis. In the fully corrected model, the logistic multiple regression showed that SIRI was associated with a high risk of COPD (OR1.350, 95% CI:1.220,1.493). The ROC curve showed that SIRI (AUC = 0.596) was significantly more efficient than other inflammatory factors in predicting COPD. Smoothed curve fit effect and threshold effect analyses showed a linear correlation between SIRI COPD prevalence, and subgroup analyses showed that the effect of SIRI on COPD was more pronounced in still smokers (OR 1.58, 95% CI: 1.34, 1.86) versus men (OR 1.62, 95% CI: 1.44, 1.83). The results of the interaction test provide evidence supporting SIRI as an independent risk factor for COPD.

Due to drug resistance, a majority of patients with non-small cell lung cancer (NSCLC) experience disease progression following immunotherapy. Therefore, there is an urgent need to develop novel biomarkers to predict the prognosis of NSCLC patients. Clinical data from 544 patients with advanced NSCLC who underwent immune checkpoint blockers (ICBs) at our clinical center were collected in this study. The results indicated that low Albumin-Globulin Ratio (AGR) and Lymphocyte-Monocyte Ratio (LMR) and high Systemic Immune-Inflammation Index (SIRI) were significantly correlated with both poor overall survival (OS) and progression-free survival (PFS) in NSCLC patients (P < 0.01). These three indicators collectively formed the most effective combined model for predicting the prognosis of NSCLC. Importantly, risk stratification based on AGR, LMR and SIRI was better than that based on the TNM stage, and served as an independent predictor of OS and PFS. Notably, the nomogram model developed by risk stratification, sex, age, smoking history, and pathological type demonstrated a good ability to predict the 1 to 5-year OS rates for NSCLC patients. In summary, AGR, LMR, and SIRI represented the optimal combined models for forecasting the prognosis of patients with advanced NSCLC who underwent ICBs, offering promising potential as biomarkers to direct personalized clinical interventions.

To evaluate the role of serum inflammatory markers in determining colposcopy indications more accurately, reducing unnecessary colposcopy requests, and preventing overtreatment.

In our study, the data of 218 patients who were followed up in our hospital's oncology outpatient clinic between April 2017 and November 2023 and who underwent colposcopy and biopsy for suspected cervical lesions due to Papanicolaou smear test abnormalities or the presence of human papillomavirus were evaluated retrospectively. The parameters of patients with and without cervical lesions were compared. Patients with cervical lesions were compared according to lesion type.

Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio levels were significantly higher in the cervical lesions (+) group compared with the cervical lesions (-) (p < 0.001 and p < 0.001, respectively). Systemic immuno-inflammation index and systemic inflammatory response index levels were significantly higher in the cervical lesions (+) group compared with the cervical lesions (-) group (p < 0.001 and p < 0.001, respectively). Mean platelet volume level was significantly lower in the cervical lesions (+) group compared with the cervical lesions (-) group (p < 0.001). In the group with cervical lesions, no significant relationship was found between the severity of the cervical lesions and serum inflammatory marker levels.

According to the results of our study, although there were significant differences between the serum inflammatory marker levels of patients with and without cervical lesions, their importance in predicting cervical lesions could not be clearly demonstrated. The importance of serum inflammatory markers should be evaluated in prospective studies with larger patient numbers and longer follow-up periods.