Zhang Weixiao, Liu Yongkang, Zhang Yiping, Zhang Dingzhe, Wang Jianhua, Chen Xiao
Department of Nuclear Medicine, Nanjing BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, China.
Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
Front Endocrinol (Lausanne). 2025 Jun 11;16:1600431. doi: 10.3389/fendo.2025.1600431. eCollection 2025.
The associations between high-density lipoprotein cholesterol (HDL-C) levels and the risk of sarcopenia are inconclusive. This study aimed to investigate the association between HDL-C levels and chest computed tomography (CT)-defined low muscle mass in older adults and its sex-related differences.
This prospective study involved 1995 participants aged ≥50 years. The muscle area of the bilateral erector spinae muscles was measured at the T12 level on a single CT image. Linear regression analysis was used to evaluate the effects of related factors on muscle area. Multivariate logistic regression and restricted cubic spline (RCS) analysis were used to analyze the relationships between HDL-C quartile and low muscle mass in all participants and in the male and female subgroups.
An increased HDL-C level was associated with a greater risk of lower muscle area overall (β=-1.91, 95% CI: -2.95 to -0.87) and in male participants (β=-3.16, 95% CI: -4.70- -1.61), whereas no significant difference was found in the female subgroup ( > 0.05). A higher continuous HDL-C level was associated with a greater risk of low muscle mass in all participants (odds ratio (OR) =2.28, 95% confidence interval (CI): 1.51-3.45) and in the male subgroup (OR=3.28, 95% CI: 1.84-5.87) after adjustment for confounders, whereas no significant difference was found in the female subgroup (P>0.05). Furthermore, the RCS model showed similar results regarding the relationship between HDL-C levels and the risk of low muscle mass.
Higher HDL-C levels were associated with a significantly greater risk of low muscle mass, particularly in older male adults. HDL-C levels are useful in identifying older individuals who are at risk for low muscle mass.
高密度脂蛋白胆固醇（HDL-C）水平与肌肉减少症风险之间的关联尚无定论。本研究旨在调查HDL-C水平与老年人胸部计算机断层扫描（CT）定义的低肌肉量之间的关联及其性别差异。
这项前瞻性研究纳入了1995名年龄≥50岁的参与者。在单张CT图像上测量T12水平双侧竖脊肌的肌肉面积。采用线性回归分析评估相关因素对肌肉面积的影响。采用多因素逻辑回归和限制性立方样条（RCS）分析，分析所有参与者以及男性和女性亚组中HDL-C四分位数与低肌肉量之间的关系。
HDL-C水平升高与总体较低肌肉面积风险增加相关（β=-1.91，95%置信区间：-2.95至-0.87），在男性参与者中也是如此（β=-3.16，95%置信区间：-4.70至-1.61），而在女性亚组中未发现显著差异（P>0.05）。在调整混杂因素后，较高的连续HDL-C水平与所有参与者（比值比（OR）=2.28，95%置信区间（CI）：1.51至3.45）和男性亚组（OR=3.28，95%CI：1.84至5.87）中低肌肉量风险增加相关，而在女性亚组中未发现显著差异（P>0.05）。此外，RCS模型显示HDL-C水平与低肌肉量风险之间的关系结果相似。
较高的HDL-C水平与低肌肉量风险显著增加相关，尤其是在老年男性中。HDL-C水平有助于识别有低肌肉量风险的老年人。
