SYSTEMATIC REVIEW article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1617814
This article is part of the Research TopicExploring the Immune-Metabolic Network in DiabetesView all 9 articles
Predictive Value of Systemic Immune-Inflammation Index (SII) in Patients with Diabetes Mellitus: A Systematic Review and Meta-Analysis
Provisionally accepted
- 1Leshan Vocational and Technical College, Leshan, China
- 2Hospital of Traditional Chinese Medicine Leshan, leshan, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Emerging evidence suggests an association between the systemic immune-inflammation index (SII) and the prognostic outcomes in individuals diagnosed with diabetes mellitus (DM). However, existing research presents inconsistent findings. Methods: PubMed, Embase, Web of Science, and the Cochrane Library from their inception to December 9, 2024, were retrieved to identify studies that scrutinized the interaction between SII and prognostic outcomes in DM patients. Primary outcomes included diabetic nephropathy (DN), diabetic retinopathy (DR), all-cause mortality, cardiovascular mortality, peripheral artery disease（PAD）, and kidney mortality. Data were analyzed using odds ratios (ORs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs). To ensure the robustness of results and uncover any underlying sources of heterogeneity, sensitivity analyses and subgroup analyses were also carried out. Results: Following a comprehensive literature search and screening, the meta-analysis incorporated 22 studies involving 85,796 patients. Categorical variable analysis revealed that elevated SII levels were correlated with a markedly increased risk of DN [OR = 1.94, 95% CI (1.02, 3.67), P = 0.04], all-cause mortality [OR = 1.38, 95% CI (1.14, 1.67), P = 0.001], and cardiovascular mortality [OR = 1.55, 95% CI (1.12, 2.16), P = 0.009] compared to those with lower SII levels. Furthermore, continuous variable analysis also indicated a significant link between SII levels and the incidence of DN [SMD = 4.56, 95% CI (1.44, 7.67), P = 0.004] and DR [SMD = 2.70, 95% CI (1.77, 3.64), P < 0.0001]. Conclusion: SII serves as a reliable and profoundly meaningful biomarker in forecasting prognostic outcomes and assessing mortality risks among DM patients. However, given the limited quantity and quality of the studies included, these findings remain to be further validated.
Keywords: SII, DM, prognosis, Meta-analysis, Mortality
Received: 25 Apr 2025; Accepted: 05 Sep 2025.
Copyright: © 2025 Dong, Tang, Xu and Peng. 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: Qiyan Peng, Leshan Vocational and Technical College, Leshan, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.