Association Between Systemic Immunity‐Inflammation Index (SII) and Fatigue, Cancer, and Cancer‐Related Fatigue: Insights From NHANES (2005–2018)

ABSTRACT Objective To investigate the association between the systemic immunity‐inflammation index (SII) and fatigue, cancer, and cancer‐related fatigue (CRF) populations. Methods The National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 provided data for this retrospective cro...

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Main Authors: Li Sun, Yanling Wu, Lydia Idowu Akinyemi, Zhiqiu Cao, Zhanhong Fan, Huahua Liu, Ziyi Yang, Leilei Zhang, Feng Zhang
Format: Article
Language:English
Published: Wiley 2025-03-01
Series:Cancer Medicine
Subjects:
Online Access:https://doi.org/10.1002/cam4.70777
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author Li Sun
Yanling Wu
Lydia Idowu Akinyemi
Zhiqiu Cao
Zhanhong Fan
Huahua Liu
Ziyi Yang
Leilei Zhang
Feng Zhang
author_facet Li Sun
Yanling Wu
Lydia Idowu Akinyemi
Zhiqiu Cao
Zhanhong Fan
Huahua Liu
Ziyi Yang
Leilei Zhang
Feng Zhang
author_sort Li Sun
collection DOAJ
description ABSTRACT Objective To investigate the association between the systemic immunity‐inflammation index (SII) and fatigue, cancer, and cancer‐related fatigue (CRF) populations. Methods The National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 provided data for this retrospective cross‐sectional study. By dividing the platelet count by the neutrophil count and the lymphocyte count, SII was calculated. Participants were categorized into four groups: normal, fatigue, cancer, and cancer‐related fatigue (CRF), with the normal group serving as the reference. Binary logistic regression was applied to assess the correlations. The dose–response relationship between SII and outcomes in the four groups was evaluated using restricted cubic splines. Use threshold effect analysis to determine the optimal SII value for each of the three groups. Stratified and subgroup analyses were performed based on sociodemographic factors and confounders, with specific attention to fatigue severity levels (mild, moderate, severe) in the fatigue and CRF groups. Results Data analysis included a total of 32,491 participants, including 14,846 in the normal group, 14,581 in the fatigue group, 1520 in the cancer group, and 1544 in the CRF group. The results of binary logistic regression showed that SII was positively correlated with the fatigue group (1.43[1.33, 1.55]), cancer group (1.67 [1.43, 1.95]) and CRF group (1.93 [1.66, 2.25]). Restricted cubic spline analysis revealed a linear relationship between SII and outcomes. The threshold values (k) for each of these groups were identified as 464.78 × 103 cells/μL, 448.97 × 103 cells/μL, and 454.65 × 103 cells/μL, respectively. Stratified analysis indicates that most groups exhibit significant differences. The subgroup analysis indicated that fatigue severity increased with higher SII levels, with the CRF group exhibiting the highest rate of severe fatigue (171% increase). Conclusion SII is positively correlated with fatigue, cancer, and CRF in a linear way. Higher SII values are associated with greater fatigue, particularly in the CRF population.
