{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T04:59:10Z","timestamp":1781240350201,"version":"3.54.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sarcopenia is strongly linked to chronic inflammation, yet most studies have focused on individual inflammatory markers. Moreover, associations between inflammatory status and sarcopenia have not been systematically compared in health examination populations. This study explored the relationships between composite inflammatory indices and sarcopenia in individuals undergoing routine health examinations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cross-sectional study included 2617 participants from a health examination cohort. Composite inflammatory indices were derived from peripheral blood cell counts and standard biochemical parameters. Independent associations between each index and sarcopenia were examined using multivariable logistic regression. Subgroup analyses by sex and age were conducted, restricted cubic spline models assessed potential non-linear relationships, and receiver operating characteristic curves were used to compare discriminative performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 2,617 participants, sarcopenia prevalence was 5.5%. After adjustment for confounders, higher inflammatory status was associated with increased sarcopenia risk. The C-reactive protein-to-lymphocyte ratio (CLR) showed the strongest association (Q4 vs. Q1: OR\u202f=\u202f4.31, 95% CI 2.35\u20137.90). Higher levels of the C-reactive protein-to-albumin ratio (CAR), systemic immune-inflammation index (SII), and platelet-to-lymphocyte ratio (PLR) were also significantly associated with higher sarcopenia risk. Associations were consistent across sex and age subgroups (all interaction\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;gt;\u202f0.05). Discriminative performance was modest; the hemoglobin\u2013albumin\u2013lymphocyte\u2013platelet score (HALP) (AUC\u202f=\u202f0.637), PLR (AUC\u202f=\u202f0.623), and CLR (AUC\u202f=\u202f0.618) performed relatively better, while combining multiple indices did not significantly improve prediction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Several composite inflammatory indices derived from routine laboratory data are associated with sarcopenia risk in health examination populations and may provide additional information for assessing inflammation-related sarcopenia risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1838379","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T04:45:58Z","timestamp":1781239558000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations between twelve composite inflammatory indices and sarcopenia in a health examination population: a cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Li","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Geriatrics, Laboratory of Research and Translation for Geriatric Diseases, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]},{"name":"Department of Oncology, Yunyang County People's Hospital","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Laboratory of Research and Translation for Geriatric Diseases, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Laboratory of Research and Translation for Geriatric Diseases, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiwen","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Neurology, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Laboratory of Research and Translation for Geriatric Diseases, The First Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2636","DOI":"10.1016\/S0140-6736(19)31138-9","article-title":"Sarcopenia","volume":"393","author":"Cruz-Jentoft","year":"2019","journal-title":"Lancet (London, England)"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1038\/s41572-024-00550-w","article-title":"Sarcopenia","volume":"10","author":"Sayer","year":"2024","journal-title":"Nat Rev Dis Primers"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"155533","DOI":"10.1016\/j.metabol.2023.155533","article-title":"Epidemiology of sarcopenia: prevalence, risk factors, and consequences","volume":"144","author":"Yuan","year":"2023","journal-title":"Metab Clin Exp"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: revised European consensus on definition and diagnosis","volume":"48","author":"Cruz-Jentoft","year":"2019","journal-title":"Age Ageing"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1002\/jcsm.12411","article-title":"Sarcopenia and its association with falls and fractures in older adults: a systematic review and meta-analysis","volume":"10","author":"Yeung","year":"2019","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"155557","DOI":"10.1016\/j.metabol.2023.155557","article-title":"Sarcopenia in youth","volume":"144","author":"Jung","year":"2023","journal-title":"Metabolism"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"956","DOI":"10.1002\/jcsm.12483","article-title":"Sarcopenia: a time for action. An SCWD position paper","volume":"10","author":"Bauer","year":"2019","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1825","DOI":"10.1016\/j.clnu.2024.06.024","article-title":"Diagnostic criteria, prevalence, and clinical outcomes of pediatric sarcopenia: a scoping review","volume":"43","author":"Inoue","year":"2024","journal-title":"Clin Nutr (Edinburgh, Scotland)"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.maturitas.2016.11.006","article-title":"Inflammation and sarcopenia: a systematic review and meta-analysis","volume":"96","author":"Bano","year":"2017","journal-title":"Maturitas"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1093\/gerona\/glp097","article-title":"Higher inflammatory marker levels in older persons: associations with 5-year change in muscle mass and muscle strength","volume":"64","author":"Schaap","year":"2009","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"101185","DOI":"10.1016\/j.arr.2020.101185","article-title":"Markers of inflammation and their association with muscle strength and mass: a systematic review and meta-analysis","volume":"64","author":"Tuttle","year":"2020","journal-title":"Ageing Res Rev"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1038\/s41569-018-0064-2","article-title":"Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty","volume":"15","author":"Ferrucci","year":"2018","journal-title":"Nat Rev Cardiol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"8236","DOI":"10.1038\/s41598-025-88939-9","article-title":"Assessment of sarcopenia in young patients with inflammatory arthritis: a cross-sectional study","volume":"15","author":"Kulyk","year":"2025","journal-title":"Sci Rep"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"526.e9","DOI":"10.1016\/j.amjmed.2005.10.049","article-title":"Inflammatory markers and loss of muscle mass (sarcopenia) and