The Associations of Two Novel Inflammation Indexes, SII and SIRI with the Risks for Cardiovascular Diseases and All-Cause Mortality: A Ten-Year Follow-Up Study in 85,154 Individuals

Figures & data

Figure 1 Flow chart of the participants.

Table 1 Baseline Characteristics of Subjects (n=85,154)

Characteristics	Overall
Age (years)	48.6±11.7
Men (%)	79.15
BMI (kg/m^2)	23.97±3.21
Married (%)	95.11
Primary education (%)	7.56
Income>¥1000/Month (%)	5.89
Smoker (%)
Never	64.51
Former/quit	5.25
Occasionally	3.16
Often	27.08
Current drinking (%)	17.91
Antihypertensive drugs (%)	16.40
Hypoglycemic drugs (%)	4.53
Lipid-lowering drugs (%)	1.29
Active physical (%)	12.31
Family history of CVD (%)	5.27
TG (mmol/L)	1.27 (0.90, 1.93)
TC (mmol/L)	4.82±1.15
LDL-C (mmol/L)	2.34±0.76
HDL-C (mmol/L)	1.58±0.40
SBP (mmHg)	127.16±19.73
DBP (mmHg)	82.08±11.48
FPG (mmol/L)	5.29±1.36
Platelet counts (10^^9/L)	203.84±62.68
Neutrophil counts (10^^10/L)	3.50±1.22
Lymphocyte counts (10^^11 L)	2.25±0.70
Monocyte counts (10^^12/L)	0.40±0.45
CRP (mg/L)	0.74 (0.30, 1.87)
SII	333.32 (137.56, 527.08)
SIRI	0.60 (0.13, 1.07)

Notes: Data was presented as mean ± SD, median (25th, 75th percentiles), or percentage.

Abbreviations: BMI, body mass index; CRP, C-reactive protein; CVDs, cardiovascular diseases; DBP, diastolic blood pressure; FPG, fast plasma glucose; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; TC, total cholesterol; TG, triglycerides; SBP, systolic blood pressure; SII, systematic inflammation index, SIRI, systematic inflammation response index.

Table 2 Hazard Ratios of Stroke, Subtypes of Stroke, MI, All-Cause Mortality According to Quantiles of SII

	Ql (n=20,054)	Q2 (n=20,151)	Q3 (n=20,148)	Q4 (n=20,045)	p for Trend
Levels of Sll	<137.56	137.56-	333.32-	≥527.08
The number of incident stroke events (n)	963	992	1048	1146
Incidence density	46.25	47.44	50.20	55.37
Model1	1 (reference)	1.025 (0.938, 1.120)	1.085 (0.994, 1.184)	1.196 (1.098, 1.303)	<0.001
Model2	1 (reference)	1.038 (0.947, 1.138)	1.124 (1.026, 1.231)	1.264 (1.157, 1.382)	<0.001
Model3	1 (reference)	1.038(0.947,1.138)	1.129(1.03,1.236)	1.274(1.166,1.393)	<0.001
The number of incident Hemorrhage stroke events (n)	183	201	202	243
Incidence density	8.79	9.61	9.68	11.74
Model1	1 (reference)	1.093 (0.895, 1.336)	l.l00 (0.900, 1.344)	1.333 (1.100, 1.615)	0.004
Model2	1 (reference)	1.136 (0.922, 1.399)	1.167 (0.947, 1.437)	1.383 (1.132, 1.690)	0.002
Model3	1 (reference)	1.146 (0.931, 1.41 1)	1.180 (0.958, 1.454)	1.382 (1.130, 1.691)	0.002
The number of incident Ischemic stroke events (n)	808	823	880	937
Incidence density	38.81	39.36	42.15	45.28
Model 1	1 (reference)	1.014 (0.920, l.l 17)	1.086 (0.987, 1.195)	1.166 (1.061, 1.281)	<0.001
Model2	1 (reference)	1.020 (0.922, 1.129)	1.122 (1.016, 1.240)	1.239 (1.125, 1.366)	<0.001
Model3	1 (reference)	1.021 (0.923, 1.130)	1.121 (1.015, 1.239)	1.254 (1.138, 1.383)	<0.001
The number of incident Ml events (n)	297	297	317	322
Incidence density	14.05	13.98	14.94	15.26
Model 1	1 (reference)	0.995 (0.847, 1.169)	1.063 (0.907, 1.245)	1.085 (0.927, 1.271)	0.218
Model2	1 (reference)	1.004 (0.848, 1.188)	1.105 (0.937, 1.304)	1.120 (0.950, 1.321)	0.100
Model3	1 (reference)	1.023 (0.865, 1.209)	1.133 (0.960, 1.337)	1.190 (1.009, 1.404)	0.020
The number of incident All-cause mortality events (n)	1761	1600	1687	2027
Incidence density	85.77	77.23	81.66	99.73
Model 1	1 (reference)	0.900 (0.841, 0.963)	0.951 (0.890, 1.017)	1.163 (1.091, 1.240)	<0.001
Model2	1 (reference)	0.955 (0.890, 1.025)	1.042 (0.972, l.l 17)	1.246 (1.165, 1.331)	<0.001
Model3	1 (reference)	0.952 (0.887, 1.022)	1.038 (0.968, l.l 13)	1.237 (1.157, 1.323)	<0.001

Notes: Data was presented as HR (95% Cl). The incidence rate was presented as per 10,000 person years. The multiple Cox analysis was conducted by quantiles of Sll. Model 1: unadjusted. Model 2: adjusted for age, gender, BMI, smoking, drinking, education, marriage, income level, physical activity, family history of cardiovascular disease, triglycerides, high-density lipoproteins, type 2 diabetes and hypertension. Model 3: model 2 plus C-reactive protein.

