Key result
High cotinine and high weight-adjusted waist index linked to ~13% higher systemic immune inflammation index.
Why the study?
Few studies have evaluated the effect of serum cotinine levels and weight-adjusted waist index on systemic immune inflammation index and systemic inflammation response index.
Are serum cotinine levels and weight-adjusted waist index associated with increased systemic immune inflammation index and systemic inflammation response index in adults?
Cross-Sectional (n=9,107)
Are serum cotinine levels and weight-adjusted waist index associated with increased systemic immune inflammation index and systemic inflammation response index in adults?
Smoking (measured by serum cotinine) and central obesity (measured by WWI) are independently and jointly associated with elevated systemic inflammation indices in US adults.
Answers are grounded in this paper and cite their sources.
High cotinine and WWI jointly tied to elevated SII; hypothesis-generating for inflammation pathways, needs longitudinal confirmation before practice implications.
BACKGROUND: Systemic immune inflammation index (SII) and systemic inflammation response index (SIRI) have recently emerged as more comprehensive indicators of systemic inflammation. However, few studies have been conducted to evaluate the effect of serum cotinine levels and weight-adjusted waist index (WWI) with SII and SIRI. This study aims to evaluate the independent and combined impact of serum cotinine levels and WWI with SII and SIRI. METHODS: This study enrolled 9,099 adults based on the National Health and Nutrition Examination Survey 2013-2016. Generalized linear models were employed to assess the associations between cotinine exposure and WWI with SII and SIRI. Moreover, smoothing curve fitting was conducted to investigate the potential nonlinear relationships between the WWI with SII and SIRI levels. Additionally, subgroup analyses and interaction tests were conducted. The combined associations of the WWI and cotinine with systemic inflammatory indices were further assessed. RESULTS: High serum cotinine exposure was associated with increased SII and SIRI. The WWI was positively correlated with SII and SIRI. Smoothing curve fitting demonstrated a nonlinearly increasing dose-response connection between WWI and SII and SIRI. Stratified analyses also showed a positive association of cotinine levels and WWI with the systemic inflammatory indices across subgroups. Furthermore, a positive joint association was observed between serum cotinine level and WWI with SII and SIRI. CONCLUSIONS: These findings suggest that serum cotinine levels and WWI may be positively related to SII and SIRI. Serum cotinine levels and WWI may have a positive combined effect.
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Wang et al. (2025) conducted a cross-sectional in Systemic inflammation (n=9,107). High serum cotinine levels and high weight-adjusted waist index vs. Low serum cotinine levels and low weight-adjusted waist index was evaluated on Systemic immune inflammation index (SII) (13.00% increase, 95% CI 4.3-22.43, p=<0.05). The combination of high serum cotinine exposure and high weight-adjusted waist index was associated with a 13.00% increase in the systemic immune inflammation index compared to low levels of both.
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