Obesity indicators mediate the association between the aggregate index of systemic inflammation (AISI) and type 2 diabetes mellitus (T2DM)

作者：Ziying Su, Lei Cao, Hailong Chen, Peng Zhang, Chun-Wei Wu, Jing Lü, Ze He · 发表于：Lipids in Health and Disease · 年份：2025 · DOI：10.1186/s12944-025-02589-4 · 被引用次数：20 · 研究领域：Adipokines, Inflammation, and Metabolic Diseases、Inflammatory Biomarkers in Disease Prognosis、Biomarkers in Disease Mechanisms

OBJECTIVE: This study analyzes data from the 2009-2018 National Health and Nutrition Examination Survey (NHANES) to explore the relationship between the Aggregate Index of Systemic Inflammation (AISI), also referred to as the pan-immune-inflammation value (PIV), and Type 2 Diabetes Mellitus (T2DM) among adults in the United States. Furthermore, it evaluates the mediating effect of obesity indicators on this association. METHODS: This study included 9,947 individuals from NHANES and applied appropriate weighting techniques. To examine the relationship between AISI and T2DM, we used various statistical models, including weighted multivariable logistic regression, smooth curve fitting, threshold effect analysis, subgroup analysis, trend tests, mediation analysis, and Shapley additive explanations (SHAP) models. RESULTS: This research included a total of 9,947 participants, with 3,220 diagnosed with T2DM, while 6,727 remained undiagnosed. Weighted multiple logistic regression with all covariates adjusted indicated that with every one-unit increment in AISI/1000, there was an 88.3% likelihood of T2DM occurrence (OR: 1.883, 95% CI: 1.378-2.571). The stratified analysis identified significant differences in this association based on age, biological sex, level of education, poverty-income ratio (PIR), tobacco consumption status, and body mass index (BMI). Interaction tests revealed a positive association between AISI and T2DM, apart from PIR, BMI, age, education attainment, race, gen...