Sex-specific prognostic utility of the sarcopenia index in all-cause mortality risk for patients with heart failure
BackgroundThe sarcopenia index (SI), derived from serum creatinine and cystatin C levels, has emerged as a novel and accessible biomarker for predicting clinical outcomes. However, its sex-specific prognostic utility in heart failure (HF) remains poorly understood. This study aimed to investigate th...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-02-01
|
| Series: | Frontiers in Nutrition |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2025.1472596/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849716771549872128 |
|---|---|
| author | Ming Li Ming Li Yanying Liang Baozhen Wu Ziliang Zhu Meifang Wang Jianying Chen Can Chen Can Chen |
| author_facet | Ming Li Ming Li Yanying Liang Baozhen Wu Ziliang Zhu Meifang Wang Jianying Chen Can Chen Can Chen |
| author_sort | Ming Li |
| collection | DOAJ |
| description | BackgroundThe sarcopenia index (SI), derived from serum creatinine and cystatin C levels, has emerged as a novel and accessible biomarker for predicting clinical outcomes. However, its sex-specific prognostic utility in heart failure (HF) remains poorly understood. This study aimed to investigate the association between SI and all-cause mortality in HF, with a focus on sex-specific differences.MethodsA retrospective cohort of 753 patients (median age: 69 years; 61% male) diagnosed with HF from a tertiary hospital in China was analyzed. Cox regression models and Kaplan–Meier survival analyses were utilized to evaluate the relationship between SI and all-cause mortality. Stratified analyses based on sex were performed, and the incremental predictive value of SI was assessed by integrating it into traditional risk models.ResultsOver a median follow-up of 537 days, 143 deaths occurred. In adjusted models, a lower SI was significantly associated with an increased risk of all-cause mortality in male patients (hazard ratio: 0.98 per unit increase, 95% confidence interval: 0.97–0.99, p = 0.002). Males in the lowest SI tertile had a 1.66-fold higher mortality risk than those in the highest tertile (p = 0.004). Kaplan–Meier survival analysis further confirmed these findings, demonstrating significantly lower survival probabilities for males in the lowest SI tertile than for those in higher tertiles (Log-rank p = 0.0013). No such association was observed in females. Adding SI to risk models improved prognostic accuracy in males, enhancing the C-statistic from 0.749 to 0.764 and significantly improving net reclassification and discrimination indices (p < 0.05).ConclusionThe SI serves as a robust sex-specific predictor of all-cause mortality in HF, demonstrating significant prognostic value in males but limited utility in females. These findings highlight the potential of SI as a cost-effective addition to existing risk stratification models for male patients with HF. |
| format | Article |
| id | doaj-art-3c676151a77641f78b2c5fc1074e494f |
| institution | DOAJ |
| issn | 2296-861X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj-art-3c676151a77641f78b2c5fc1074e494f2025-08-20T03:12:53ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2025-02-011210.3389/fnut.2025.14725961472596Sex-specific prognostic utility of the sarcopenia index in all-cause mortality risk for patients with heart failureMing Li0Ming Li1Yanying Liang2Baozhen Wu3Ziliang Zhu4Meifang Wang5Jianying Chen6Can Chen7Can Chen8The First Clinical Medical College, Jinan University, Guangzhou, ChinaDepartment of Cardiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, ChinaDepartment of Cardiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, ChinaDepartment of Cardiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, ChinaDepartment of Cardiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, ChinaDepartment of Cardiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, ChinaDepartment of Cardiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, ChinaThe First Clinical Medical College, Jinan University, Guangzhou, ChinaDepartment of Cardiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, ChinaBackgroundThe sarcopenia index (SI), derived from serum creatinine and cystatin C levels, has emerged as a novel and accessible biomarker for predicting clinical