Introduction
Materials and methods
Study population
Assessment of CBC-derived inflammatory indicators
Assessment of sarcopenia
Assessment of mortality
Covariates
Statistical analysis
Results
Baseline characteristics of the study cohort
Characteristics | Total (n = 12,689) | Sarcopenia | P value | ||
---|---|---|---|---|---|
No (n = 10,964) | Yes (n = 1725) | ||||
Age, years | < 0.001 | ||||
<39 | 4449 (35.1) | 4220 (38.5) | 229 (13.3) | ||
40–59 | 4240 (33.4) | 3822 (34.9) | 418 (24.2) | ||
> 59 | 4000 (31.5) | 2922 (26.7) | 1078 (62.5) | ||
Male, % | 6471 (51.0) | 5537 (50.5) | 934 (54.1) | 0.005 | |
Race/ethnicity, % | < 0.001 | ||||
Mexican American | 2951 (23.3) | 2181 (19.9) | 770 (44.6) | ||
Other Hispanic | 568 (4.5) | 469 (4.3) | 99 (5.7) | ||
Non-Hispanic White | 6389 (50.4) | 5647 (51.5) | 742 (43.0) | ||
Non-Hispanic Black | 2329 (18.4) | 2271 (20.7) | 58 (3.4) | ||
Other race | 452 (3.6) | 396 (3.6) | 56 (3.2) | ||
Education level, % | < 0.001 | ||||
Below high school | 3881 (30.6) | 3017 (27.5) | 864 (50.1) | ||
High school | 3012 (23.7) | 2631 (24.0) | 381 (22.1) | ||
Above high school | 5796 (45.7) | 5316 (48.5) | 480 (27.8) | ||
Family PIR, % | < 0.001 | ||||
≤ 1.0 | 2240 (17.7) | 1833 (16.7) | 407 (23.6) | ||
1.1–3.0 | 5187 (40.9) | 4326 (39.5) | 861 (49.9) | ||
> 3.0 | 5262 (41.5) | 4805 (43.8) | 457 (26.5) | ||
Smoking status, % | < 0.001 | ||||
Never smoker | 6427 (50.7) | 5574 (50.8) | 853 (49.4) | ||
Former smoker | 3246 (25.6) | 2663 (24.3) | 583 (33.8) | ||
Current smoker | 3016 (23.8) | 2727 (24.9) | 289 (16.8) | ||
Drinking status, % | < 0.001 | ||||
Nondrinker | 2819 (22.2) | 2291 (20.9) | 528 (30.6) | ||
Low-to-moderate drinker | 8740 (68.9) | 7645 (69.7) | 1095 (63.5) | ||
Heavy drinker | 1130 (8.9) | 1028 (9.4) | 102 (5.9) | ||
Physical activity, % | < 0.001 | ||||
Inactive | 3396 (26.8) | 2716 (24.8) | 680 (39.4) | ||
Insufficiently active | 6290 (49.6) | 5563 (50.7) | 727 (42.1) | ||
Active | 3003 (23.7) | 2685 (24.5) | 318 (18.4) | ||
Total energy intakes, kcal/day | 1962.00 [1438.00, 2643.00] | 2017.49 [1480.45, 2712.83] | 1656.00 [1223.79, 2194.10] | < 0.001 | |
Self-reported hypertension, % | 3727 (29.4) | 2971 (27.1) | 756 (43.8) | < 0.001 | |
Self-reported diabetes, % | 1150 (9.1) | 830 (7.6) | 320 (18.6) | < 0.001 | |
CBC count, 103/µL | |||||
White blood cell | 6.90 [5.70, 8.20] | 6.80 [5.60, 8.20] | 7.20 [6.10, 8.60] | < 0.001 | |
Neutrophils | 4.00 [3.10, 5.10] | 3.90 [3.10, 5.00] | 4.30 [3.40, 5.30] | < 0.001 | |
Monocyte | 0.50 [0.40, 0.60] | 0.50 [0.40, 0.60] | 0.60 [0.50, 0.70] | < 0.001 | |
Lymphocyte | 2.00 [1.60, 2.50] | 2.00 [1.60, 2.50] | 2.00 [1.60, 2.50] | 0.466 | |
CBC-derived indicators | |||||
NLR | 1.95 [1.48, 2.60] | 1.93 [1.46, 2.56] | 2.12 [1.60, 2.80] | < 0.001 | |
