Frontiers in Endocrinology (Jan 2024)
Association of systemic immune-inflammation index with diabetic kidney disease in patients with type 2 diabetes: a cross-sectional study in Chinese population
- Pijun Yan,
- Pijun Yan,
- Pijun Yan,
- Pijun Yan,
- Pijun Yan,
- Yuxia Yang,
- Yuxia Yang,
- Yuxia Yang,
- Yuxia Yang,
- Yuxia Yang,
- Xing Zhang,
- Xing Zhang,
- Xing Zhang,
- Xing Zhang,
- Xing Zhang,
- Yi Zhang,
- Yi Zhang,
- Yi Zhang,
- Yi Zhang,
- Yi Zhang,
- Jia Li,
- Jia Li,
- Jia Li,
- Jia Li,
- Jia Li,
- Zujiao Wu,
- Xiaofang Dan,
- Xiaofang Dan,
- Xiaofang Dan,
- Xiaofang Dan,
- Xiaofang Dan,
- Xian Wu,
- Xian Wu,
- Xian Wu,
- Xian Wu,
- Xian Wu,
- Xiping Chen,
- Shengxi Li,
- Yong Xu,
- Yong Xu,
- Yong Xu,
- Yong Xu,
- Yong Xu,
- Qin Wan,
- Qin Wan,
- Qin Wan,
- Qin Wan,
- Qin Wan
Affiliations
- Pijun Yan
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Pijun Yan
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Pijun Yan
- Sichuan Clinical Research Center for Diabetes and Metabolism, Luzhou, China
- Pijun Yan
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Pijun Yan
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
- Yuxia Yang
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Yuxia Yang
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Yuxia Yang
- Sichuan Clinical Research Center for Diabetes and Metabolism, Luzhou, China
- Yuxia Yang
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Yuxia Yang
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
- Xing Zhang
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Xing Zhang
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Xing Zhang
- Sichuan Clinical Research Center for Diabetes and Metabolism, Luzhou, China
- Xing Zhang
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Xing Zhang
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
- Yi Zhang
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Yi Zhang
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Yi Zhang
- Sichuan Clinical Research Center for Diabetes and Metabolism, Luzhou, China
- Yi Zhang
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Yi Zhang
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
- Jia Li
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Jia Li
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Jia Li
- Sichuan Clinical Research Center for Diabetes and Metabolism, Luzhou, China
- Jia Li
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Jia Li
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
- Zujiao Wu
- Department of Clinical Nutrition, Chengdu Eighth People’s Hospital (Geriatric Hospital of Chengdu Medical College), Chengdu, China
- Xiaofang Dan
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Xiaofang Dan
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Xiaofang Dan
- Sichuan Clinical Research Center for Diabetes and Metabolism, Luzhou, China
- Xiaofang Dan
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Xiaofang Dan
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
- Xian Wu
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Xian Wu
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Xian Wu
- Sichuan Clinical Research Center for Diabetes and Metabolism, Luzhou, China
- Xian Wu
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Xian Wu
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
- Xiping Chen
- Clinical Medical College, Southwest Medical University, Luzhou, China
- Shengxi Li
- Clinical Medical College, Southwest Medical University, Luzhou, China
- Yong Xu
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Yong Xu
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Yong Xu
- Sichuan Clinical Research Center for Diabetes and Metabolism, Luzhou, China
- Yong Xu
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Yong Xu
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
- Qin Wan
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, China
- Qin Wan
- Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, China
- Qin Wan
- Sichuan Clinical Research Center for Diabetes and Metabolism, Luzhou, China
- Qin Wan
- Sichuan Clinical Research Center for Nephropathy, Luzhou, China
- Qin Wan
- Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, China
- DOI
- https://doi.org/10.3389/fendo.2023.1307692
- Journal volume & issue
-
Vol. 14
Abstract
ObjectiveSystemic immune-inflammation index (SII), a novel inflammatory marker, has been reported to be associated with diabetic kidney disease (DKD) in the U.S., however, such a close relationship with DKD in other countries, including China, has not been never determined. We aimed to explore the association between SII and DKD in Chinese population.MethodsA total of 1922 hospitalized patients with type 2 diabetes mellitus (T2DM) included in this cross-sectional study were divided into three groups based on estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR): non-DKD group, DKD stages 1–2 Alb group, and DKD-non-Alb+DKD stage 3 Alb group. The possible association of SII with DKD was investigated by correlation and multivariate logistic regression analysis, and receiver-operating characteristic (ROC) curves analysis.ResultsMoving from the non-DKD group to the DKD-non-Alb+DKD stage 3 Alb group, SII level was gradually increased (P for trend <0.01). Partial correlation analysis revealed that SII was positively associated with urinary ACR and prevalence of DKD, and negatively with eGFR (all P<0.01). Multivariate logistic regression analysis showed that SII remained independently significantly associated with the presence of DKD after adjustment for all confounding factors [(odds ratio (OR), 2.735; 95% confidence interval (CI), 1.840-4.063; P < 0.01)]. Moreover, compared with subjects in the lowest quartile of SII (Q1), the fully adjusted OR for presence of DKD was 1.060 (95% CI 0.773-1.455) in Q2, 1.167 (95% CI 0.995-1.368) in Q3, 1.266 (95% CI 1.129-1.420) in the highest quartile (Q4) (P for trend <0.01). Similar results were observed in presence of DKD stages 1–2 Alb or presence of DKD-non- Alb+DKD stage 3 Alb among SII quartiles. Last, the analysis of ROC curves revealed that the best cutoff values for SII to predict DKD, Alb DKD stages 1- 2, and DKD-non-Alb+ DKD stage 3 Alb were 609.85 (sensitivity: 48.3%; specificity: 72.8%), 601.71 (sensitivity: 43.9%; specificity: 72.3%), and 589.27 (sensitivity: 61.1%; specificity: 71.1%), respectively.ConclusionHigher SII is independently associated with an increased risk of the presence and severity of DKD, and SII might be a promising biomarker for DKD and its distinct phenotypes in Chinese population.
Keywords
- systemic immune-inflammation index
- diabetic kidney disease
- distinct phenotypes
- Chinese population
- biomarker