Association of serum uric acid to high density lipoprotein cholesterol ratio with incident sarcopenia.

BACKGROUND AND AIM: Sarcopenia is a skeletal muscle disorder that commonly occurs with advancing age, as well as in individuals with several long-term conditions. The impact of the serum uric acid to high-density lipoprotein cholesterol ratio (UHR) on incident sarcopenia remains unclear. This study aims to explore the longitudinal association between UHR and the incidence of sarcopenia, based on a nationally representative large-scale survey.

METHODS AND

RESULTS

The China Health and Retirement Longitudinal Study (CHARLS) included 5700 participants aged 45 and older, all of whom were free from sarcopenia at baseline. Sarcopenia was defined according to the 2019 criteria established by the Asian Working Group for Sarcopenia (AWGS). Due to gender differences, UHR levels were analyzed by categorizing participants into gender-specific quartiles or by treating UHR as a continuous variable. The Cox proportional hazards regression model was used to assess the longitudinal association between UHR and incident sarcopenia. Restricted cubic splines (RCS) were employed to examine the non-linear relationship between UHR and the incidence of sarcopenia. Over a 4-year follow-up period, 554 participants (9.72 %) developed sarcopenia, including 278 males and 276 females. In the male group, compared to the Q1 group, the risk of incident sarcopenia was significantly reduced in the Q2, Q3, and Q4 groups, with hazard ratios (HRs) and 95 % confidence intervals (CIs) of 0.60 [0.43-0.84], 0.50 [0.34-0.72], and 0.26 [0.16-0.42], respectively. When UHR was treated as a continuous variable, the association remained significant (HR and 95 % CI: 0.91 [0.87-0.95]). For females, compared to the Q1 group, the risk of incident sarcopenia was also significantly reduced in the Q2, Q3, and Q4 groups, with HRs and 95 % CIs of 0.66 [0.46-0.96], 0.63 [0.43-0.92], and 0.48 [0.30-0.76], respectively. When UHR was considered as a continuous variable, the correlation remained significant (HR and 95 % CI: 0.95 [0.90-0.99]). RCS analysis revealed a significant non-linear relationship between UHR and the incidence of sarcopenia in both male and female participants.

CONCLUSIONS

This study demonstrates that UHR is negatively correlated with the incidence of sarcopenia in middle-aged and elderly populations, with a stronger association observed in males than in females.