Abstract
BACKGROUND: Celiac disease (CD) is an immune-mediated enteropathy characterized by histopathological changes, such as villous atrophy and chronic inflammation, often assessed using the Marsh classification. The systemic immune-inflammation index (SII), a novel inflammatory biomarker, has been increasingly investigated in chronic inflammatory diseases, including CD. OBJECTIVE: This study aims to evaluate the relationship between SII and histopathological progression in CD, as classified by the Marsh scores, and to assess other hematological and inflammatory parameters. METHODS: A retrospective analysis was conducted on 115 biopsy-confirmed CD patients from 2 hospitals between February 2022 and November 2023. Demographic, clinical, and laboratory data were analyzed, and SII values were calculated. Statistical comparisons were performed across Marsh stages. RESULTS: SII levels did not significantly differ among Marsh groups (p = 0.408). However, the Marsh Grade 3a group exhibited higher median SII values compared to others. Hemoglobin (Hb) levels showed significant differences across Marsh stages (p = 0.012), with a notable decrease in Marsh Grade 3c. Other parameters, such as ESR and CRP, showed no significant variation across groups. CONCLUSION: While SII shows potential as an inflammatory marker, its limited association with histological stages suggests a need for larger, prospective studies to validate its utility in clinical practice.