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. 2024 May 6;19(5):e0301300.
doi: 10.1371/journal.pone.0301300. eCollection 2024.

Joint effect of abnormal systemic immune-inflammation index (SII) levels and diabetes on cognitive function and survival rate: A population-based study from the NHANES 2011-2014

Wanying Chen  1 , Xinyue Sun  1 , Jiaxin Han  1 , Xiaoyu Wu  1 , Qingfan Wang  1 , Mengmeng Li  1 , Xiangyu Lei  1 , Yixuan Wu  1 , Zhiheng Li  1 , Guogang Luo  1 , Meng Wei  1
Affiliations

Joint effect of abnormal systemic immune-inflammation index (SII) levels and diabetes on cognitive function and survival rate: A population-based study from the NHANES 2011-2014

Wanying Chen et al. PLoS One. .

Abstract

Objective: The purpose of this study was to investigate whether the combination of abnormal systemic immune-inflammation index (SII) levels and hyperglycemia increased the risk of cognitive function decline and reduced survival rate in the United States.

Methods: This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) database from 2011-2014 and enrolled 1,447 participants aged 60 years or older. Restricted cubic splines (RCS), linear regression and kaplan-meier(KM) curve were employed to explore the combined effects of abnormal SII and hyperglycemia on cognitive function and survival rate, and subgroup analysis was also conducted.

Results: The RCS analysis revealed an inverted U-shaped relationship between lgSII levels and cognitive function. Linear regression analysis indicated that neither abnormal SII nor diabetes alone significantly contributed to the decline in cognitive function compared to participants with normal SII levels and blood glucose. However, when abnormal SII coexisted with diabetes (but not prediabetes), it resulted to a significant decline in cognitive function. After adjusting for various confounding factors, these results remained significant in Delayed Word Recall (β:-0.76, P<0.05) and Digit Symbol Substitution tests (β:-5.02, P<0.05). Nevertheless, these results showed marginal significance in Total Word Recall test as well as Animal Fluency test. Among all subgroup analyses performed, participants with both abnormal SII levels and diabetes exhibited the greatest decline in cognitive function compared to those with only diabetes. Furthermore, KM curve demonstrated that the combination of abnormal SII levels and diabetes decreased survival rate among participants.

Conclusion: The findings suggest that the impact of diabetes on cognitive function/survival rate is correlated with SII levels, indicating that their combination enhances predictive power.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of the study population inclusion.
body mass index BMI.
Fig 2
Fig 2. RCS was used to analyze the association between lgSII and cognitive function scores.The analysis was performed after adjusting for age, sex, race, education level, Marital status, Poverty income ratio, smoking status, drinking status, hypercholesteremia, hypertension, Coronary heart disease, stroke, depressive state, Intake of energy and Physical activity.
The solid line represents β, and the shaded red represents 95% CI.
Fig 3
Fig 3. Association between quartiles of SII and cognitive function scores.
the first quartile: Q1; the second quartile: Q2; the third quartile: Q3; the fourth quartile:Q4. *P<0.05, ***P<0.001.
Fig 4
Fig 4. The joint association of abnormal SII levels and diabetes with cognitive function scores.
*P<0.05, ***P<0.001.
Fig 5
Fig 5. Subgroup analyses of the association of abnormal SII levels and hyperglycemia with cognitive function scores in participants.
Fig 6
Fig 6. Kaplan–Meier survival curves in six groups in NHANES.
See this image and copyright information in PMC

References

    1. United Nations. World Population Ageing 2019. United Nations; New York, NY, USA: 2019.
    1. Dominguez LJ, Veronese N, Vernuccio L, Catanese G, Inzerillo F, Salemi G, Barbagallo M. Nutrition, Physical Activity, and Other Lifestyle Factors in the Prevention of Cognitive Decline and Dementia. Nutrients. 2021. Nov 15;13(11):4080. doi: 10.3390/nu13114080 - DOI - PMC - PubMed
    1. Rajan KB, Weuve J, Barnes LL, McAninch EA, Wilson RS, Evans DA. Population estimate of people with clinical Alzheimer’s disease and mild cognitive impairment in the United States (2020–2060). Alzheimers Dement. 2021. Dec;17(12):1966–1975. doi: 10.1002/alz.12362 - DOI - PMC - PubMed
    1. Ruangritchankul S, Peel NM, Shafiee Hanjani L, Gray LC. The Changes in Medication Prescribing Among the Older People with Cognitive Impairment in the Acute Care Setting. Clin Interv Aging. 2020. Jun 8;15:865–876. doi: 10.2147/CIA.S252432 - DOI - PMC - PubMed
    1. Li W, Li S, Shang Y, Zhuang W, Yan G, Chen Z, et al.. Associations between dietary and blood inflammatory indices and their effects on cognitive function in elderly Americans. Front Neurosci. 2023. Feb 21;17:1117056. doi: 10.3389/fnins.2023.1117056 - DOI - PMC - PubMed

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