AUTHOR=He Qiang , Wang Zhen , Mei Jie , Xie Chengxin , Sun Xin TITLE=Relationship between systemic immune-inflammation index and osteoarthritis: a cross-sectional study from the NHANES 2005–2018 JOURNAL=Frontiers in Medicine VOLUME=Volume 11 - 2024 YEAR=2024 URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1433846 DOI=10.3389/fmed.2024.1433846 ISSN=2296-858X ABSTRACT=Objective: The study aimed to explore the relationship between systemic inflammatory response index (SIRI) levels and osteoarthritis (OA) using cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) database from 2005 to 2018. Methods: Using cross-sectional data from the NHANES database from 2005 to 2018, we included 11,381 study participants divided into OA (n=1,437) and non-OA (n=9,944) groups. Weighted multivariable regression models and subgroup analyses were employed to investigate the relationship between SIRI and OA. Additionally, restricted cubic spline models were used to explore nonlinear relationships. Results: This study enrolled 11,381 participants aged ≥20 years, including 1,437 (14%) with OA. Weighted multivariable regression analysis in the fully adjusted Model 3 indicated a correlation between higher levels of SIRI (log2-transformed) and an increased OA risk (odds ratio: 1.150; 95% confidence interval: 1.000–1.323, P<0.05). Interaction tests showed that the variables did not significantly affect this correlation (P for interaction all >0.05). Additionally, a restricted cubic spline model revealed a nonlinear relationship between log2(SIRI) and OA risk, with a threshold effect showing 4.757 as the critical value of SIRI. SIRI <4.757 showed almost unchanged OA risk, whereas SIRI >4.757 showed rapidly increasing OA risk. Conclusion: The positive correlation between SIRI and OA risk, with a critical value of 4.757, holds clinical value in practical applications. Additionally, our study indicates that SIRI is a novel, clinically valuable, and convenient inflammatory biomarker that can be used to predict OA risk in adults.