dNLR | 1.42 [1.10, 1.80] | 1.40 [1.09, 1.79] | 1.52 [1.18, 1.90] | < 0.001 | |
MLR | 0.26 [0.21, 0.33] | 0.25 [0.20, 0.33] | 0.27 [0.21, 0.36] | < 0.001 | |
NMLR | 2.21 [1.71, 2.91] | 2.19 [1.69, 2.87] | 2.40 [1.83, 3.15] | < 0.001 | |
SIRI, 103/µL | 1.02 [0.71, 1.48] | 1.00 [0.70, 1.44] | 1.18 [0.80, 1.69] | < 0.001 | |
SII, 103/µL | 509.22 [367.88, 707.44] | 504.67 [364.50, 700.62] | 546.54 [392.33, 763.82] | < 0.001 |
Associations between CBC-Derived indicators and sarcopenia prevalence
Quartiles of CBC-derived inflammatory biomarkers levels | Ptrend | ||||
---|---|---|---|---|---|
Quartile 1 | Quartile 2 | Quartile 3 | Quartile 4 | ||
NLR | |||||
Range | < 1.48 | 1.48–1.95 | 1.96–2.60 | > 2.60 | |
Crude | 1 [Reference] | 1.194 (1.023–1.395) | 1.450 (1.247–1.686) | 1.748 (1.510–2.026) | < 0.001 |
Model 1 | 1 [Reference] | 0.984 (0.835–1.159) | 1.162 (0.990–1.364) | 1.296 (1.107–1.518) | < 0.001 |
Model 2 | 1 [Reference] | 0.985 (0.836–1.161) | 1.157 (0.986–1.359) | 1.215 (1.037–1.425) | 0.004 |
dNLR | |||||
Range | < 1.10 | 1.10–1.42 | 1.43–1.80 | > 1.80 | |
Crude | 1 [Reference] | 1.186 (1.017–1.383) | 1.397 (1.204–1.623) | 1.620 (1.400-1.877) | < 0.001 |
Model 1 | 1 [Reference] | 0.998 (0.849–1.175) | 1.150 (0.982–1.349) | 1.261 (1.079–1.475) | < 0.001 |
Model 2 | 1 [Reference] | 0.971 (0.825–1.143) | 1.159 (0.988–1.359) | 1.177 (1.006–1.378) | 0.008 |
MLR | |||||
Range | < 0.21 | 0.21–0.26 | 0.27–0.33 | > 0.33 | |
Crude | 1 [Reference] | 0.979 (0.842–1.139) | 1.073 (0.924–1.247) | 1.408 (1.225–1.618) | < 0.001 |
Model 1 | 1 [Reference] | 0.840 (0.715–0.987) | 0.842 (0.716–0.991) | 1.048 (0.896–1.226) | 0.381 |
Model 2 | 1 [Reference] | 0.823 (0.700-0.968) | 0.822 (0.699–0.967) | 1.004 (0.857–1.176) | 0.705 |
NMLR | |||||
Range | < 1.71 | 1.71–2.21 | 2.22–2.91 | > 2.91 | |
Crude | 1 [Reference] | 1.219 (1.044–1.423) | 1.411 (1.213–1.642) | 1.766 (1.527–2.045) | < 0.001 |
Model 1 | 1 [Reference] | 1.006 (0.854–1.185) | 1.142 (0.973–1.342) | 1.305 (1.115–1.529) | < 0.001 |
Model 2 | 1 [Reference] | 1.001 (0.850–1.180) | 1.140 (0.971–1.340) | 1.226 (1.046–1.437) | 0.004 |
SIRI | |||||
Range | < 0.71 | 0.71–1.02 | 1.03–1.48 | > 1.48 | |
Crude | 1 [Reference] | 1.314 (1.123–1.538) | 1.523 (1.306–1.776) | 1.997 (1.723–2.317) | < 0.001 |
Model 1 | 1 [Reference] | 1.046 (0.886–1.235) | 1.184 (1.005–1.395) | 1.525 (1.299–1.792) | < 0.001 |
Model 2 | 1 [Reference] | 1.016 (0.861–1.201) | 1.138 (0.966–1.342) | 1.397 (1.188–1.645) | < 0.001 |
SII | |||||
Range | < 367.88 | 367.88-509.22 | 509.23-7707.44 | > 707.44 | |
Crude | 1 [Reference] | 1.155 (0.993–1.343) | 1.309 (1.129–1.518) | 1.470 (1.271-1.700) | < 0.001 |
Model 1 | 1 [Reference] | 0.999 (0.852–1.173) | 1.218 (1.041–1.425) | 1.357 (1.163–1.585) | < 0.001 |
Model 2 | 1 [Reference] | 1.001 (0.853–1.176) | 1.226 (1.047–1.437) | 1.311 (1.122–1.533) | < 0.001 |
