Systemic immune-inflammation index and risk of gestational diabetes and preeclampsia: a systematic review and meta-analysis

The systemic immune-inflammation index (SII) has been a marker and prognostic indicator of several diseases. However, its utility in pregnancy is unknown. Herein, we reviewed the evidence on the ability of SII to predict gestational diabetes mellitus (GDM) and preeclampsia (PE). A systematic search of PubMed, Embase, Scopus and Web of Science was conducted for studies comparing SII between GDM/PE and non-GDM/non-PE groups. Studies reporting diagnostic accuracy data were also included. The last date of the search was 5 November 2024. Risk of bias was assessed using Newcastle Ottawa Scale. Random-effect meta-analysis was conducted comparing values of SII between GDM/PE and non-GDM/non-PE groups. Nine studies were eligible. Four studies reported data on GDM and five on PE. Most studies measured SII in the first trimester. The pooled analysis showed no statistically significant difference in the SII values between PE and non-PE groups (MD: 13.07, 95% confidence interval (CI): −117.21, 143.35, <i>I</i>² = 78%). Meta-analysis of four studies comparing data of GDM and non-GDM groups showed that SII was significantly higher in GDM females (MD: 210.32, 95% CI: 57.3, 363.34, <i>I</i>² = 94%). The sensitivity of SII to predict PE varied from 40 to 77.5% while specificity varied from 53.8 to 67.5%. For studies on GDM, the sensitivity and specificity values varied from 66 to 80.2% and 34.4 to 65%, respectively. SII values are significantly higher in GDM compared to non-GDM females. However, SII values did not correlate with PE. SII may have potential in predicting GDM which needs to be explored by further studies. The systemic immune-inflammation index, a blood count-based index, has been used to predict disease occurrence and outcomes. However, its role in pregnancy remains unclear. We searched scientific literature for studies that compared SII values between pregnant women with and without gestational diabetes/preeclampsia (PE). After combining data from studies, we noted that SII values were not notably different between women with or without PE. However, it was noted that SII values was notably higher in women with gestational diabetes. To conclude, SII levels are much higher in women with GDM compared to women who do not have gestational diabetes. But SII value does not seem to be linked to PE.

系统性免疫炎症指数（systemic immune-inflammation index, SII）是多种疾病的标志物与预后判断指标，但其在妊娠领域的应用价值尚未明确。本文综述了SII预测妊娠糖尿病（gestational diabetes mellitus, GDM）与子痫前期（preeclampsia, PE）的相关研究证据。我们系统检索了PubMed、Embase、Scopus及Web of Science数据库，筛选对比GDM/PE组与非GDM/非PE组受试者SII水平的研究，同时纳入报告诊断准确性数据的相关文献。本次检索的截止日期为2024年11月5日。采用纽卡斯尔-渥太华量表（Newcastle Ottawa Scale）评估纳入研究的偏倚风险，并通过随机效应meta分析对比GDM/PE组与非GDM/非PE组的SII水平。最终纳入9项符合标准的研究，其中4项针对GDM，5项针对PE。多数研究于妊娠早期检测受试者的SII水平。合并分析结果显示，PE组与非PE组的SII水平无统计学显著差异（均数差MD=13.07，95%置信区间CI：-117.21~143.35，I²=78%）。针对4项对比GDM组与非GDM组的研究开展的meta分析显示，妊娠糖尿病女性的SII水平显著升高（MD=210.32，95%CI：57.3~363.34，I²=94%）。SII预测PE的灵敏度介于40%~77.5%之间，特异度介于53.8%~67.5%之间；针对GDM的相关研究中，SII的灵敏度与特异度分别介于66%~80.2%与34.4%~65%之间。研究结果表明，GDM患者的SII水平显著高于非GDM妊娠女性，而PE患者与非PE妊娠女性的SII水平无明显关联。SII在预测GDM方面具有潜在应用价值，有待后续研究进一步探索。
作为一种基于血常规的检测指标，系统性免疫炎症指数已被用于预测疾病的发生与转归，但其在妊娠领域的作用仍不明确。我们检索了科学文献，筛选对比伴与不伴妊娠糖尿病/子痫前期（PE）的妊娠女性SII水平的研究。合并纳入研究的数据后发现，伴与不伴PE的妊娠女性SII水平无显著差异；而妊娠糖尿病女性的SII水平显著升高。综上，GDM患者的SII水平显著高于非GDM妊娠女性，且SII水平与PE并无明显关联。