Relationship between cumulative exposure to systemic inflammation response index and risk of all-cause mortality in middle-aged and older adults with cardiovascular-kidney-metabolic syndrome stage 0–2
X Liu, W Chen, Y Chen, W Li, Z Li, D Du, Y Du, Z Li, N Zhang, R HuangAbstract
Background
The systemic inflammation response index (SIRI) was associated with higher risk of mortality in individuals with Cardiovascular-Kidney-Metabolic (CKM) syndrome stages 0–2. However, the long-term effect of high SIRI on all-cause mortality risk remains unclear in middle-aged and elderly individuals with CKM syndrome stages 0–2.
Objective
This study aimed to evaluate the relationship between the cumulative SIRI and the risk of all-cause mortality in middle-aged and elderly individuals with CKM syndrome stages 0–2.
Methods
Participants were enrolled from the Tongzhou cohort, who participated in health examinations in 2016 and 2018. The cumulative SIRI was calculated as the weighted sum (value × time) of the mean SIRI for each time interval, reflecting the cumulative inflammatory burden over time. The participants were categorized into high and low cumulative SIRI groups based on the cut-off value determined by time-dependent receiver operating characteristic (ROC) curve analysis. Follow-up ended on December 31, 2024, and the primary outcome was all-cause mortality. In addition, a Cox proportional hazards regression model and a restricted cubic spline (RCS) analysis were performed to further evaluate the relationship between cumulative SIRI and all-cause mortality risk.
Results
A total of 3,410 middle-aged and elderly participants with CKM syndrome stages 0–2 were enrolled. During a median follow-up of 5.73 years, 71 all-cause deaths (2.08%) occurred. After adjusting for potential confounders, high cumulative SIRI was associated with an increased risk of all-cause mortality (HR = 2.29, 95% CI: 1.03–5.07). Subgroup analysis revealed no significant interactions between cumulative SIRI and age, sex, marital status, education, smoking, or drinking status. RCS analysis showed a linear positive association between cumulative SIRI and all-cause mortality risk.
Conclusions
High cumulative SIRI was independently associated with an increased risk of all-cause mortality among middle-aged and older individuals with CKM syndrome stages 0–2. Thus, long-term dynamic monitoring of cumulative SIRI may be useful for the early identification and assessment of individuals at high risk of mortality.