Association of Systemic Inflammatory Indices and Adiposity Indices in a Rural T2DM Population of the Mandya Region.

Abstract

Background: Low grade inflammation and central obesity plays a key role in development of pathogenesis of T2DM and its vascular complications. Cardiometabolic Index (CMI), closely related metabolic dysfunction and Systemic Immune-Inflammation Index, and Systemic Inflammatory Response Index provides the reflection of inflammatory state and immune response of the body. However, their combined relationship with CVD in T2DM remains inadequately characterized. The study aims to evaluate the association of CMI, SII, and SIRI with cardiovascular disease in patients with T2DM and to assess their diagnostic performance across different levels of glycaemic control.Methodology: A total 250 study participants were included in this cross-sectional study. Biochemical and haematological parameters were recorded along with the anthropometric data. Standards formulas were used to calculate the indices; CMI, SII and SIRI and their association with cardiovascular risk assessment were analysed by correlation analysis and logistic regressions models. Their discriminative performance was assessed using receiver operating characteristic curve (ROC) analysis, with further evaluation with glycaemic control of the study participants. Results: Progressive elevation was observed in median CMI, SII and SIRI from controls to T2DM and T2DM+CVD study groups. T2DM participants with poor glycaemic control (HbA1c ≥ 7%) exhibited significantly higher CMI compared with good glycaemic control T2DM participants (p=0.008). Logistic regression models showed that CMI was independently associated with CVD (OR=1.273, 95% CI: 1.103–1.469, p<0.001), combination with SII and SIRI significantly improved model performance, with log10(SII) (OR=14.58, p<0.001) and log10(SIRI) (OR=8.12, p<0.001) making them significant predictors. However, ROC analysis exhibited moderate discriminatory ability for CMI (AUC=0.711), SII (AUC=0.639), and SIRI (AUC=0.700) among participants with HbA1c ≥7%.Conclusion: Combined assessment of CMI, SII and SIRI reflects metabolic and inflammatory pathways associated with cardiovascular risk stratification, in patients with T2DM. These markers are accessible and cost-effective, underscores their potential as early biological indicators.