目的:全身炎症反应指数(SIRI)与各种具有炎症成分的疾病有关,但其与代谢功能障碍相关脂肪变性肝病(MASLD)患者肝纤维化进展和生存结局的关系仍不清楚。这项研究旨在调查SIRI和晚期肝纤维化(AHF)之间的潜在关联以及SIRI和MASLD个体的长期结果之间的潜在关联。
结果:使用2005年至2016年国家健康与营养调查(NHANES)收集的数据进行了一项前瞻性队列研究。加权二元逻辑回归,Cox比例风险模型,和时间相关的接收器工作特性(ROC)分析被用来评估SIRI之间的关系,AHF,MASLD患者的死亡率。我们的研究共纳入5126例MASLD患者。较高的SIRI与AHF的几率增加显著相关(OR1.55,95%CI1.22,1.96)。根据生存分析,校正后较高的SIRI与较高的全因死亡率(HR1.19,95%CI1.15,1.22)和心血管死亡率(HR1.25,95%CI1.19,1.32)相关.时间依赖性ROC分析表明,SIRI对区分3年以上死亡率风险较高和较低的MASLD个体具有适度的预测价值。5年,和10年的随访。
结论:SIRI是一个很有前途的工具,用于识别有进展为AHF风险的MASLD个体和预测死亡结果。
OBJECTIVE: The systemic inflammation response index (SIRI) is associated with various diseases with inflammatory components, but its relationship with the progression of hepatic fibrosis and survival outcomes in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) is still unclear. This study was designed to investigate the potential associations between the SIRI and advanced hepatic fibrosis (AHF) as well as between the SIRI and long-term outcomes in individuals with MASLD.
RESULTS: A prospective cohort study was conducted using data gathered from the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2016. Weighted binary logistic regression, the Cox proportional hazards model, and time-dependent receiver operating characteristic (ROC) analyses were employed to assess the relationships among the SIRI, AHF, and mortality in patients with MASLD. Our study included a total of 5126 patients with MASLD. A higher SIRI was significantly associated with increased odds of AHF (OR 1.55, 95% CI 1.22, 1.96). According to the survival analyses, a higher SIRI was associated with greater all-cause (HR 1.19, 95% CI 1.15, 1.22) and cardiovascular mortality (HR 1.25, 95% CI 1.19, 1.32) after adjustment. The time-dependent ROC analysis indicated that the SIRI had a modest predictive value for discriminating MASLD individuals at higher versus lower mortality risk over 3-year, 5-year, and 10-year follow-up.
CONCLUSIONS: The SIRI is a promising tool for identifying MASLD individuals at risk of progressing to AHF and for predicting mortality outcomes.