Comprehensive Analysis of the Correlation Between Immune-Inflammatory Biomarkers and Intestinal Necrosis in Patients With Acute Intestinal Ischemia

Q: Which biomarkers are evaluated for predicting intestinal necrosis?

The study evaluates immune-inflammation biomarkers including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII).

Q: How were independent risk factors for intestinal necrosis determined?

Patients were analyzed using Lasso-logistic regression to identify independent risk factors, followed by multivariate logistic regression to quantify associations between NLR/SII and intestinal necrosis.

Q: What do the results show about NLR and SII thresholds?

Optimal thresholds were identified for NLR and SII to differentiate intestinal necrosis, and after adjustment, higher Ln-NLR and Ln-SII were positively correlated with intestinal necrosis.

Sep 29, 2026

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Elevated immune-inflammation biomarkers are suspected to reflect intestinal necrosis risk in acute intestinal ischemia, yet their relationships across different ischemic types remain uncertain. This study analyzes 138 patients, comparing non-necrosis (n=65) and necrosis (n=73) groups, and applies Lasso-logistic regression, multivariate logistic regression, sensitivity analyses, and propensity score matching to evaluate neutrophil-to-lymphocyte ratio and systemic immune-inflammation index thresholds.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Introduction

Background and rationale

Serological biomarkers and diagnostic challenges

Methods

Study design and patient grouping

Statistical analyses and sensitivity procedures

Results

Threshold identification for NLR and SII

Independent risk factors and effect sizes

Subgroup and nonlinear relationship findings

Conclusion

Clinical implications and need for validation

Wiley Mediators of Inflammation Volume 2025, Article ID 8701105, 12 pages [https://doi.org/10.1155/mi/8701105](https://doi.org/10.1155/mi/8701105) Research Article Comprehensive Analysis of the Correlation Between ImmuneInﬂammatory Biomarkers and Intestinal Necrosis in Patients With Acute Intestinal Ischemia Yu Tian, 1 Feifan Wang , 1 Mingshuo Zhang, 1,2 Rui Ding, 1,3 and Yimin Wang 4 1Department of Hand and Foot Surgery, First Hospital of Qinhuangdao, Qinhuangdao 066000, China 2Graduate School, Hebei North University, Zhangjiakou 075000, China 3Graduate School, Hebei Medical University, Shijiazhuang 050017, China 4Department of General Surgery, First Hospital of Qinhuangdao, Qinhuangdao 066000, China Correspondence should be addressed to Yimin Wang; [drwangyimin@126.com](drwangyimin@126.com) Received 5 August 2025; Revised 27 October 2025; Accepted 18 November 2025 Academic Editor: Tânia Silvia Fröde Copyright © 2025 Yu Tian et al. Mediators of Inﬂammation published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Background: The relationship between immune-inﬂammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inﬂammation index (SII) and intestinal necrosis in different types of acute intestinal ischemia remains unclear. Methods: A total of 138 patients with acute intestinal ischemia were divided into a nonnecrosis group (n = 65) and a necrosis group (n = 73) . Least absolute shrinkage and selection operator (Lasso)-logistic regression model was used to identify independent risk factors for intestinal necrosis. Multivariate logistic regression was conducted to assess the associations between NLR and SII levels and intestinal necrosis. Sensitivity analyses were performed using smooth curve ﬁtting, threshold effect analysis, subgroup analysis, and propensity score matching (PSM) . Results: The optimal thresholds of NLR and SII for differentiating intestinal necrosis were 8.85 and 1492.11, respectively, while PLR showed no signiﬁcant association. In Lasso-logistic regression analysis, vascular intestinal ischemia, NLR≥8.85, SII≥ 1492.11, C-reactive protein (CRP), and D-dimer > 0.5mg/L were independent risk factors for intestinal necrosis. After adjusting for potential confounding variables, the multivariate logistic regression analysis showed a positive correlation between natural logarithm (Ln)-NLR (OR = 20.187, 95% CI = 3.788–107.578, p < 0:001) and Ln-SII (OR = 5.375, 95% CI = 1.141–25.313, p < 0:033) and intestinal necrosis. Subgroup analysis showed a signiﬁcant interaction between NLR, intestinal necrosis, and coronary heart disease (p interaction = 0.016) . Smooth curve ﬁtting indicated the relationship between Ln-NLR and Ln-SII and intestinal necrosis was nonlinear, with inﬂection points at 1.78 (NLR = 5.93) and 7.32 (SII = 1510.20), respectively. When NLR > 5.93 or SII < 1510.20, the risk of intestinal necrosis signiﬁcantly increased. The associations remained robust after PSM. Conclusion: This study demonstrates that elevated levels of NLR and SII are signiﬁcantly associated with intestinal necrosis, suggesting that these biomarkers may help identify patients at higher risk of intestinal necrosis in acute intestinal ischemia. However, prospective studies are needed to validate their predictive value. Keywords: acute intestinal ischemia; intestinal necrosis; neutrophil-to-lymphocyte ratio; relationship; risk factor; systemic immune-inﬂammation index 1. Introduction Acute intestinal ischemia is a gastrointestinal emergency characterized by a lack of mesenteric blood supply or obstruction of blood return due to various etiologies and risk factors, leading to varying degrees of intestinal wall lesions and damage [1]. It can be categor

FAQs

Which biomarkers are evaluated for predicting intestinal necrosis?

The study evaluates immune-inflammation biomarkers including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII).

How were independent risk factors for intestinal necrosis determined?

Patients were analyzed using Lasso-logistic regression to identify independent risk factors, followed by multivariate logistic regression to quantify associations between NLR/SII and intestinal necrosis.

What do the results show about NLR and SII thresholds?

Optimal thresholds were identified for NLR and SII to differentiate intestinal necrosis, and after adjustment, higher Ln-NLR and Ln-SII were positively correlated with intestinal necrosis.

Sep 29, 2026

Upload by Mafia Boss