C-reactive protein-albumin-lymphocyte (CALLY) index as a novel inflammatory marker for sarcopenia: evidence from a cross-sectional study.

Background/aim: Sarcopenia is a geriatric syndrome characterized by progressive impairments in skeletal muscle mass and performance, with chronic low-grade systemic inflammation playing a pivotal role in its development. The C-reactive protein-albumin-lymphocyte (CALLY) index reflects inflammatory burden alongside immune and nutritional status; however, its association with sarcopenia in older populations has yet to be sufficiently elucidated. The present study investigates the relationship between CALLY index values and probable sarcopenia (PS) in a large cohort of geriatric outpatients. Materials and methods: Included in this retrospective cross-sectional study were 2042 geriatric outpatients aged ≥65 years who were assessed between May 2022 and March 2025. PS was defined based on EWGSOP-2 criteria (handgrip strength or chair stand test), while sarcopenia risk was assessed using the SARC-F questionnaire (assessing strength, assistance with walking, rise from a chair, climb stairs, and falls). The CALLY index was calculated based on comprehensive geriatric assessment results and laboratory parameters. A complete case analysis was performed and patients with incomplete data were excluded. Group comparisons, logistic regression, ROC curve analyses, and correlation analyses were performed. Results: Of the participants, 1092 (53.5%) were classified as PS and 950 (46.5%) as normal. Lower CALLY index values were observed in those with PS and high SARC-F scores (p <0.001), and were independently associated with both PS and sarcopenia risk in logistic regression analysis. In addition, the CALLY index was negatively correlated with SARC-F, timed up and go, chair stand test, and 4-meter walking time, and positively correlated with handgrip strength (all p <0.001). Conclusion: Lower CALLY values were independently associated with both PS and sarcopenia risk among older adults, supporting its use as a practical and accessible biomarker alongside routine geriatric assessment. Due to the cross-sectional nature of the study, further prospective studies involving a larger cohort are necessary to verify these associations and to assess prognostic utility.