The association between HDL-c levels and computed tomography-based osteosarcopenia in older adults

Associations between serum lipid levels and osteoporosis and sarcopenia have been reported. However, few studies have reported a link between serum lipid levels and osteosarcopenia. In the present study, we investigated the association between serum high-density lipoprotein cholesterol (HDL-c) and osteosarcopenia.

A total of 1995 participants aged 50 years and above who underwent chest CT physical examinations from 2016 to 2019 were included. Demographic information, including age, sex, and body mass index, and laboratory data, including liver and kidney function, blood lipids (HDL-c, low-density lipoprotein cholesterol (LDL-c), triglyceride (TG), total cholesterol (TC), blood glucose, and serum albumin, were collected from the medical records system. Osteosarcopenia was defined on the basis of the presence of low bone mass (bone CT values < 110 HU) and low muscle mass of bilateral erector spinae (< 25.0 cm² in men and < 20.0 cm² in women). The relationships between HDL-c (continuous data and categorical data) and osteosarcopenia were analyzed via multivariable logistic regression and restricted cubic spline analysis.

One hundred forty-one patients with osteosarcopenia (7.7%) were observed. The individuals with osteosarcopenia had significantly greater HDL-c levels than did those without osteosarcopenia (1.65 ± 0.30 vs. 1.49 ± 0.34 mmol/L, P < 0.001). Multivariate logistic regression revealed that HDL-c (odds ratio (OR) = 2.72, 95% confidence interval (CI): 1.30-5.69) was associated with osteosarcopenia. The third and fourth HDL-c quartiles were significantly related to a greater incidence of osteosarcopenia (OR = 3.36, 95% CI: 1.66-6.80; OR = 3.66, 95% CI: 1.67-8.01) than the first quartile was. Similar trends were observed in the male population. For female individuals, the fourth HDL-c quartile was significantly related to a greater incidence of osteosarcopenia than the first quartile was (OR = 2.73, 95% CI: 1.03-7.21). Restricted cubic splines revealed similar relationships between HDL-c and osteosarcopenia.

High serum HDL-c levels were associated with the risk of osteosarcopenia in older adults.