M Yogesh, Parmar Parth Anilbhai, Sharma Soumya, Kakadiya Jay Pareshbhai, Lakkad Dhruv
Department of Community Medicine, Shri M P Shah Government Medical College, Jamnagar, Gujarat, India.
Shri M P Shah Government Medical College, Jamnagar, 361006, Gujarat, India.
BMC Musculoskelet Disord. 2025 Jan 10;26(1):39. doi: 10.1186/s12891-025-08291-x.
Sarcopenia is prevalent among hemodialysis patients and is associated with poor outcomes. The neutrophil-to-lymphocyte ratio (NLR), an easily obtainable marker of inflammation, may predict sarcopenia risk. This study aimed to investigate the association between NLR and sarcopenia risk in maintenance hemodialysis patients, examining this association in the context of obesity.
This cross-sectional study included 411 maintenance hemodialysis patients. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia criteria-2019 (AWGS 2019). Body composition was assessed using bioelectrical impedance analysis. Logistic regression models examined associations between NLR and sarcopenia risk, adjusting for potential confounders. Analyses were stratified by obesity status.
The prevalence of sarcopenia was 51% (95% CI: 45.1-54.9%), with 37.2% classified as sarcopenic non-obese and 13.6% as sarcopenic obese. In fully adjusted models, each unit increase in NLR was associated with 10% higher odds of sarcopenia overall (OR 1.10, 95% CI: 1.00-1.21, p = 0.048). This association remained significant in sarcopenic obese patients (OR 1.15, 95% CI: 1.00-1.32, p = 0.049). Patients in the highest NLR tertile had 1.95 times higher odds of sarcopenia compared to the lowest tertile (95% CI: 1.12-3.40, p = 0.018), with a significant trend across tertiles (p-trend = 0.015).
NLR is independently associated with sarcopenia risk in hemodialysis patients, including those with obesity. These findings suggest NLR could serve as a simple, cost-effective tool for identifying hemodialysis patients at high risk of sarcopenia, potentially facilitating early intervention strategies.
肌肉减少症在血液透析患者中普遍存在，且与不良预后相关。中性粒细胞与淋巴细胞比值（NLR）是一种易于获取的炎症标志物，可能预测肌肉减少症风险。本研究旨在探讨维持性血液透析患者中NLR与肌肉减少症风险之间的关联，并在肥胖背景下考察这种关联。
这项横断面研究纳入了411例维持性血液透析患者。采用亚洲肌肉减少症工作组2019年标准（AWGS 2019）诊断肌肉减少症。使用生物电阻抗分析评估身体成分。逻辑回归模型检验了NLR与肌肉减少症风险之间的关联，并对潜在混杂因素进行了调整。分析按肥胖状态分层。
肌肉减少症的患病率为51%（95%CI：45.1 - 54.9%），其中37.2%为非肥胖型肌肉减少症，13.6%为肥胖型肌肉减少症。在完全调整模型中，NLR每增加一个单位，总体肌肉减少症的发生几率就高出10%（OR 1.10，95%CI：1.00 - 1.21，p = 0.048）。这种关联在肥胖型肌肉减少症患者中仍然显著（OR 1.15，95%CI：1.00 - 1.32，p = 0.049）。与最低三分位数相比，NLR最高三分位数的患者发生肌肉减少症的几率高1.95倍（95%CI：1.12 - 3.40，p = 0.018），三分位数间存在显著趋势（p趋势 = 0.015）。
NLR与血液透析患者（包括肥胖患者）的肌肉减少症风险独立相关。这些发现表明，NLR可作为一种简单、经济有效的工具，用于识别肌肉减少症高危的血液透析患者，可能有助于早期干预策略。
