Abstract
ObjectiveSarcopenia poses a significant global public health burden, underscoring the urgency of identifying reliable risk markers for early detection and intervention. This study aimed to elucidate the association between the neutrophil-to-high-density lipoprotein cholesterol ratio and sarcopenia as well as explore how various covariates modify this relationship.MethodsA cross-sectional analysis was performed using data from 9040 individuals who participated in the National Health and Nutrition Examination Survey 2011-2018, of whom 721 were diagnosed with sarcopenia. Multivariable logistic regression models were employed to estimate the odds ratios and 95% confidence intervals for the association between the neutrophil-to-high-density lipoprotein cholesterol ratio and sarcopenia. Restricted cubic spline regression analysis was utilized to assess the nonlinear relationship between the neutrophil-to-high-density lipoprotein cholesterol ratio and sarcopenia risk. Subgroup analysis was performed to identify the relationship between different subgroups of neutrophil-to-high-density lipoprotein cholesterol ratio and sarcopenia. Considering the conflict between the lower age threshold and the diagnostic criteria for sarcopenia, we conducted sensitivity analysis among participants aged ≥40 years.ResultsMultivariable logistic regression analysis revealed that the neutrophil-to-high-density lipoprotein cholesterol ratio was positively associated with sarcopenia risk (odds ratio = 1.16, 95% confidence interval: 1.11-1.22, P < 0.0001). Restricted cubic spline regression analysis demonstrated a nonlinear relationship between the neutrophil-to-high-density lipoprotein cholesterol ratio and sarcopenia risk (nonlinear P < 0.05). Subgroup analyses indicated that sex, race, and hyperlipidemia significantly modified the association between the neutrophil-to-high-density lipoprotein cholesterol ratio and sarcopenia risk (P for interaction <0.05).ConclusionsAn elevated neutrophil-to-high-density lipoprotein cholesterol ratio is associated with a high risk of sarcopenia, indicating that the ratio can effectively assess the risk of sarcopenia and may contribute to early diagnosis and preventive intervention.