Key points are not available for this paper at this time.
Background 95% CI: 1.10–1.31, P<0.001), including myocardial infarction (HR: 1.22; 95% CI: 1.01–1.48, P=0.045), total stroke (HR: 1.18; 95% CI: 1.06–1.31, P=0.003), and mortality (HR: 1.34; 95% CI: 1.24–1.46, P<0.001) in MASLD. Associations were stronger among women (HR: 1.17; 95% CI: 1.07–1.29, P<0.01) and physically inactive individuals (HR: 1.09; 95% CI: 1.05–1.13, P<0.01). SIRI improved outcome prediction over hs-CRP and others, with significant reclassification gains(5.84;95% CI: 2.57–9.12; P < 0.001). TyG partially mediated these associations(5.3% for CVD, P=0.006; 2.9% for mortality, P=0.003), whereas PLT exhibited slight inverse mediation on mortality(-3.3%, P=0.032). Conclusions High SIRI independently correlates with a heightened risk of CVD and mortality in MASLD. The findings underscore systemic inflammation's role and propose SIRI as an effective biomarker for risk stratification in this individuals. Clinical trial number ChiCTR-TNC-11001489 Impact and implications This study provides important evidence linking systemic inflammation, as measured by the systemic inflammation response index (SIRI), to increased CVD and mortality in individuals with MASLD, a prevalent condition with rising global burden. The findings underscore the clinical relevance of inflammation markers in cardiovascular risk stratification, particularly for patients and healthcare providers managing MASLD. Physicians and policymakers could incorporate SIRI into routine assessments to identify MASLD patients at higher risk of cardiovascular events, potentially guiding targeted interventions aimed at mitigating systemic inflammation and metabolic dysfunction. Nonetheless, due to the predominantly male, community-based cohort from northern China, further research across diverse populations is warranted to confirm these associations before widespread clinical implementation.
Zheng et al. (Thu,) studied this question.