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. 2025 Mar;19(5):149-156.
doi: 10.1080/17520363.2025.2473312. Epub 2025 Mar 2.

Novel inflammatory biomarkers for discriminating vascular involvement in Behçet's syndrome: evaluating SII, SIRI, and NPAR

Bahar Özdemir Ulusoy  1 , Berkan Armağan  2 , Esra Kayacan Erdoğan  2 , Yüksel Maraş  2 , İsmail Doğan  3 , Kevser Orhan  2 , Serdar Can Güven  2 , Ebru Atalar  2 , Hatice Ecem Konak  2 , Pınar Akyüz Dağlı  2 , Ahmet Omma  2 , Orhan Küçükşahin  3 , Şükran Erten  3 , Hakan Babaoğlu  2
Affiliations

Novel inflammatory biomarkers for discriminating vascular involvement in Behçet's syndrome: evaluating SII, SIRI, and NPAR

Bahar Özdemir Ulusoy et al. Biomark Med. 2025 Mar.

Abstract

Objective: This study aims to investigate discriminatory ability of the Systemic Immune-Inflammation Index (SII), Systemic Inflammation Response Index (SIRI), and Neutrophil Percentage-to-Albumin Ratio (NPAR), in differentiating Behçet's Syndrome (BS) organ involvements from mucocutaneous involvement.

Methods: This retrospective cohort study analyzed 436 patients diagnosed with BS from 2018 to 2023. Patients were categorized into three groups based on organ involvement: vascular, only mucocutaneous, and other organ involvement. Receiver Operating Characteristic (ROC) analysis was used to evaluate the discriminatory ability (mucocutaneous vs rest, vascular vs rest). DeLong's test was used to determine statistical differences in discriminatory power between the models.

Results: Out of 436, 115 patients had vascular involvement. SII, SIRI, and NPAR were notably elevated in the vascular involvement group (p < 0.001). ROC analysis revealed that, SII, SIRI and NPAR showed discriminative ability for vascular involvement with AUCs of 0.87 for SII, 0.87 for SIRI, and 0.88 for NPAR. Pairwise comparisons using DeLong's test indicated that all three models performed similarly.

Conclusion: SII, SIRI, and NPAR are promising noninvasive biomarkers for predicting vascular involvement. These indices, derived from routine laboratory tests, could enhance early screening and may improve patient outcomes by enabling timely intervention.

Keywords: Behçet’s syndrome; neutrophil percentage-to-albumin ratio; systemic immune-inflammation index; systemic inflammation response index; vascular involvement.

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Conflict of interest statement

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

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