Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16

Published: Jan. 28, 2025

Background Rheumatoid arthritis (RA) is a chronic autoimmune disease marked by systemic inflammation and immune dysregulation, leading to higher risk of all-cause mortality. The Pan-Immune Inflammation Value (PIV), novel biomarker capturing immune-inflammatory activity, has shown prognostic value in various diseases. However, its role predicting outcomes RA patients remains largely unexplored. Objectives This study aimed evaluate the association between PIV mortality patients, investigate nonlinear relationships, identify threshold effects. Methods Data from 1999–2018 National Health Nutrition Examination Survey (NHANES) were used, including 1,882 patients. was calculated as (neutrophil count×platelet count×monocyte count)/lymphocyte count categorized into quartiles (Q1–Q4). Multivariable Cox proportional hazards models applied assess relationship mortality, with results expressed hazard ratios (HRs) 95% confidence intervals (CIs). Restricted cubic splines (RCS) explored trends, segmented regression identified Kaplan-Meier survival curves subgroup analyses validated findings assessed potential modifiers. Results Elevated levels strongly associated increased Compared Q1, adjusted HRs for Q2, Q3, Q4 1.60 (95% CI: 1.01–2.53, P = 0.047), 1.70 1.10–2.63, 0.016), 2.12 1.33–3.37, 0.002), respectively (P trend < 0.001). RCS analysis revealed at 302. Below this threshold, increasing (HR 1.67, 1.07–2.61, 0.024). Conversely, above further increases linked reduced 0.98, 0.97–0.99, 0.026). showed clear decline probability Subgroup confirmed consistent findings, notable interaction observed diabetic 0.002). Conclusions significant independent predictor characterized distinct effect. These highlight pragmatic stratifying informing personalized treatment strategies RA.

Language: Английский