陆军军医大学学报2026，Vol.48Issue(5)：611-621,11.DOI:10.16016/j.2097-0927.202512070
泛免疫炎症值对抑郁人群全因和特定原因死亡率的预测价值:基于NHANES与NDI的队列数据分析
Predictive value of pan-immune-inflammation value for all-cause and cause-specific mortality in depressed individuals:a cohort study
摘要
Abstract
Objective To assess the predictive value of the pan-immune-inflammation value(PIV)for all-cause and cause-specific mortality among individuals with depressive symptoms.Methods This prospective cohort study utilized data from the US National Health and Nutrition Examination Survey(NHANES,2005 to 2018)and the National Death Index(NDI,2005 to 2019).A total of 8 567 American patients with depression were enrolled.Participants were grouped by PIV quartiles(Q1,Q2,Q3,Q4)or dichotomized(low group,high group).Cox proportional hazards models were employed to estimate the association between PIV and all-cause,cardiovascular,and cancer mortality in patients with depression.Smooth curve fitting was applied to explore potential non-linear dose-response relationships.Threshold effect analysis was conducted to identify an inflection point,upon which a two-piecewise regression model was constructed.Kaplan-Meier survival curves were plotted to examine the association between PIV levels and survival status.Subgroup analyses were performed to evaluate the robustness of the observed associations.Results Cox regression showed that higher PIV levels were significantly associated with increased risks of all-cause mortality(HR=1.05,95%CI:1.04 to 1.07,P<0.001),cardiovascular mortality(HR=1.07,95%CI:1.05 to 1.10,P<0.001),and cancer mortality(HR=1.05,95%CI:1.01 to 1.08,P<0.001).Smooth curve fitting revealed a U-shaped relationship between PIV and all-cause mortality,with an inflection point at 80.97(P<0.05).Survival analysis indicated that when PIV>80.97,compared with the low group,the high group had increased all-cause mortality(HR=1.29,95%CI:1.12 to 1.48,P<0.001);compared with the Q1 group,the Q4 group also showed increased all-cause mortality(HR=1.53,95%CI:1.25 to 1.87,P<0.001).Subgroup analyses revealed stronger associations in specific populations:among females,for all-cause mortality(HR=1.08,95%CI:1.05 to 1.10,P=0.038)and cardiovascular mortality(HR=1.11,95%CI:1.07 to 1.16,P=0.031);In individuals with diabetes and those of other races(excluding Mexican American,other Hispanic,non-Hispanic White,and non-Hispanic Black),stronger associations were found between PIV and all-cause mortality(diabetes:HR=1.09,95%CI:1.06 to 1.10,P=0.023;other races:HR=1.22,95%CI:1.11 to 1.35,P=0.032)and cancer mortality(diabetes:HR=1.12,95%CI:1.06 to 1.18,P=0.006;other races:HR=2.00,95%CI:1.79 to 2.24,P=0.002).Conclusion Elevated PIV serves as an independent risk factor for multiple mortality outcomes in individuals with depressive symptoms.This study underscores the potential of PIV as a biomarker for predicting mortality risk.Utilizing PIV could aid in the early identification and targeted management of high-risk individuals,contributing to a comprehensive strategy for reducing the disease burden.关键词
泛免疫炎症值/死亡率/NHANES/抑郁Key words
pan-immune-inflammation value/mortality/NHANES/depression分类
医药卫生引用本文复制引用
林博,鲁洺佑,袁杭滔,马学红,胡慧,郑入文..泛免疫炎症值对抑郁人群全因和特定原因死亡率的预测价值:基于NHANES与NDI的队列数据分析[J].陆军军医大学学报,2026,48(5):611-621,11.基金项目
国家自然科学基金面上项目(82575223) （82575223）
北京中医药大学2023年度基本科研业务费(2023-JYB-JBZD-025) Supported by the General Program of National Natural Science Foundation of China(82575223)and the 2023 Basic Research Business Expense of Beijing University of Chinese Medicine(2023-JYB-JBZD-025) （2023-JYB-JBZD-025）
