CLINICAL TRIAL article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1538704
This article is part of the Research TopicRenal Dysfunction in Cardiometabolic Disease: Implications of Inflammation and Oxidative StressView all 5 articles
Associations between systemic inflammatory indices and the risk of renal function decline in patients with type 2 diabetes mellitus: a retrospective cohort study
Provisionally accepted
- 1Department of Cardiology, Peking University Third Hospital, Beijing, China
- 2Department of Nephrology, Peking University Third Hospital, Beijing, China
- 3Key Laboratory of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, Jiangsu Province, China
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This study aimed to investigate the associations between three systemic inflammatory indices, including the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV), and the risk of renal function decline in patients with type 2 diabetes mellitus (T2DM).We consecutively enrolled 9,537 patients with T2DM hospitalized at Peking University Third Hospital. The systemic inflammatory indices were calculated from baseline blood routine indicators. Renal function decline was defined as an estimated glomerular filtration rate decreasing 2 by ≥ 40% from baseline. All participants were categorized into tertiles according to the systemic inflammatory indices. Restricted cubic spline (RCS) curves, multivariable Cox proportional hazard regression models, and receiver operating characteristic (ROC) curves were used for analysis.Results: A total of 1,495 outcome events were recorded during the follow-up. The RCS analysis suggested a non-linear association of systemic inflammatory indices with the risk of renal function decline (P for nonlinear < 0.001). Using the lowest tertile as reference, multivariate Cox regression revealed that patients in the highest tertile of the three systemic inflammatory indices had a significantly higher risk of renal function decline (SII: HR=1.67, 95% CI=1. P<0.001; SIRI： HR=1.69, P<0.001; PIV: HR=1.58, P<0.001). The ROC curves showed that the SIRI was better than other two indices at predicting renal function decline.A significantly positive association was shown between systemic inflammatory indices and the risk of renal function decline in T2DM patients. Among these inflammatory indices, SIRI has relatively high predictive performance for renal function decline.
Keywords: type 2 diabetes mellitus, Renal function, systemic immune-inflammation index, systemic inflammation response index, Pan-Immune-Inflammation Value
Received: 07 Dec 2024; Accepted: 15 Aug 2025.
Copyright: © 2025 Shang, Zhang, Qian, Gao and Feng. 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:
Yue-Ming Gao, Department of Nephrology, Peking University Third Hospital, Beijing, China
Songtao Feng, Key Laboratory of Laboratory Medicine, School of Medicine, Jiangsu University, Zhenjiang, 2012013, Jiangsu Province, China
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