Association of Hemoglobin-to-red blood cell distribution width ratio and risk of sarcopenia: a cross sectional study

Abstract

Background The incidence rate of sarcopenia is high and it will lead to many adverse consequences. It is necessary to explore the influencing factors of sarcopenia and find out its inflammatory indicators. Objectives We aimed to explore the association between hemoglobin-to-red blood cell distribution width ratio (HRR) and the risk of sarcopenia from the large and diverse National Health and Nutrition Examination Survey (NHANES) 1999–2006, 2011–2018 population sample. Methods The general characteristics, disease related characteristics, diet and exercise characteristics, blood indicators, appendicular lean mass index, the peak isokinetic strength of the knee extensors, gait speed, combined grip strength and appendicular lean mass index extracted from the adult(18-79y) from the NHANES database. t test, two sample Kolmogorove-Smirnov test, Chi-square test, multiple linear regression analyses, binary logistic regression was used to assess the association between HRR and sarcopenia. The cut-off value invented by Budczies et al was used to found the cut-off value for the HRR to sarcopenia. Results A total sample of 28,531 participants were included in the study (50.85% males and 49.15% females). The prevance of sarcopenia is 23.87% (43.52% males and 56.48% females) and severe-sarcopenia is 18.13% (53.03% males and 46.97% females). HRR levels were significantly lower in sarcopenic people than non-sarcopenic people, and lower in severe-sarcopenia people than light-sarcopenia people(P < 0.05). HRR was significantly positive associated with appendicular lean mass index (ALMI), gait speed, peak isokinetic, and combined grip strength (P < 0.05). Regression analysis shows that HRR was independently associated with sarcopenia (P < 0.05). Conclusions This study first reveal that HRR is an independent risk factor for sarcopenia and the mechanism of HRR to sarcopenia is not clear. It is necessary to further explore the mechanism of HRR to sarcopenia in the future research.