Abbreviations: Cl, confidence interval; HR, hazard ratio; Ml, myocardial infarction; Sll, systemic immune-inflammation index.

Figure 2 (A–C) The Kaplan–Meier curves for 10-year incident of stroke (A), myocardial infarction (B), and all-cause mortality (C) by quartiles of SII. (D–F) The Kaplan–Meier curves for 10-year incident of stroke (D), myocardial infarction (E), and all-cause mortality (F) by quartiles of SIRI. The cumulative hazard risk was calculated according to the multiple Cox regression adjusted for age, gender, BMI, smoking, drinking, education, marriage, income level, physical activity, family history of cardiovascular disease, TG, HDL-C, a history of hypertension and type 2 diabetes.

Abbreviations: SII, systemic immune-inflammation index; SIRI, systemic inflammation response index.

Table 3 Hazard Ratios of Stroke, Subtypes of Stroke, MI, All-Cause Mortality According to Quantiles of SIRI

	Ql (n= 17,833)	Q2 (n=20,896)	Q3 (n=20,870)	Q4 (n=20,382)	p for Trend
Levels of SIRI	<0.13	0.13-	0.60-	≥1.07
The number of incident stroke events (n)	756	1046	1098	1235
Incidence density	40.78	48.26	50.75	58.74
Model1	1 (reference)	1.184 (1.078, 1.300)	1.245 (1.135, 1.366)	1.441 (1.316, 1.578)	<0.001
Model2	1 (reference)	1.135 (1.030, 1.251)	1.101 (0.999, 1.212)	1.194 (1.087, 1.313)	0.001
Model3	1 (reference)	1.124 (1.012, 1.248)	1.061 (0.957, 1.176)	1.152 (1.040, 1.276)	0.028
The number of incident Hemorrhage stroke events (n)	137	197	225	265
Incidence density	7.39	9.09	10.40	12.60
Model1	1 (reference)	1.229 (0.989, 1.529)	1.407 (1.138, 1.740)	1.703 (1.385, 2.093)	<0.001
Model2	1 (reference)	1.198 (0.956, 1.503)	1.267 (1.014, 1.583)	1.498 (1.207, 1.859)	<0.001
Model3	1 (reference)	1.212(0.968,1.517)	1.274(1.025,1.583)	1.487(1.201,1.84)	<0.001
The number of incident Ischemic stroke events (n)	640	871	914	1012
Incidence density	34.52	40.19	42.25	48.13
Model1	1 (reference)	1.165 (1.052, 1.290)	1.225 (1.107, 1.355)	1.396 (1.264, 1.541)	<0.001
Model2	1 (reference)	1.109 (0.998, 1.233)	1.071 (0.964, 1.190)	1.138 (1.026, 1.262)	0.042
Model3	1 (reference)	1.145 (1.040, 1.261)	1.091 (0.993, 1.199)	1.201 (1.094, 1.318)	0.001
The number of incident Ml events (n)	234	289	327	379
Incidence density	12.46	13.1 1	14.87	17.68
Model1	1 (reference)	1.053 (0.886, 1.251)	1.195 (1.010, 1.413)	1.420 (1.206, 1.671)	<0.001
Model2	1 (reference)	1.002 (0.835, 1.202)	1.090 (0.913, 1.301)	1.204 (1.013, 1.431)	0.014
Model3	1 (reference)	l.l 16 (0.930, 1.339)	1.226 (1.031, 1.458)	1.366 (1.150, 1.621)	<0.001
The number of incident All-cause mortality events (n)	1260	1655	1880	2246
	68 64	77 00	88 05	109 00
Model1	1 (reference)	1.122 (1.043, 1.208)	1.284 (1.196, 1.379)	1.593 (1.486, 1.706)	<0.001
Model2	1 (reference)	1.115 (1.033, 1.204)	1.206 (1.1 18, 1.300)	1.393 (1.296, 1.498)	<0.001
Model3	1 (reference)	1.126 (1.043, 1.215)	1.187 (1.103, 1.278)	1.372 (1.277, 1.474)	<0.001

Notes: Data was presented as HR (95% Cl). The incidence rate was presented as per 10,000 person years. The multiple Cox analysis was conducted by quantiles of SIRI. Model 1: unadjusted. Model 2: adjusted for age, gender, BMI, smoking, drinking, education, marriage, income level, physical activity, family history of cardiovascular disease, triglycerides, high-density lipoproteins, type 2 diabetes and hypertension. Model 3: model 2 plus C-reactive protein.

Abbreviations: Cl, confidence interval; HR, hazard ratio; Ml, myocardial infarction; SIRI, systematic inflammation response index.