Higher CALLY index levels indicate lower sarcopenia risk among middle-aged and elderly community residents as well as hospitalized patients

Abstract

The C-reactive protein-albumin-lymphocyte (CALLY) index, which integrates albumin, lymphocytes, and C-reactive protein levels, has emerged as a novel method to assess nutritional and inflammatory statuses in patients. This study examined the correlation between the CALLY index and sarcopenia risk using two cohorts: 1804 community dwellers from the NHANES database in the United States and 139 patients from the Department of Gerontology at Kunshan Hospital, China. In the US community cohort, RCS curve analysis was used to examine the non-linear relationship between inflammatory/nutritional markers and sarcopenia, subgroup analysis was also conducted. Logistic regression was employed to evaluate the association between the CALLY index and the risk of sarcopenia in both cohorts. Results demonstrated a significant non-linear relationship between the CALLY index and the risk of sarcopenia (P < 0.001). Elevated levels of the CALLY index are independently linked to a decreased risk of sarcopenia in both community residents (OR = 0.35, 95% CI 0.20-0.57, Q3 CALLY index and OR = 0.26, 95% CI 0.11-0.56, Q4 CALLY index) and hospitalized patients (OR = 0.35, 95% CI 0.12-0.96). This finding identified low CALLY index as a conveniently measurable parameter, serving as a nutritional and inflammatory risk factor for sarcopenia.

Keywords: CRP-albumin-lymphocyte (CALLY) index; Inflammation; Nutrition; Sarcopenia.

Fig. 1

Flowchart of the sample selection from NHANES 2015–2018.

Fig. 2

Analysis of weighted restricted cubic spline regression was conducted to examine the association between inflammation markers and sarcopenia. OR and 95% CI for Model 2 were adjusted for age, sex, race, smoking status, BMI, hypertension, CHF, and diabetes. The shaded portion in the analysis represents the estimation of the 95% confidence intervals.

Fig. 3

ROC curves of two cohorts. A: NHANES cohort, B: Kunshan cohort. AUC, area under the curve; model 1, unadjusted model; Model 2 was built upon Model 1 by incorporating adjustments for age, gender, race, smoking status, as well as comorbidities such as hypertension, diabetes, and congestive heart failure. Model 3 further extended Model 2 by incorporating adjustments for the inflammatory biomarker SII.

Fig. 4

The relationship between the CALLY index and Sarcopenia, stratified by sex, age, BMI, hypertension and diabetes. Abbreviations: CI, confidence interval; BMI, body mass index; CHF, congestive heart failure.

Fig. 5

Violin plots illustrating the distribution of CALLY values among participants for sarcopenia measures. The red color represented participants with negative results, and the blue color represented participants with positive results. The box plots within the violin plots showed the median and interquartile range of the CALLY values. Asterisks indicated statistically significant differences between the negative and positive groups.