Association of nutritional and inflammatory status with all-cause and cardiovascular mortality in adults with sarcopenia: Insights from NHANES

Abstract

Objective

Associations between scores on the advanced lung cancer inflammation index (ALI) and mortality among sarcopenic adults remains unknown. This study investigates the relationship between ALI and both all-cause and cardiovascular mortality among adults with sarcopenia.

Methods

The study involved sarcopenic adults from the National Health and Nutrition Examination Survey (NHANES), conducted between 1999 and 2006 and 2011–2018. Mortality information was acquired from the National Death Index, which tracks deaths through to December 31, 2019. Weighted multivariable Cox proportional hazards regression was employed to calculate hazard ratios (HRs) for mortality in different models. Additionally, the restricted cubic spline (RCS) method was used to investigate non-linear associations. Subgroup analyses and sensitivity analyses were conducted to detect differences and examine the reliability of the findings.

Results

This study included 2074 American adults with sarcopenia categorized into quartiles. 701 deaths occurred from all causes, with 236 linked to cardiovascular issues. Multivariate Cox regression models showed that those in the highest ALI quartile had a lower all-cause mortality rate than those in the lowest quartile (model 1: HR = 0.69, 95 % CI 0.55–0.87, P = 0.002; model 2: HR = 0.73, 95 % CI 0.56–0.94, P = 0.017). Likewise, those in the highest ALI quartile had a lower risk of death from cardiovascular causes (model 1: HR = 0.55, 95 % CI 0.36–0.85, P = 0.007; model 2: HR = 0.59, 95 % CI 0.37–0.95, P = 0.031). RCS results revealed an L-shaped correlation between ALI score and all-cause mortality.

Conclusions

A higher ALI score was strongly associated with lower rates of both all-cause and cardiovascular mortality among sarcopenic adults, particularly in the older population, males, smokers, and those with hypertension. This suggests that ALI may serve as a risk stratification tool.