Comparison of systemic immunoinflammatory biomarkers for assessing severe abdominal aortic calcification among US adults aged≥40 years: A cross-sectional analysis from NHANES

Objective: Several novel biomarkers, including the systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), aggregate index of systemic inflammation (AISI), platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and monocyte-lymphocyte ratio (MLR), are linked to the systemic immunity inflammation response and the odds and severity of abdominal aortic calcification (AAC). However, still no previous research has systematically compared their association with severe AAC. Methods: This study utilized a cross-sectional approach, examining a cohort of 3,047 adults from National Health and Nutrition Examination Survey (NHANES). Weighted logistic regression was utilized to investigate the associations between a range of immunoinflammatory biomarkers and the likelihood of severe AAC. Segmented regression and limited cubic spline models were used in the investigation to characterize the threshold effects and non-linear correlations. Additionally, subgroup and interaction tests, Spearman correlation, least absolute shrinkage, and selection operator regression studies were conducted. Results: The 3047 participants included in this study had a mean age of 58.63 years and 51.79% were female. After fully adjusting for all covariates, the ln-SIRI (OR 1.39 [CI 1.10–1.74], P = 0.005), ln-AISI (OR 1.26 [1.03–1.53], P = 0.024), and ln-MLR (OR 1.62 [1.15–2.30], P = 0.006) were significantly correlated with the odds of severe AAC. A non-linear dose-response relationship was observed between ln-SII and severe AAC. Additional subgroup analyses revealed that this relationship was more evident in the diabetic population. Additionally, MLR (AUC = 0.644) predicted the prevalence of severe AAC better than other biomarkers, and the prediction model constructed in conjunction with screened clinical indicators showed good predictive value (AUC = 0.853). Conclusions: In this study, we comprehensively evaluated and compared the associations between six biomarkers and severe AAC, and developed a clinical prediction model using the MLR with the best predictive effect. However, cohort studies and model validation are still needed in the future to further confirm their relationship.