Cross-Population Analysis of Naples Prognostic Score's Association With Sarcopenia: Insights From US and Chinese Cohorts

Abstract

Objective

This study aimed to evaluate the feasibility of the NPS for predicting sarcopenia in adults and to explore potential interventions or mechanistic links to mitigate sarcopenia risk.

Methods

This study included two distinct cohorts as follows: 282 patients from the geriatric department of the First People's Hospital of Kunshan in China, and 1811 community members from the National Health and Nutrition Examination Survey (NHANES) database in the United States, spanning the 2015–2016 and 2017–2018 survey cycles. One-way analysis of variance (ANOVA) was employed to assess trends between NPS levels and factors such as sex, BMI, age, and sarcopenia. In order to evaluate the sarcopenia risk factors linked to the Naples Prognostic Score (NPS), logistic regression analyses were conducted.

Results

Comparing the group with low NPS levels, the group with high NPS levels exhibited a significantly increased risk of sarcopenia in the NHANES (p = 0.006) and Kunshan cohorts (p < 0.001). In the NHANES cohort, after adjusting for covariates, a high NPS was substantially linked to a higher sarcopenia risk (odds ratio [OR] = 1.990, 95% confidence interval 1.086–3.646 for a high NPS). In the Kunshan cohort, the NPS (OR = 5.255, p = 0.005) was confirmed to be an independent predictor of sarcopenia, along with age (OR = 4.100, p < 0.001), sex (OR = 4.428, p = 0.003), and body mass index (OR = 0.153, p < 0.001).

Conclusion

In the NHANES and Kunshan cohorts, there was a substantial correlation between greater NPS levels and an increased sarcopenia risk. This study reveals the crucial role of nutritional status and immune-inflammatory processes in the development of sarcopenia among hospitalized and elderly community individuals. Meanwhile, a simplified clinical screening tool is introduced to assess sarcopenia risk in elderly and middle-aged populations.