systemic inflammation response index and immune-inflammation index as predictors of metabolic syndrome in obese children and adolescents: a prospective cross-sectional study

Background: with the increase in pediatric obesity, the prevalence of metabolic syndrome (mets) is rising worldwide. early identification of children with obesity who are prone to developing mets is important. objectives: this study aimed to evaluate the value of the systemic immune–inflammation index (sii) and the systemic inflammatory response index (siri) in predicting mets in obese children and adolescents. methods: this prospective single-center cross-sectional study involved 99 children and adolescents with obesity. the patients were assigned to two groups, mets+ (n = 42) and mets- (n = 57), based on the presence of mets. complete blood count results from the first visit were evaluated. results: the white blood cell (wbc), platelet, and neutrophil counts were higher in the mets+ group (p = 0.003, p = 0.022, and p < 0.001, respectively), while no significant difference was observed in lymphocyte (p = 0.865) and monocyte counts (p = 0.488) between the two groups. when inflammatory parameters were compared, sii (p < 0.001), platelet-to-lymphocyte ratio (plr) (p = 0.024), neutrophil-to-lymphocyte ratio (nlr) (p = 0.002), and siri (p = 0.012) were significantly elevated in the mets+ group compared to the mets- group. binary logistic regression analysis revealed that sii and homeostasis model assessment of insulin resistance (homa-ir) were statistically significant risk factors for the presence of mets (p = 0.003, p = 0.012, respectively). additionally, a significant positive correlation was found between sii and diastolic blood pressure (dbp) (p = 0.024), high-density lipoprotein cholesterol (hdl-c) (p = 0.019), and fasting plasma glucose (fpg) (p = 0.048), as well as between siri and hdl-c (p = 0.044) and fpg (p < 0.001). receiver operating characteristic analysis of the sii and siri ability to predict mets in adolescents and children with obesity showed that the sii was more discriminative than the siri, with a specificity of 0.82, sensitivity of 0.57, and an area under the curve of 0.708. conclusions: the sii and siri can be used for the early diagnosis of mets in pediatric obesity patients.