Systemic Immune-Inflammation Index and Selected Immune-Based Scores in the Diagnosis and Monitoring of Celiac Disease

Abstract

Background/Aims: The aim of this study was to investigate the value and effectiveness of the systemic immune-inflammation index (SII) in the diagnosis and follow-up of celiac disease (CD) is an immune-mediated enteropathy that requires reliable non-invasive markers for monitoring.

Materials and Methods: This retrospective analysis included patients diagnosed with CD who were followed up and treated at the Gastroenterology Department between 2018 and 2022. Healthy individuals (n=133) were included as the control group (n=121). Comparative analyses were conducted on CD patients and control group. Demographic data, hemogram, biochemical parameters, SII, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume-to-platelet ratio (MPR) values were recorded. Measurements at the initiation of treatment and at the 6th and 12th months post treatment were evaluated for the CD group.

Results: The SII, PLR, NLR, and MPR values were significantly higher in the CD group at diagnosis compared to the healthy group (P < .001). Receiver operating characteristic analysis showed that SII had a significantly higher discriminatory power in differentiating CD from healthy individuals (P < .001), with a sensitivity of 86% and specificity of 90% for the diagnosis of CD. The SII values showed a significant progressive decrease in the CD group at the 6th and 12th months after initiation of diet (P < .001), parallel to improvements in laboratory findings. Similar results were detected in PLR and NLR, but their sensitivities were lower with an AUC of 0.942. 

Conclusion: Systemic immune-inflammation index may serve as an easily accessible, cost-effective, and promising biomarker for the diagnosis and follow-up of CD.

Cite this article as: Yilmaz PC, Sezgin O. Systemic immune-inflammation index and selected immune-based scores in the
diagnosis and monitoring of celiac disease. Turk J Gastroenterol. Published online March 16, 2026. doi: 10.5152/tjg.2026.25194.