Evaluation of ten composite inflammatory indicators for sarcopenia in type 2 diabetes mellitus

Objective The value of composite inflammatory indicators in identifying sarcopenia in patients with type 2 diabetes mellitus (T2DM) remains unclear. This study investigated associations between ten composite inflammatory indicators and sarcopenia, aiming to identify optimal indicators for sarcopenia detection in T2DM. Methods The ten indicators were: systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), pan-immune inflammation value (PIV), platelet-to-lymphocyte ratio (PLR), advanced lung cancer inflammation index (ALI), neutrophil-to-albumin percentage ratio (NPAR), platelet-to-neutrophil ratio (PNR), neutrophil-lymphocyte-platelet ratio (NLPR), and hemoglobin-to-red cell distribution width ratio (HRR). Associations with sarcopenia and severe sarcopenia were assessed using restricted cubic splines (RCS) and multivariable logistic regression. Receiver operating characteristic (ROC) curves evaluated their identification ability. Results Sarcopenia prevalence was 34.1% ( n  = 261); severe sarcopenia was 11.5% ( n  = 78). RCS analysis showed positive correlations of SII, SIRI, NLR, PIV, PLR, NPAR, and NLPR with sarcopenia, while ALI, PNR, and HRR showed inverse trends. Multivariable regression confirmed positive associations for SII, SIRI, NLR, PIV, NPAR, NLPR, and an inverse association for ALI (all P  < 0.05). The area under the ROC curve (AUC) for ALI in identifying sarcopenia and severe sarcopenia was 0.68 and 0.70, respectively. Conclusion Elevated SII, SIRI, PIV, NPAR, NLPR, and NLR were positively associated with sarcopenia in T2DM, while ALI was inversely associated. Among all composite inflammatory indicators, ALI demonstrated the best ability to identify sarcopenia and severe sarcopenia in T2DM patients.