Correlation Analysis of Systemic Immune-inflammation Index with Coronary Lesions in Elderly Patients with Coronary Heart Disease Complicated with Type 2 Diabetes Mellitus

LI Ruiyuan; ZHANG Yi; GUO Lipeng

doi:10.3969/j.issn.2096-305X.2026.01.010

Abstract：Objective To investigate the correlation between systemic immune inflammation index(SII)and the severity of coronary artery lesions in patients aged≥65 years with coronary artery disease(CAD)and type 2 diabetes mellitus(T2DM).Methods A total of 122 patients admitted to the Department of Cardiovascular Medicine at the Dalian No.3 People's Hospital from January 2023 to August 2024 were enrolled.Spearman correlation analysis was used to assess the relationship between SII/100 and modified Gensini scores.Patients were divided into two groups based on modified Gensini scores:mild stenosis group(≤22 points)and moderate-to-severe stenosis group(＞22 points).Clinical characteristics were compared between the two groups.Multivariate analysis was performed using logistic regression,and the model was evaluated using ROC curves and calibration curves.Additionally,RCS analysis was employed to further examine the linear relationship between SII/100 and coronary lesion severity.Results The SII/100,total cholesterol,low-density lipoprotein,alanine aminotransferase(ALT),aspartate aminotransferase(AST),and fibrinogen levels in the moderate-severe lesion group were significantly higher than those in the mild lesion group(P＜0.005),while the serum cystatin C level was lower than that in the mild lesion group(P＜0.005).Multivariate logistic regression analysis showed that SII/100(OR=1.835,95%CI:1.285-2.620,P＜0.001)and serum cystatin C(OR=0.155,95%CI:0.026-0.935,P=0.042)were independent factors influencing coronary lesion severity.The ROC curve of the multivariate logistic regression model showed an AUC of 0.793(95%CI:0.735-0.906),and the calibration curve demonstrated a good fit.SII/100 was significantly positively correlated with modified Gensini scores(r=0.360,P＜0.05).After adjusting for confounding factors such as age,BMI,CAD history,smoking,alcohol consumption,hypertension,LDL,ALT,AST,fibrinogen,and serum cystatin,SII/100 remained independently and positively associated with coronary lesion severity(OR:1.96,95%CI:1.300-2.970,P＜0.001),with a linear relationship and with an inflection point at 5.11.Conclusion SII was closely associated with the severity of coronary artery lesions in elderly patients(≥65 years)with CAD and T2DM.Early monitoring of SII levels in this population may provide valuable insights for the prevention and management of coronary artery disease.