Association between inflammatory biomarkers and mortality in individuals with type 2 diabetes: NHANES 2005–2018

Abstract

Purpose

This study aimed to examine independent association between inflammatory biomarkers and all-cause mortality as well as cardio-cerebrovascular disease (CCD) mortality among U.S. adults with diabetes.

Methods

A cohort of 6412 U.S. adults aged 20 or older was followed from the start until December 31, 2019. Statistical models such as Cox proportional hazards model (Cox) and Kaplan-Meier (K-M) survival curves were employed to investigate the associations between the inflammatory biomarkers and all-cause mortality and CCD mortality.

Results

After adjusting for confounding factors, the highest quartile of inflammatory biomarkers (NLR HR = 1.99; 95 % CI:1.54–2.57, MLR HR = 1.93; 95 % CI:1.46–2.54, SII HR = 1.49; 95 % CI:1.18–1.87, SIRI HR = 2.32; 95 % CI:1.81–2.96, nLPR HR = 2.05; 95 % CI:1.61–2.60, dNLR HR = 1.94; 95 % CI:1.51–2.49, AISI HR = 1.73; 95 % CI:1.4 1–2.12)) were positively associated with all-cause mortality compared to those in the lowest quartile. K-M survival curves indicated that participants with an inflammatory biomarker above a certain threshold had a higher risk of both all-cause mortality and CCD mortality (Log rank P < 0.05).

Conclusion

Some biomarkers such as NLR, MLR, SII, AISI, SIRI, and dNLR, are significantly associated with all-cause mortality and CCD mortality among U.S. adults with diabetes. The risk of both outcomes increased when the biomarkers surpassed a specific threshold.