Associations between CBC-Derived indicators and all-cause mortality among adults with Sarcopenia
Quartiles of CBC-derived inflammatory biomarkers levels | Ptrend | ||||
---|---|---|---|---|---|
Quartile 1 | Quartile 2 | Quartile 3 | Quartile 4 | ||
NLR | |||||
Range | < 1.60 | 1.60–2.12 | 2.13–2.80 | > 2.80 | |
No. deaths/total | 174/437 | 160/427 | 186/429 | 262/431 | |
Crude | 1 [Reference] | 0.909 (0.733–1.126) | 1.118 (0.909–1.375) | 1.908 (1.575–2.311) | < 0.001 |
Model 1 | 1 [Reference] | 0.842 (0.678–1.046) | 1.010 (0.819–1.246) | 1.391 (1.141–1.695) | < 0.001 |
Model 2 | 1 [Reference] | 0.830 (0.667–1.032) | 0.950 (0.768–1.175) | 1.336 (1.095–1.631) | < 0.001 |
dNLR | |||||
Range | < 1.18 | 1.18–1.52 | 1.53–1.90 | > 1.90 | |
No. deaths/total | 188/438 | 162/424 | 196/433 | 236/429 | |
Crude | 1 [Reference] | 0.839 (0.680–1.036) | 1.063 (0.871–1.299) | 1.475 (1.218–1.787) | < 0.001 |
Model 1 | 1 [Reference] | 0.833 (0.674–1.030) | 0.990 (0.809–1.212) | 1.326 (1.092–1.611) | < 0.001 |
Model 2 | 1 [Reference] | 0.784 (0.633–0.971) | 0.934 (0.761–1.146) | 1.274 (1.046–1.550) | 0.004 |
MLR | |||||
Range | < 0.21 | 0.21–0.27 | 0.28–0.36 | > 0.36 | |
No. deaths/total | 133/440 | 176/453 | 191/386 | 292/445 | |
Crude | 1 [Reference] | 1.339 (1.069–1.677) | 1.831 (1.467–2.284) | 2.961 (2.409–3.640) | < 0.001 |
Model 1 | 1 [Reference] | 1.028 (0.817–1.294) | 1.186 (0.942–1.494) | 1.572 (1.257–1.967) | < 0.001 |
Model 2 | 1 [Reference] | 1.085 (0.861–1.368) | 1.178 (0.933–1.487) | 1.619 (1.290–2.032) | < 0.001 |
NMLR | |||||
Range | < 1.83 | 1.83–2.40 | 2.41–3.15 | > 3.15 | |
No. deaths/total | 161/426 | 165/437 | 195/430 | 261/431 | |
Crude | 1 [Reference] | 0.978 (0.787–1.215) | 1.273 (1.033–1.568) | 2.045 (1.680–2.490) | < 0.001 |
Model 1 | 1 [Reference] | 0.926 (0.744–1.152) | 1.108 (0.896–1.370) | 1.450 (1.183–1.777) | < 0.001 |
Model 2 | 1 [Reference] | 0.929 (0.745–1.157) | 1.040 (0.839–1.290) | 1.390 (1.132–1.707) | < 0.001 |
SIRI | |||||
Range | < 0.80 | 0.80–1.18 | 1.18–1.69 | > 1.69 | |
No. deaths/total | 148/440 | 155/422 | 219/430 | 260/432 | |
Crude | 1 [Reference] | 1.116 (0.891–1.398) | 1.776 (1.441–2.188) | 2.320 (1.896–2.840) | < 0.001 |
Model 1 | 1 [Reference] | 1.049 (0.836–1.317) | 1.390 (1.121–1.723) | 1.589 (1.284–1.968) | < 0.001 |
Model 2 | 1 [Reference] | 1.050 (0.835–1.319) | 1.313 (1.058–1.631) | 1.501 (1.210–1.862) | < 0.001 |
SII | |||||
Range | < 392.25 | 392.25-546.75 | 546.76-764.06 | > 764.06 | |
No. deaths/total | 201/431 | 190/431 | 180/431 | 211/431 | |
Crude | 1 [Reference] | 0.907 (0.744–1.106) | 0.879 (0.719–1.075) | 1.090 (0.899–1.323) | 0.455 |
Model 1 | 1 [Reference] | 0.875 (0.717–1.068) | 0.918 (0.749–1.125) | 1.092 (0.898–1.328) | 0.350 |
Model 2 | 1 [Reference] | 0.872 (0.714–1.065) | 0.901 (0.735–1.105) | 1.073 (0.881–1.307) | 0.455 |
