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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1436999

Gender differences in the relationship between the systemic immune-inflammation index (SII) and all-cause and cardiovascular mortality among adults with hypertension: evidence from NHANES 1999-2018

Provisionally accepted
Ting Cheng Ting Cheng 1Dongdong Yu Dongdong Yu 2Qi Tang Qi Tang 1Xingying Qiu Xingying Qiu 1Geng Li Geng Li 3Li Zhou Li Zhou 3Yue Yang Yue Yang 2Zehuai Wen Zehuai Wen 3*
  • 1 Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
  • 2 First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, Anhui Province, China
  • 3 Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China

The final, formatted version of the article will be published soon.

    Background: There are gender differences in hypertension and the effect of gender on the relationship between SII and mortality in hypertensive patients is unclear. Methods: Hypertensive patients (n=7444) from ten cycles of the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2018 were enrolled in this study. The maximally selected rank statistics method was employed to identify the optimal cut-off value for the SII. Survey-weighted Cox regression analysis was utilized to explore the links between SII and all-cause and cardiovascular mortality. Kaplan-Meier method and time-dependent receiver operating characteristic curve analysis was conducted to assess the predictive accuracy of SII for mortality. Results: Whether SII was considered as a numerical variable or as a binary variable (higher- and lower-SII groups), higher SII levels were associated with a higher risk of all-cause and cardiovascular mortality in female hypertensive patients (all P < 0.001), but no such association was observed in the males. The area under the curve of the SII was 0.602, 0.595, and 0.569 for 3-, 5-, and 10-year all-cause mortality, respectively, in females, but was 0.572, 0.548, and 0.554 in males. High SII levels interacted with the poverty income ratio and physical activity to affect mortality in the male population (P for interaction < 0.05), and there was an interaction between race and SII in the female cardiovascular mortality rate (P for interaction < 0.05). Conclusion: Higher levels of SII may be closely related to the high risk of all-cause and cardiovascular mortality in hypertensive patients, and the results showed that this relationship is more significant and stable in the female group. High SII interacts with PIR, physical activity, and race to affect the mortality rate in different gender populations.

    Keywords: systemic immune-inflammation index, All-cause mortality, Cardiovascular mortality, Hypertension, gender differences

    Received: 23 May 2024; Accepted: 23 Sep 2024.

    Copyright: © 2024 Cheng, Yu, Tang, Qiu, Li, Zhou, Yang and Wen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Zehuai Wen, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China

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