{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T11:07:26Z","timestamp":1779188846854,"version":"3.51.4"},"reference-count":45,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Key Discipline Construction Project of Tangdu Hospital","award":["2024JCRH037"],"award-info":[{"award-number":["2024JCRH037"]}]},{"name":"the Talent Project of the Air Force Military Medical University","award":["4145D3"],"award-info":[{"award-number":["4145D3"]}]},{"DOI":"10.13039\/501100007547","name":"Air Force Military Medical University","doi-asserted-by":"crossref","award":["2024LC2442"],"award-info":[{"award-number":["2024LC2442"]}],"id":[{"id":"10.13039\/501100007547","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Science Progress"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Low lean mass (LLM), as a critical element of sarcopenia, is associated with chronic inflammation and malnutrition and presents substantial risks to ageing populations. Although the red blood cell distribution width-to-albumin ratio (RAR) has been identified as a promising biomarker in various inflammatory and nutritional contexts, its relationship with LLM has not yet been investigated. This study seeks to examine the association between RAR and the risk of LLM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional analysis was conducted using data from 22,299 adults participating in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. LLM was defined according to the criteria established by the Foundation for the National Institutes of Health. Multivariable logistic regression and restricted cubic spline models were employed to assess the relationship between RAR and LLM, adjusting for variables including age, gender, marital status, race and ethnicity, body mass index, smoking status, alcohol consumption, educational attainment, diabetes mellitus, cardiovascular disease, moderate-to-vigorous physical activity, and time spent in sedentary activities. Subgroup analyses and propensity score matching analyses were also conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of LLM was 10.3% in NHANES 1999\u20132018. Restricted cubic splines analysis revealed a significant dose-response relationship between RAR and LLM risk (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Based on multivariate logistic regression, elevated RAR levels were linked to a higher odds of LLM (OR 1.84, 95% CI 1.64\u20132.06,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Specifically, individuals in the highest RAR quartile (Q4) had an OR of 2.38 (95% CI 2.00\u20132.83,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001) for developing LLM compared to those in the lowest quartile (Q1). Sensitivity analysis confirmed the robustness of this positive association in several subgroup analyses and propensity score matching analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>High RAR is associated with higher odds of LLM risk in community populations. These findings serve as a basis for further research on sarcopenia and need thorough validation in various populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00368504261426679","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T18:36:06Z","timestamp":1773254166000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between red blood cell distribution width-to-albumin ratio and risk of low lean mass: A cross-sectional study of NHANES 1999\u20132018"],"prefix":"10.1177","volume":"109","author":[{"given":"Yifeng","family":"Niu","sequence":"first","affiliation":[{"name":"College of Basic Medicine, the Fourth Military Medical University, Xi\u2019an, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lihua","family":"Yang","sequence":"additional","affiliation":[{"name":"College of Basic Medicine, the Fourth Military Medical University, Xi\u2019an, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haolei","family":"Yong","sequence":"additional","affiliation":[{"name":"College of Basic Medicine, the Fourth Military Medical University, Xi\u2019an, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9112-6463","authenticated-orcid":false,"given":"Min","family":"Li","sequence":"additional","affiliation":[{"name":"the Second Affiliated Hospitals, the Fourth Military Medical University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,3,4]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1042\/CS20231197"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afy169"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.exger.2022.111931"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2022.101611"},{"key":"e_1_3_3_6_2","article-title":"Red blood cell distribution width to albumin ratio as a novel predictor for mortality in chronic obstructive pulmonary disease patients: results from the cohort study of NHANES, 1999\u20132018","volume":"20","author":"Zhang G","year":"2025","unstructured":"Zhang G, Xu B, Zhao X. Red blood cell distribution width to albumin ratio as a novel predictor for mortality in chronic obstructive pulmonary disease patients: results from the cohort study of NHANES, 1999\u20132018. PLoS One 2025; 20: e319869.","journal-title":"PLoS One"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.13213"},{"key":"e_1_3_3_8_2","article-title":"Detection of a novel, integrative aging process suggests complex physiological integration","volume":"10","author":"Cohen AA","year":"2015","unstructured":"Cohen AA, Milot E, Li Q, et al. Detection of a novel, integrative aging process suggests complex physiological integration. Plos One 2015; 10: e0116489.","journal-title":"Plos One"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s42003-023-05456-z"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002718"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/acel.13872"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2018.04.014"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mam.2011.12.002"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0894-0959.2004.17603.x"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2022.1019502"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S476048"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-42986-2"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-024-01762-7"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1101\/2023.02.06.23284573"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glu010"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-018-1139-9"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-022-03704-1"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4614-7138-7"},{"key":"e_1_3_3_25_2","volume-title":"Multivariate data analysis","author":"Hair JF","year":"2010","unstructured":"Hair JFJr, Black WC, Babin BJ, et al. Multivariate data analysis. 7th ed. Upper Saddle River: Pearson, 2010.","edition":"7"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e40144"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/2333794X241304642"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms24108944"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2022.1032450"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2021.111464"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajcnut.2025.07.009"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-024-11864-z"},{"key":"e_1_3_3_33_2","article-title":"Desnutrici\u00f3n durante la estancia hospitalaria: desgaste muscular, inflamaci\u00f3n, ancho de distribuci\u00f3n eritrocitaria y su relaci\u00f3n con resultados adversos","volume":"92","author":"Galindo-Mart\u00edn CA","year":"2024","unstructured":"Galindo-Mart\u00edn CA, Chong-Avi\u00f1a PA, God\u00ednez-Breacher V, et al. Desnutrici\u00f3n durante la estancia hospitalaria: desgaste muscular, inflamaci\u00f3n, ancho de distribuci\u00f3n eritrocitaria y su relaci\u00f3n con resultados adversos. Cirug\u00eda Y Cirujanos 2024; 92: e02000634.","journal-title":"Cirug\u00eda Y Cirujanos"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-29855-z"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12986-024-00856-2"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S451769"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.15335"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1362077"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2017.05.006"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.smim.2018.09.003"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-018-0064-2"},{"key":"e_1_3_3_42_2","article-title":"The relationship between red cell distribution width and all-cause and cause-specific mortality in a population-based cohort","volume":"12","author":"Sahin AA","year":"2017","unstructured":"Sahin AA. The relationship between red cell distribution width and all-cause and cause-specific mortality in a population-based cohort. PLoS One 2017; 12: e0189268.","journal-title":"PLoS One"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-07-2599"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2000.tb06651.x"},{"key":"e_1_3_3_45_2","article-title":"Hematocrit and hemoglobin: relationship to blood pressure in the Framingham population","volume":"7","author":"Gagnon DR","year":"1989","unstructured":"Gagnon DR. Hematocrit and hemoglobin: relationship to blood pressure in the Framingham population. J Hypertens 1989; 7: S142\u2013S143.","journal-title":"J Hypertens"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1038\/nm1629"}],"container-title":["Science Progress"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00368504261426679","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00368504261426679","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00368504261426679","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T10:14:33Z","timestamp":1779185673000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00368504261426679"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":45,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1177\/00368504261426679"],"URL":"https:\/\/doi.org\/10.1177\/00368504261426679","relation":{},"ISSN":["0036-8504","2047-7163"],"issn-type":[{"value":"0036-8504","type":"print"},{"value":"2047-7163","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"article-number":"00368504261426679"}}