Abstract
Sarcopenic obesity (SO) is a major public health concern linked to lipid metabolism disorders. This study investigated the association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) and possible SO prevalence in China using data from the 2015 China Health and Retirement Longitudinal Study (CHARLS). Among 3,320 participants(21.02% men; median age 66.00 years [interquartile range, IQR 62.00-71.00]), multivariate logistic regression revealed that individuals in the highest NHHR tertile had a 66% increased risk of possible SO compared to the lowest tertile. Restricted cubic spline analysis identified a significant nonlinear relationship (p < 0.05). A two-piecewise regression model showed that for NHHR < 3.262, the adjusted odds ratio (OR) for possible SO was 2.27 (95% CI, 1.48-3.45; p < 0.001), whereas for NHHR ≥ 3.262, the OR was 0.97 (95% CI, 0.78-1.21; p = 0.78). This finding suggests that NHHR could serve as a novel and convenient biomarker for possible SO risk stratification; maintaining an NHHR below 3.262 may be a valuable target for preventing possible SO in the middle-aged and elderly Chinese population.