Systemic inflammatory response index mediates the association between stroke and hypertension: a cross-sectional study from NHANES 2001 to 2016
BackgroundSystemic inflammation plays a vital role in the development of hypertension and stroke. The systemic immune response index (SIRI), calculated from the numbers of neutrophils, monocytes, and lymphocytes, is a promising indicator of immune dysregulation. Yet, its role in mediating the link b...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1603241/full |
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| author | Mingzhu Tang Fangming Diao Yaxian Dong Jianpeng Lin Tiezhu Wang Lihua Yang Xuanming Lai Xiaolian Chen Jinxi Zuo Junyang Xu Hongting Shi |
| author_facet | Mingzhu Tang Fangming Diao Yaxian Dong Jianpeng Lin Tiezhu Wang Lihua Yang Xuanming Lai Xiaolian Chen Jinxi Zuo Junyang Xu Hongting Shi |
| author_sort | Mingzhu Tang |
| collection | DOAJ |
| description | BackgroundSystemic inflammation plays a vital role in the development of hypertension and stroke. The systemic immune response index (SIRI), calculated from the numbers of neutrophils, monocytes, and lymphocytes, is a promising indicator of immune dysregulation. Yet, its role in mediating the link between hypertension and stroke remains underexplored.MethodsThis study analysed data from 9,699 adults aged ≥20 years from the National Health and Nutrition Examination Survey (NHANES) 2001–2016. We used logistics regression analyses, Receiver Operating Characteristic (ROC) curve analyses, mediation analyses, trend tests, restricted cubic splines (RCS) and stratified by sex, to explore the associations between SIRI, hypertension, and stroke.ResultsSIRI was significantly associated with stroke (adjusted OR = 1.10, 95% CI: 1.00–1.21, p = 0.047). Hypertension was independently linked to both stroke (adjusted OR = 2.06, 95% CI: 1.42–2.99, p < 0.001) and higher SIRI levels (adjusted β = 1.07, 95% CI: 1.03–1.12, p = 0.002). ROC analysis confirmed strong predictive power for hypertension and SIRI in stroke risk assessment. RCS analysis revealed a nonlinear U-shaped relationship between SIRI and stroke in the overall population and males, but a flatter trend in females. SIRI mediated 1.65% of the hypertension-stroke association (p < 2 × 10−16), with a stronger effect in males (3.38%) than females (1.16%).ConclusionHypertension, SIRI, and stroke were closely related, with SIRI partially mediating their association, particularly in males. SIRI might be potential as a biomarker and therapeutic target for stroke prevention in hypertensive individuals. |
| format | Article |
| id | doaj-art-64a024b3cc9245a0ac4410fc0ff3722f |
| institution | Matheson Library |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-64a024b3cc9245a0ac4410fc0ff3722f2025-07-31T07:32:56ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-07-011610.3389/fneur.2025.16032411603241Systemic inflammatory response index mediates the association between stroke and hypertension: a cross-sectional study from NHANES 2001 to 2016Mingzhu TangFangming DiaoYaxian DongJianpeng LinTiezhu WangLihua YangXuanming LaiXiaolian ChenJinxi ZuoJunyang XuHongting ShiBackgroundSystemic inflammation plays a vital role in the development of hypertension and stroke. The systemic immune response index (SIRI), calculated from the numbers of neutrophils, monocytes, and lymphocytes, is a promising indicator of immune dysregulation. Yet, its role in mediating the link between hypertension and stroke remains underexplored.MethodsThis study analysed data from 9,699 adults aged ≥20 years from the National Health and Nutrition Examination Survey (NHANES) 2001–2016. We used logistics regression analyses, Receiver Operating Characteristic (ROC) curve analyses, mediation analyses, trend tests, restricted cubic splines (RCS) and stratified by sex, to explore the associations between SIRI, hypertension, and stroke.ResultsSIRI was significantly associated with stroke (adjusted OR = 1.10, 95% CI: 1.00–1.21, p = 0.047). Hypertension was independently linked to both stroke (adjusted OR = 2.06, 95% CI: 1.42–2.99, p < 0.001) and higher SIRI levels (adjusted β = 1.07, 95% CI: 1.03–1.12, p = 0.002). ROC analysis confirmed strong predictive power for hypertension and SIRI in stroke risk assessment. RCS analysis revealed a nonlinear U-shaped relationship between SIRI and stroke in the overall population and males, but a flatter trend in females. SIRI mediated 1.65% of the hypertension-stroke association (p < 2 × 10−16), with a stronger effect in males (3.38%) than females (1.16%).ConclusionHypertension, SIRI, and stroke were closely related, with SIRI partially mediating their association, particularly in males. SIRI might be potential as a biomarker and therapeutic target for stroke prevention in hypertensive individuals.https://www.frontiersin.org/articles/10.3389/fneur.2025.1603241/fullstrokehypertensionsystemic immune response indexinflammationcross-sectional studymediation |
| spellingShingle | Mingzhu Tang Fangming Diao Yaxian Dong Jianpeng Lin Tiezhu Wang Lihua Yang Xuanming Lai Xiaolian Chen Jinxi Zuo Junyang Xu Hongting Shi Systemic inflammatory response index mediates the association between stroke and hypertension: a cross-sectional study from NHANES 2001 to 2016 Frontiers in Neurology stroke hypertension systemic immune response index inflammation cross-sectional study mediation |
| title | Systemic inflammatory response index mediates the association between stroke and hypertension: a cross-sectional study from NHANES 2001 to 2016 |
| title_full | Systemic inflammatory response index mediates the association between stroke and hypertension: a cross-sectional study from NHANES 2001 to 2016 |
| title_fullStr | Systemic inflammatory response index mediates the association between stroke and hypertension: a cross-sectional study from NHANES 2001 to 2016 |
| title_full_unstemmed | Systemic inflammatory response index mediates the association between stroke and hypertension: a cross-sectional study from NHANES 2001 to 2016 |
| title_short | Systemic inflammatory response index mediates the association between stroke and hypertension: a cross-sectional study from NHANES 2001 to 2016 |
| title_sort | systemic inflammatory response index mediates the association between stroke and hypertension a cross sectional study from nhanes 2001 to 2016 |
| topic | stroke hypertension systemic immune response index inflammation cross-sectional study mediation |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1603241/full |
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