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. 2022 Sep 15:13:925690.
doi: 10.3389/fimmu.2022.925690. eCollection 2022.

Association between SII and hepatic steatosis and liver fibrosis: A population-based study

Ruijie Xie  1 , Mengde Xiao  2 , Lihong Li  3 , Nengqian Ma  3 , Mingjiang Liu  1 , Xiongjie Huang  1 , Qianlong Liu  1 , Ya Zhang  3
Affiliations

Association between SII and hepatic steatosis and liver fibrosis: A population-based study

Ruijie Xie et al. Front Immunol. .

Abstract

Background: The systemic immune-inflammation index (SII) is a novel marker of inflammation, and hepatic steatosis and fibrosis are associated with inflammation. This study aimed to investigate the possible relationship between SII and hepatic steatosis and fibrosis.

Methods: The datasets from the National Health and Nutrition Examination Survey (NHANES) 2017-2020 were used in a cross-sectional investigation. Multivariate linear regression models were used to examine the linear connection between SII and controlled attenuation parameter (CAP) and liver stiffness measurement (LSM). Fitted smoothing curves and threshold effect analysis were used to describe the nonlinear relationship.

Results: This population-based study included a total of 6,792 adults aged 18-80 years. In a multivariate linear regression analysis, a significant positive association between SII and CAP was shown [0.006 (0.001, 0.010)]. This positive association in a subgroup analysis was maintained in men [0.011 (0.004, 0.018)] but not in women. Furthermore, the association between SII and CAP was nonlinear; using a two-segment linear regression model, we found an inverted U-shaped relationship between SII and CAP with an inflection point of 687.059 (1,000 cells/µl). The results of the multiple regression analysis showed that the relationship between SII and LSM was not significant (P = 0.263).

Conclusions: Our findings imply that increased SII levels are linked to hepatic steatosis, but SII is not linked to liver fibrosis. To confirm our findings, more large-scale prospective investigations are needed.

Keywords: NAFLD; NHANES; hepatic steatosis; liver fibrosis; systemic immune-inflammatory index.

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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
Flowchart of participant selection. NHANES, National Health and Nutrition Examination Survey; SII, systemic immune-inflammation index; CAP, controlled attenuation parameter; LSM, liver stiffness measurement.
Figure 2
Figure 2
The association between SII and CAP. (A) Each black point represents a sample. (B) The solid red line represents the smooth curve fit between variables. Blue bands represent the 95% confidence interval from the fit. SII, systemic immune-inflammation index; CAP, controlled attenuation parameter.
Figure 3
Figure 3
The association between SII and CAP stratified by gender. SII, systemic immune-inflammation index; CAP, controlled attenuation parameter.
Figure 4
Figure 4
The association between SII and LSM. (A) Each black point represents a sample. (B) The solid red line represents the smooth curve fit between variables. Blue bands represent the 95% confidence interval from the fit. SII, systemic immune-inflammation index; LSM, liver stiffness measurement.
See this image and copyright information in PMC

References

    1. Díaz LA, Fuentes-López E, Ayares G, Idalsoaga F, Arnold J, Márquez-Lomas A, et al. The establishment of public health policies and the burden of non-alcoholic fatty liver disease in the americas. Lancet Gastroenterol Hepatol (2022) 7(6):552–9. doi: 10.1016/S2468-1253(22)00008-5 - DOI - PubMed
    1. Ginès P, Krag A, Abraldes JG, Solà E, Fabrellas N, Kamath PS. Liver cirrhosis. Lancet (2021) 398:1359–76. doi: 10.1016/S0140-6736(21)01374-X - DOI - PubMed
    1. Rich NE, Noureddin M, Kanwal F, Singal AG. Racial and ethnic disparities in non-alcoholic fatty liver disease in the USA. Lancet Gastroenterol Hepatol (2021) 6:422–4. doi: 10.1016/S2468-1253(21)00100-X - DOI - PubMed
    1. Xie R, Liu M. Relationship between non-alcoholic fatty liver disease and degree of hepatic steatosis and bone mineral density. Front Endocrinol (2022) 13. doi: 10.3389/fendo.2022.857110 - DOI - PMC - PubMed
    1. Brunt EM, Janney CG, Di Bisceglie AM, Neuschwander-Tetri BA, Bacon BR. Nonalcoholic steatohepatitis: A proposal for grading and staging the histological lesions. Am J Gastroenterol (1999) 94:2467–74. doi: 10.1111/j.1572-0241.1999.01377.x - DOI - PubMed