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spelling doaj-art-ccf098e40d49440094f7532ff90e8eb42025-08-20T02:12:23ZengWileyCancer Medicine2045-76342025-03-01146n/an/a10.1002/cam4.70777Association Between Systemic Immunity‐Inflammation Index (SII) and Fatigue, Cancer, and Cancer‐Related Fatigue: Insights From NHANES (2005–2018)Li Sun0Yanling Wu1Lydia Idowu Akinyemi2Zhiqiu Cao3Zhanhong Fan4Huahua Liu5Ziyi Yang6Leilei Zhang7Feng Zhang8School of Nursing and Rehabilitation, Nantong University Nantong Jiangsu ChinaSchool of Nursing and Rehabilitation, Nantong University Nantong Jiangsu ChinaSchool of Nursing and Rehabilitation, Nantong University Nantong Jiangsu ChinaSchool of Nursing and Rehabilitation, Nantong University Nantong Jiangsu ChinaSchool of Nursing and Rehabilitation, Nantong University Nantong Jiangsu ChinaNantong Maternal and Child Health Care Hospital Nantong Jiangsu ChinaSchool of Nursing and Rehabilitation, Nantong University Nantong Jiangsu ChinaNantong Stomatological Hospital affiliated to Nantong University Nantong Jiangsu ChinaSchool of Nursing and Rehabilitation, Nantong University Nantong Jiangsu ChinaABSTRACT Objective To investigate the association between the systemic immunity‐inflammation index (SII) and fatigue, cancer, and cancer‐related fatigue (CRF) populations. Methods The National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 provided data for this retrospective cross‐sectional study. By dividing the platelet count by the neutrophil count and the lymphocyte count, SII was calculated. Participants were categorized into four groups: normal, fatigue, cancer, and cancer‐related fatigue (CRF), with the normal group serving as the reference. Binary logistic regression was applied to assess the correlations. The dose–response relationship between SII and outcomes in the four groups was evaluated using restricted cubic splines. Use threshold effect analysis to determine the optimal SII value for each of the three groups. Stratified and subgroup analyses were performed based on sociodemographic factors and confounders, with specific attention to fatigue severity levels (mild, moderate, severe) in the fatigue and CRF groups. Results Data analysis included a total of 32,491 participants, including 14,846 in the normal group, 14,581 in the fatigue group, 1520 in the cancer group, and 1544 in the CRF group. The results of binary logistic regression showed that SII was positively correlated with the fatigue group (1.43[1.33, 1.55]), cancer group (1.67 [1.43, 1.95]) and CRF group (1.93 [1.66, 2.25]). Restricted cubic spline analysis revealed a linear relationship between SII and outcomes. The threshold values (k) for each of these groups were identified as 464.78 × 103 cells/μL, 448.97 × 103 cells/μL, and 454.65 × 103 cells/μL, respectively. Stratified analysis indicates that most groups exhibit significant differences. The subgroup analysis indicated that fatigue severity increased with higher SII levels, with the CRF group exhibiting the highest rate of severe fatigue (171% increase). Conclusion SII is positively correlated with fatigue, cancer, and CRF in a linear way. Higher SII values are associated with greater fatigue, particularly in the CRF population.https://doi.org/10.1002/cam4.70777Cancercancer‐related fatigue (CRF)FatigueNHANESsystemic immunity‐inflammation index (SII)
spellingShingle Li Sun
Yanling Wu
Lydia Idowu Akinyemi
Zhiqiu Cao
Zhanhong Fan
Huahua Liu
Ziyi Yang
Leilei Zhang
Feng Zhang
Association Between Systemic Immunity‐Inflammation Index (SII) and Fatigue, Cancer, and Cancer‐Related Fatigue: Insights From NHANES (2005–2018)
Cancer Medicine
Cancer
cancer‐related fatigue (CRF)
Fatigue
NHANES
systemic immunity‐inflammation index (SII)
title Association Between Systemic Immunity‐Inflammation Index (SII) and Fatigue, Cancer, and Cancer‐Related Fatigue: Insights From NHANES (2005–2018)
title_full Association Between Systemic Immunity‐Inflammation Index (SII) and Fatigue, Cancer, and Cancer‐Related Fatigue: Insights From NHANES (2005–2018)
title_fullStr Association Between Systemic Immunity‐Inflammation Index (SII) and Fatigue, Cancer, and Cancer‐Related Fatigue: Insights From NHANES (2005–2018)
title_full_unstemmed Association Between Systemic Immunity‐Inflammation Index (SII) and Fatigue, Cancer, and Cancer‐Related Fatigue: Insights From NHANES (2005–2018)
title_short Association Between Systemic Immunity‐Inflammation Index (SII) and Fatigue, Cancer, and Cancer‐Related Fatigue: Insights From NHANES (2005–2018)
title_sort association between systemic immunity inflammation index sii and fatigue cancer and cancer related fatigue insights from nhanes 2005 2018
topic Cancer
cancer‐related fatigue (CRF)
Fatigue
NHANES
systemic immunity‐inflammation index (SII)
url https://doi.org/10.1002/cam4.70777
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