Associations between CBC-Derived indicators and Cardiovascular Mortality among adults with Sarcopenia
Quartiles of CBC-derived inflammatory biomarkers levels | Ptrend | ||||
---|---|---|---|---|---|
Quartile 1 | Quartile 2 | Quartile 3 | Quartile 4 | ||
NLR | |||||
Range | < 1.60 | 1.60–2.12 | 2.13–2.80 | > 2.80 | |
No. deaths/total | 39/437 | 45/427 | 46/429 | 65/431 | |
Crude | 1 [Reference] | 1.148 (0.747–1.762) | 1.231 (0.804–1.887) | 2.085 (1.402–3.103) | < 0.001 |
Model 1 | 1 [Reference] | 1.038 (0.674–1.598) | 1.057 (0.686–1.629) | 1.407 (0.936–2.116) | 0.144 |
Model 2 | 1 [Reference] | 1.011 (0.654–1.564) | 0.949 (0.613–1.470) | 1.301 (0.863–1.962) | 0.295 |
dNLR | |||||
Range | < 1.18 | 1.18–1.52 | 1.53–1.90 | > 1.90 | |
No. deaths/total | 44/438 | 46/424 | 50/433 | 55/429 | |
Crude | 1 [Reference] | 1.027 (0.679–1.552) | 1.158 (0.772–1.737) | 1.460 (0.982–2.171) | 0.090 |
Model 1 | 1 [Reference] | 1.003 (0.661–1.522) | 1.038 (0.689–1.564) | 1.250 (0.836–1.868) | 0.343 |
Model 2 | 1 [Reference] | 0.917 (0.600-1.401) | 0.942 (0.622–1.427) | 1.157 (0.771–1.737) | 0.470 |
MLR | |||||
Range | < 0.21 | 0.21–0.27 | 0.28–0.36 | > 0.36 | |
No. deaths/total | 28/440 | 41/453 | 46/386 | 80/445 | |
Crude | 1 [Reference] | 1.477 (0.913–2.388) | 2.078 (1.299–3.324) | 3.902 (2.536–6.005) | < 0.001 |
Model 1 | 1 [Reference] | 1.062 (0.651–1.732) | 1.227 (0.753–1.998) | 1.842 (1.158–2.932) | 0.006 |
Model 2 | 1 [Reference] | 1.123 (0.685–1.841) | 1.234 (0.754–2.022) | 1.874 (1.169–3.003) | 0.008 |
NMLR | |||||
Range | < 1.83 | 1.83–2.40 | 2.41–3.15 | > 3.15 | |
No. deaths/total | 36/426 | 45/437 | 47/430 | 67/431 | |
Crude | 1 [Reference] | 1.200 (0.774–1.859) | 1.364 (0.884–2.105) | 2.314 (1.543–3.471) | < 0.001 |
Model 1 | 1 [Reference] | 1.110 (0.714–1.725) | 1.122 (0.722–1.742) | 1.506 (0.992–2.287) | 0.090 |
Model 2 | 1 [Reference] | 1.118 (0.717–1.743) | 1.003 (0.642–1.567) | 1.388 (0.911–2.114) | 0.231 |
SIRI | |||||
Range | < 0.80 | 0.80–1.18 | 1.18–1.69 | > 1.69 | |
No. deaths/total | 30/440 | 40/422 | 49/430 | 76/432 | |
Crude | 1 [Reference] | 1.419 (0.884–2.278) | 1.933 (1.227–3.046) | 3.292 (2.156–5.025) | < 0.001 |
Model 1 | 1 [Reference] | 1.294 (0.802–2.088) | 1.409 (0.883–2.249) | 2.053 (1.315–3.205) | < 0.001 |
Model 2 | 1 [Reference] | 1.285 (0.795–2.078) | 1.272 (0.796–2.032) | 1.838 (1.175–2.878) | 0.016 |
SII | |||||
Range | < 392.25 | 392.25-546.75 | 546.76-764.06 | > 764.06 | |
No. deaths/total | 57/431 | 48/431 | 40/431 | 50/431 | |
Crude | 1 [Reference] | 0.810 (0.552–1.190) | 0.693 (0.462–1.038) | 0.911 (0.623–1.331) | 0.470 |
Model 1 | 1 [Reference] | 0.767 (0.521–1.127) | 0.706 (0.469–1.061) | 0.882 (0.600-1.295) | 0.470 |
Model 2 | 1 [Reference] | 0.770 (0.522–1.136) | 0.693 (0.460–1.044) | 0.845 (0.573–1.246) | 0.400 |