outcomes. However, its sex-specific prognostic utility in heart failure (HF) remains poorly understood. This study aimed to investigate the association between SI and all-cause mortality in HF, with a focus on sex-specific differences.MethodsA retrospective cohort of 753 patients (median age: 69 years; 61% male) diagnosed with HF from a tertiary hospital in China was analyzed. Cox regression models and Kaplan–Meier survival analyses were utilized to evaluate the relationship between SI and all-cause mortality. Stratified analyses based on sex were performed, and the incremental predictive value of SI was assessed by integrating it into traditional risk models.ResultsOver a median follow-up of 537 days, 143 deaths occurred. In adjusted models, a lower SI was significantly associated with an increased risk of all-cause mortality in male patients (hazard ratio: 0.98 per unit increase, 95% confidence interval: 0.97–0.99, p = 0.002). Males in the lowest SI tertile had a 1.66-fold higher mortality risk than those in the highest tertile (p = 0.004). Kaplan–Meier survival analysis further confirmed these findings, demonstrating significantly lower survival probabilities for males in the lowest SI tertile than for those in higher tertiles (Log-rank p = 0.0013). No such association was observed in females. Adding SI to risk models improved prognostic accuracy in males, enhancing the C-statistic from 0.749 to 0.764 and significantly improving net reclassification and discrimination indices (p < 0.05).ConclusionThe SI serves as a robust sex-specific predictor of all-cause mortality in HF, demonstrating significant prognostic value in males but limited utility in females. These findings highlight the potential of SI as a cost-effective addition to existing risk stratification models for male patients with HF.https://www.frontiersin.org/articles/10.3389/fnut.2025.1472596/fullsarcopenia indexheart failureall-cause mortalitysex-specific differencesprognostic biomarker |
| spellingShingle | Ming Li Ming Li Yanying Liang Baozhen Wu Ziliang Zhu Meifang Wang Jianying Chen Can Chen Can Chen Sex-specific prognostic utility of the sarcopenia index in all-cause mortality risk for patients with heart failure Frontiers in Nutrition sarcopenia index heart failure all-cause mortality sex-specific differences prognostic biomarker |
| title | Sex-specific prognostic utility of the sarcopenia index in all-cause mortality risk for patients with heart failure |
| title_full | Sex-specific prognostic utility of the sarcopenia index in all-cause mortality risk for patients with heart failure |
| title_fullStr | Sex-specific prognostic utility of the sarcopenia index in all-cause mortality risk for patients with heart failure |
| title_full_unstemmed | Sex-specific prognostic utility of the sarcopenia index in all-cause mortality risk for patients with heart failure |
| title_short | Sex-specific prognostic utility of the sarcopenia index in all-cause mortality risk for patients with heart failure |
| title_sort | sex specific prognostic utility of the sarcopenia index in all cause mortality risk for patients with heart failure |
| topic | sarcopenia index heart failure all-cause mortality sex-specific differences prognostic biomarker |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2025.1472596/full |
| work_keys_str_mv | AT mingli sexspecificprognosticutilityofthesarcopeniaindexinallcausemortalityriskforpatientswithheartfailure AT mingli sexspecificprognosticutilityofthesarcopeniaindexinallcausemortalityriskforpatientswithheartfailure AT yanyingliang sexspecificprognosticutilityofthesarcopeniaindexinallcausemortalityriskforpatientswithheartfailure AT baozhenwu sexspecificprognosticutilityofthesarcopeniaindexinallcausemortalityriskforpatientswithheartfailure AT ziliangzhu sexspecificprognosticutilityofthesarcopeniaindexinallcausemortalityriskforpatientswithheartfailure AT meifangwang sexspecificprognosticutilityofthesarcopeniaindexinallcausemortalityriskforpatientswithheartfailure AT jianyingchen sexspecificprognosticutilityofthesarcopeniaindexinallcausemortalityriskforpatientswithheartfailure AT canchen sexspecificprognosticutilityofthesarcopeniaindexinallcausemortalityriskforpatientswithheartfailure AT canchen sexspecificprognosticutilityofthesarcopeniaindexinallcausemortalityriskforpatientswithheartfailure |