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Introduction Routine blood factors can be economic and easily accessible candidates for sarcopenia screening and monitoring. The associations between sarcopenia and routine blood factors remain unclear. This study aimed to examine sarcopenia and blood factor associations based on a nation-wide cohort in China. Methods 1307 participants and 17 routine blood indices were selected from two waves (Year 2011 and Year 2015) of the China Health and Retirement Longitudinal Study (CHARLS). The diagnosis of sarcopenia was based on the criteria proposed by Asian Working Group for Sarcopenia (AWGS 2019). Generalized mixed-effects models were performed for association analyses. A logistic regression (LR) model was conducted to examine the predictive power of identified significant blood factors for sarcopenia. Results A higher sarcopenia risk was cross-sectionally associated with elevated blood concentrations of high-sensitivity C-reactive protein (hsCRP) (OR = 1.030, 95%CI [1.007, 1.053]), glycated hemoglobin (HbA1c) (OR = 1.407, 95%CI [1.126, 1.758]) and blood urea nitrogen (BUN) (OR = 1.044, 95%CI [1.002, 1.089]), and a decreased level of glucose (OR = 0.988, 95%CI [0.979, 0.997]). A higher baseline hsCRP value (OR = 1.034, 95%CI [1.029, 1.039]) and a greater over time change in hsCRP within four years (OR = 1.034, 95%CI [1.029, 1.039]) were associated with a higher sarcopenia risk. A higher BUN baseline value was related to a decreased sarcopenia risk over time (OR = 0.981, 95%CI [0.976,0.986]), while a greater over time changes in BUN (OR = 1.034, 95%CI [1.029,1.040]) and a smaller over time change in glucose (OR = 0.992, 95%CI [0.984, 0.999]) within four years were also related to a higher sarcopenia risk. LR based on significant blood factors (i.e., hsCRP, HbA1c, BUN, and glucose), and sarcopenia status in Year 2015 yielded an area under the curve (AUC) of 0.859 (95% CI 0.836-0.882). Conclusion Routine blood factors involved in inflammation, protein metabolism, and glucose metabolism are significantly associated with sarcopenia. In clinical practice, plasma hsCRP, BUN, blood sugar levels, sex, age, marital status, height, and weight might be helpful for sarcopenia evaluation and monitoring.

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