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Background <p>Anemia is a global health problem, and its link with inflammation is well-established. The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) are novel inflammatory markers whose association with anemia isn’t fully elucidated. In resource-limited clinical settings, such simple indices may provide valuable support for early detection and management of inflammation-related anemia. This study employed a population-based approach to evaluate and compare the clinical utility of SII and SIRI in detecting anemia in the Saudi general population.</p> Patients and Methods <p>The laboratory and demographic data of 8232 participants were retrieved, and the association between SII and SIRI with hemoglobin (Hb) was comprehensively evaluated using Spearman’s rank correlation coefficient, the Mann–Whitney U test, risk assessment, odds ratio, multivariable linear regression, and receiver operating characteristic curve (ROC) analyses.</p> Results <p>In contrast to SIRI, SII was significantly elevated in anemic subjects across all age and gender groups. Elevated SII was more common among anemic individuals (PR = 1.459, p &lt; 0.0001) and was associated with a greater risk of anemia (OR = 2.128, p &lt; 0.0001) compared with SIRI. Although diagnostic accuracy remained modest, SII (AUC = 0.634, p &lt; 0.0001) demonstrated better discriminative ability than SIRI.</p> Conclusion <p>SII levels were significantly elevated in anemic individuals and consistently outperformed SIRI. SII may serve as a simple and accessible marker to support early detection and management of anemia; however, it should be considered complementary rather than definitive. Future longitudinal studies are needed to validate these findings.</p>

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Novel Inflammatory Indices in Clinical Anemia: SII and SIRI Assessment in a Large Middle Eastern General Population

  • 期刊论文

  • 发表日期：

    2025年10月10日

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  • Hamood AlSudais,
  • Mohammad A. Alfhili,
  • Abdulaziz M. Almuqrin

摘要

Background

Anemia is a global health problem, and its link with inflammation is well-established. The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) are novel inflammatory markers whose association with anemia isn’t fully elucidated. In resource-limited clinical settings, such simple indices may provide valuable support for early detection and management of inflammation-related anemia. This study employed a population-based approach to evaluate and compare the clinical utility of SII and SIRI in detecting anemia in the Saudi general population.

Patients and Methods

The laboratory and demographic data of 8232 participants were retrieved, and the association between SII and SIRI with hemoglobin (Hb) was comprehensively evaluated using Spearman’s rank correlation coefficient, the Mann–Whitney U test, risk assessment, odds ratio, multivariable linear regression, and receiver operating characteristic curve (ROC) analyses.

Results

In contrast to SIRI, SII was significantly elevated in anemic subjects across all age and gender groups. Elevated SII was more common among anemic individuals (PR = 1.459, p < 0.0001) and was associated with a greater risk of anemia (OR = 2.128, p < 0.0001) compared with SIRI. Although diagnostic accuracy remained modest, SII (AUC = 0.634, p < 0.0001) demonstrated better discriminative ability than SIRI.

Conclusion

SII levels were significantly elevated in anemic individuals and consistently outperformed SIRI. SII may serve as a simple and accessible marker to support early detection and management of anemia; however, it should be considered complementary rather than definitive. Future longitudinal studies are needed to validate these findings.