Association Between Non-traditional Lipid Indices and Sarcopenia: Evidence from a Prospective Chinese Cohort Study

Recent study links sarcopenia with lipid metabolism disorders. This study aimed to examine the associations between non-traditional lipid indices-specifically the lipoprotein combined index (LCI) and the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (non-HDL-C to HDL-C ratio, NHHR)-and incident sarcopenia in a Chinese population.

Participants aged ≥ 45 years were enrolled from the 2011-2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Multivariate logistic regression was applied in cross-sectional analyses (n = 3,161) to assess the associations between log-transformed LCI, NHHR and sarcopenia. Longitudinal analyses (n = 2,898) were performed using multivariate Cox proportional hazards models, restricted cubic splines, subgroup analyses, and receiver operating characteristic (ROC) curves. Sensitivity analyses were conducted to test the robustness of the results.

Higher quartiles of lnLCI and lnNHHR were inversely associated with sarcopenia in both cross-sectional (lnLCI Q4: OR 0.58, P = 0.015; lnNHHR Q3: OR 0.56, P = 0.005) and longitudinal analyses (lnLCI Q4: HR 0.57, P = 0.001; lnNHHR Q4: HR 0.46, P = 0.002), with linear trends observed in spline models. Alcohol intake modified the association between lnNHHR and sarcopenia (P = 0.017), whereas the association of lnLCI with sarcopenia remained consistent in alcohol intake subgroup. ROC analyses showed similar predictive ability (lnLCI AUC 0.599; lnNHHR AUC 0.603). Sensitivity analyses excluding participants with hypercholesterolemia further validated the findings.

Among Chinese adults aged ≥ 45 years, LCI and NHHR were inversely associated with sarcopenia, with NHHR demonstrating slightly superior diagnostic potential.