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Association Between Uric Acid-to-HDL Cholesterol Ratio and Sarcopenia: Sex-Specific Patterns From NHANES 2011-2018
Tingting Liu1, Xi Liu2, Jianling Fan1
1Department of Health Management Center, The Second Affiliated Hospital of Naval Medical University, Shanghai, China.
International Journal of Endocrinology
|May 14, 2026
Summary
The uric acid-to-high-density lipoprotein cholesterol Ratio (UHR) is linked to sarcopenia, a muscle-loss condition in older adults. Higher UHR levels increase the risk of sarcopenia, with notable differences observed between males and females.
Area of Science:
- Gerontology and Aging Research
- Metabolic and Inflammatory Biomarkers
- Sarcopenia Etiology
Background:
- Sarcopenia, characterized by loss of muscle mass and strength, is a significant health concern for the elderly population.
- The uric acid-to-high-density lipoprotein cholesterol Ratio (UHR) is an emerging marker of metabolic and inflammatory status.
- Large-scale studies investigating the association between UHR and sarcopenia are limited.
Purpose of the Study:
- To investigate the association between the uric acid-to-high-density lipoprotein cholesterol Ratio (UHR) and sarcopenia in a large, nationally representative sample.
- To explore potential gender-specific differences in the relationship between UHR and sarcopenia.
Main Methods:
- Cross-sectional analysis of NHANES data from 2011-2018, including over 112 million weighted participants.
- Sarcopenia was defined using the FNIH criteria based on appendicular skeletal muscle index (ASM/BMI).
- UHR was calculated as (uric acid/HDL-C) × 100 and adjusted for various demographic, lifestyle, and clinical factors.
Main Results:
- Elevated UHR was significantly associated with increased odds of sarcopenia after multivariable adjustment (OR = 1.060, p < 0.001).
- Individuals in the highest UHR tertile had significantly higher odds of sarcopenia compared to the lowest tertile (OR = 2.244, p < 0.001).
- Sex-stratified analyses revealed distinct patterns: males showed a monotonic increase in sarcopenia odds with rising UHR, while females exhibited an inverted U-shaped relationship.
Conclusions:
- Elevated UHR is a significant independent predictor of sarcopenia in the aging population.
- The association between UHR and sarcopenia differs notably between males and females.
- UHR may serve as a valuable, cost-effective biomarker for early sarcopenia detection in older adults.
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