Correlation of Systemic Immune Inflammatory Index and Systemic Inflammatory Response Index with Microalbuminuria in Middle-aged and Elderly People Undergoing Health Examination

Abstract

Background Microalbuminuria is a sensitive indicator of early renal microvascular damage and an independent risk factor for cardiovascular diseases. Previous studies have shown that long-term chronic inflammation plays an important role in the occurrence and development of microalbuminuria. However, the correlation between blood inflammatory markers and microalbuminuria has been less frequently reported. Objective To investigate the correlation of systemic immune inflammatory index (SII) and systemic inflammatory response index (SIRI) with microalbuminuria in a middle-aged and elderly physical examination population. Methods This was a cross-sectional study in which 2 105 medical examiners over the age of 40 years who underwent health check-ups from April to July 2023 at the Department of Health Medicine, General Hospital of the Eastern Theatre of Operations were selected as study subjects. The study subjects were divided into two groups based on the urinary microalbumin/urinary creatinine ratio (UACR) values: the non-microalbuminuric group (1 857 cases, UACR<30 mg/g) and the microalbuminuric group (248 cases, UACR=30-300 mg/g). SII was divided into T1 (0.09-0.27), T2 (0.28-0.40) and T3 (0.41-1.38) according to tertile grouping, and SIRI was divided into t1 (0.11-0.41), t2 (0.42-0.66) and t3 (0.67-3.52). The general information and laboratory test results of the two study groups were collected and compared, and linear regression analysis was used to explore the correlation between the levels of SII and SIRI and the log-transformed value of UACR (log UACR), and binary Logistic regression analysis was used to explore the correlation between the levels of SII and SIRI and the risk of microalbuminuria. Results Comparison of gender, waist-to-hip ratio, total cholesterol, low density lipoprotein cholesterol, and uric acid levels between the two groups showed no statistically significant difference (P>0.05) ; age, BMI, systolic blood pressure, diastolic blood pressure, fasting blood glucose, 2 h blood glucose, glycosylated hemoglobin, triglycerides, homocysteine, glomerular filtration rate erythrocyte sedimentation rate, SII, and SIRI levels were higher in the microalbuminuria group than those in the non-microalbuminuria group, and high density lipoprotein cholesterol level was lower than that in the non-microalbuminuria group (P<0.05). Linear regression analysis showed that the levels of SII and SIRI were positively correlated with log UACR (P<0.05). The results of binary Logistic regression analysis showed that, after correcting for each control variable, elevated SII levels was a risk factor for microalbuminuria (OR=1.17, 95%CI=1.01-1.35, P=0.031), and T3 was positively correlated with the risk of microalbuminuria when compared to T1 (OR=1.43, 95%CI=1.01-2.03, P=0.046), and the risk of microalbuminuria tended to increase with increasing SII (Ptrend=0.038). After correcting for each control variable, elevated SIRI levels was a risk factor for microalbuminuria (OR=1.18, 95%CI=1.03-1.35, P=0.019) ; t3 was positively correlated with the risk of microalbuminuria compared to t1 (OR=1.45, 95%CI=1.01-2.09, P=0.046) and the risk tended to increase with increasing SIRI (Ptrend=0.032) . Conclusion SII and SIRI levels correlated positively with both log UACR and risk of microalbuminuria in middle-aged and elderly subjects who received health examination.

Keywords

• albuminuria|microalbuminuria|systemic immune inflammatory index|systemic inflammatory response index|middle-aged and elderly