Sex‐Specific Associations of Inflammatory Biomarkers With All‐Cause and Cardiovascular Mortality Across Glycaemic Status: A Prospective UK Biobank Study
Authors' conclusion
Inflammatory biomarkers show sex- and glycaemia-specific patterns in mortality discrimination, with NLR and SIRI showing comparatively stable discrimination, particularly in diabetes.
Study context
- Population
- UK Biobank participants, stratified by sex and glycaemic statusUK Biobank
- Participants
- 450,438 participants
- Exposure
- Inflammatory markers across glycaemic states, by sex
- Outcome
- All-cause and cardiovascular mortality: prognostic discrimination of 8 inflammatory markers (CRP, WBC, NLR, CRP-to-lymphocyte ratio (CLR), inflammatory burden index (IBI), SII, PIV, SIRI)
- Follow-up
- Median : 15.3 years
Methodological detailsstratified by sex and glycaemic status, Cox models; markers analysed in parallel in independent models; Restricted cubic splines (RCS) for dose-response; time-dependent ROC for discrimination; Spearman correlations with cardiometabolic phenotypes
- Stratified by sex and glycaemic status
- Cox models; markers analysed in parallel in independent models; RCS for dose-response; time-dependent ROC for discrimination; Spearman correlations with cardiometabolic phenotypes
Main finding
As reported in the abstract
- Deteriorating glycaemic status associated with progressively higher all-cause and cardiovascular mortality in both sexes
- As glycaemia worsened, discriminative performance of inflammatory markers tended to attenuate in women but remained generally more stable in men
- Time-dependent ROC analyses suggested stage- and sex-specific heterogeneity
- In diabetes, neutrophil-to-lymphocyte ratio (NLR) showed stronger early discrimination in women; Systemic inflammation response index (SIRI) more stable discrimination in men and at later follow-up in women
Observational data: associations, not effects.
Original publication
Sex‐Specific Associations of Inflammatory Biomarkers With All‐Cause and Cardiovascular Mortality Across Glycaemic Status: A Prospective UK Biobank Study. Diabetes Obes Metab. Published 10 March 2026. doi:10.
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