Association of sarcopenia with geriatric syndromes and neutrophil / lymphocyte ratio

We aimed to search the relationship of sarcopenia with chronic diseases, geriatric syndromes and neutrophil/lymphocyte ratio (NLR). Our study included 258 patients who were admitted to Cerrahpaşa Medical Faculty geriatrics outpatient clinic for the first time between March 2018 and February 2019, and underwent comprehensive geriatric evaluation. Patients under 65 years of age, with active infection, terminal illness, diagnosis of malignancy, presence of trauma and infection in the last month were excluded from the study. Sarcopenia was present in 77 (30%) of the 258 participants involved in the study. Frequency of diabetes mellitus, dementia, delirium, polypharmacy and malnutrition was statistically significantly higher in patients with sarcopenia compared to patients without sarcopenia (p=0.020, p=0.024, p=0.016, p=0.018 and p<0.001, respectively). In multivariate logistic regression analysis, only malnutrition was found to be independently associated with sarcopenia [odds ratio (OR) 5.455 (95%) confidence interval (CI) 2.981–9.984, p<0.001]. Patients with sarcopenia had statistically significantly higher NLR, sedimentation and C-reactive protein (CRP) values than patients without sarcopenia (p=0.030, p=0.002 and p=0.015, respectively). Area under the ROC curve (AUC) of NLR was found to be 0.60 [odds ratio (OR) 1.214 (95%) confidence interval (CI) 1.016–1.451, p=0.033]. The significant relationship between sarcopenia and malnutrition revealed that these two geriatric syndromes should be evaluated together. In addition, increased CRP, sedimentation and NLR in sarcopenia support the idea of mild chronic inflammation in sarcopenia. More comprehensive studies are required to evaluate the usability of NLR in screening for sarcopenia.

Keywords: Sarcopenia, malnutrition, geriatric syndrome, neutrophil/lymphocyte ratio