strength","volume":"119","author":"Schaap","year":"2006","journal-title":"Am J Med"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"M326","DOI":"10.1093\/gerona\/57.5.M326","article-title":"Relationship of interleukin-6 and tumor necrosis factor-alpha with muscle mass and muscle strength in elderly men and women: the health ABC study","volume":"57","author":"Visser","year":"2002","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"6212","DOI":"10.1158\/1078-0432.CCR-14-0442","article-title":"Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma","volume":"20","author":"Hu","year":"2014","journal-title":"Clin Cancer Res"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"7559","DOI":"10.1097\/JS9.0000000000002996","article-title":"Extensive study on the associations of 12 composite inflammatory indices with colorectal cancer risk and mortality: a cross-sectional analysis of NHANES 2001-2020","volume":"111","author":"Zhou","year":"2025","journal-title":"International journal of surgery (London, England)"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"345","DOI":"10.3343\/alm.2019.39.4.345","article-title":"The platelet-to-lymphocyte ratio as an inflammatory marker in rheumatic diseases","volume":"39","author":"Gasparyan","year":"2019","journal-title":"Ann Lab Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"3295","DOI":"10.7150\/jca.25691","article-title":"Prognostic value of systemic immune-inflammation index in cancer: a meta-analysis","volume":"9","author":"Yang","year":"2018","journal-title":"J Cancer"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","article-title":"Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"335","author":"von Elm","year":"2007","journal-title":"BMJ (Clinical research ed)"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1426404","DOI":"10.3389\/fendo.2024.1426404","article-title":"Association between systemic immune-inflammatory index and systemic inflammatory response index with body mass index in children and adolescents: a population-based study based on the National Health and nutrition examination survey 2017-2020","volume":"15","author":"Luo","year":"2024","journal-title":"Front Endocrinol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1007\/s10654-021-00752-6","article-title":"Systemic inflammation markers and cancer incidence in the UK biobank","volume":"36","author":"N\u00f8st","year":"2021","journal-title":"Eur J Epidemiol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s12979-023-00410-3","article-title":"Inflammatory markers and physical frailty: towards clinical application","volume":"21","author":"Pan","year":"2024","journal-title":"Immun Ageing"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/j.jamda.2019.12.012","article-title":"Asian working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment","volume":"21","author":"Chen","year":"2020","journal-title":"J Am Med Dir Assoc"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"101264","DOI":"10.1016\/j.eclinm.2021.101264","article-title":"Association between sarcopenia and cardiovascular disease among middle-aged and older adults: findings from the China health and retirement longitudinal study","volume":"44","author":"Gao","year":"2022","journal-title":"EClinicalMedicine"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1186\/s40001-024-01873-w","article-title":"Development and validation of a predictive model for the risk of sarcopenia in the older adults in China","volume":"29","author":"Li","year":"2024","journal-title":"Eur J Med Res"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"4989","DOI":"10.3892\/ijmm.2021.4989","article-title":"Pathophysiology and mechanisms of primary sarcopenia (review)","volume":"48","author":"Nishikawa","year":"2021","journal-title":"Int J Mol Med"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1381","DOI":"10.1249\/01.MSS.0000078924.61453.FB","article-title":"International physical activity questionnaire: 12-country reliability and validity","volume":"35","author":"Craig","year":"2003","journal-title":"Med Sci Sports Exerc"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.cger.2016.08.002","article-title":"Pathogenesis and management of sarcopenia","volume":"33","author":"Dhillon","year":"2017","journal-title":"Clin Geriatr Med"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1498757","DOI":"10.3389\/fnut.2025.1498757","article-title":"The association between eight complete blood count-derived inflammatory markers and muscle health","volume":"12","author":"Zhang","year":"2025","journal-title":"Front Nutr"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"146","DOI":"10.3390\/geriatrics9060146","article-title":"The prevalence of malnutrition and sarcopenia and the relationship with inflammation and anemia among community-dwelling older adults: a preliminary cross-sectional study","volume":"9","author":"Yuenyongchaiwat","year":"2024","journal-title":"Geriatrics (Basel, Switzerland)"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"111931","DOI":"10.1016\/j.exger.2022.111931","article-title":"Inflammaging: the ground for sarcopenia?","volume":"168","author":"Liang","year":"2022","journal-title":"Exp Gerontol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"112020","DOI":"10.1016\/j.mad.2024.112020","article-title":"Molecular mechanisms and potential interventions during aging-associated sarcopenia","volume":"223","author":"Luo","year":"2025","journal-title":"Mech Ageing Dev"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"12147","DOI":"10.3390\/ijms262412147","article-title":"Sarcopenia in the aging process: pathophysiological mechanisms, clinical implications, and emerging therapeutic approaches","volume":"26","author":"Ara\u00fajo","year":"2025","journal-title":"Int J Mol Sci"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1038\/s41584-023-00921-9","article-title":"Rheumatoid sarcopenia: loss of skeletal muscle strength and mass in rheumatoid arthritis","volume":"19","author":"Bennett","year":"2023","journal-title":"Nat Rev Rheumatol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/j.arr.2016.09.008","article-title":"Sarcopenic obesity or obese sarcopenia: a cross talk between age-associated adipose tissue and skeletal muscle inflammation as a main mechanism of the pathogenesis","volume":"35","author":"Kalinkovich","year":"2017","journal-title":"Ageing Res Rev"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1838379\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T04:46:05Z","timestamp":1781239565000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1838379\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,12]]},"references-count":36,"alternative-id":["10.3389\/fpubh.2026.1838379"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1838379","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,12]]},"article-number":"1838379"}}