中国医学科学院学报2026，Vol.48Issue(4)：660-670,11.DOI:10.3881/j.issn.1000-503X.17026
非高密度与高密度脂蛋白胆固醇比值与中国老年男性肌少症的关联
Association Between the Non-High-Density Lipoprotein/High-Density Lipoprotein Cholesterol Ratio and Sarcopenia in Older Chinese Men
摘要
Abstract
Objective To investigate the association between the non-high-density lipoprotein choles-terol to high-density lipoprotein cholesterol ratio(NHHR)and the risk of sarcopenia in older Chinese men.Methods This study was based on the baseline data from the China Health and Retirement Longitudinal Study,including 1 849 men aged≥60 years.Missing data were handled through multiple imputation.Participants were categorized into quartiles of NHHR(Q1-Q4).Multivariable Logistic regression models were constructed with step-wise adjustment for demographic factors,lifestyle,chronic diseases,and body mass index(BMI)to estimate odds ratios(OR)and 95%CI.Restricted cubic spline analysis was performed to examine potential non-linear as-sociations.Subgroup and sensitivity analyses(with possible sarcopenia as an alternative outcome)were per-formed.Results NHHR was significantly and inversely associated with sarcopenia.In models without BMI adjust-ment,the highest NHHR quartile(Q4)showed a lower risk of sarcopenia than the lowest quartile(Q1)(OR=0.199,95%CI=0.112-0.338,P<0.001).However,the association was attenuated after adjustment for BMI(OR=0.403,95%CI=0.220-0.709,P=0.002;the OR for each 1-standard-deviation increase in NHHR was ap-proximately 0.680).Restricted cubic spline analysis indicated a linear association(Poverall<0.001,Pnon-linear=0.793).In sensitivity analyses,NHHR remained significantly and inversely associated with possible sarcope-nia.The fully adjusted model showed that the risk of possible sarcopenia was lower in the Q4 group than in the Q1 group(OR=0.613,95%CI=0.404-0.924,P=0.020),and each 1-standard-deviation increase in NHHR was associated with a reduced risk of possible sarcopenia(OR=0.849,95%CI=0.728-0.987,P=0.034).Subgroup analyses showed that the inverse association between NHHR and sarcopenia risk was directionally con-sistent across strata of age,smoking,drinking,and hypertension,while the association in the diabetes sub-group did not reach statistical significance,possibly owing to the limited sample size(OR=0.46,95%CI=0.16-1.37,P=0.164).Conclusions NHHR is inversely associated with sarcopenia risk among older Chi-nese men,while this association is substantially attenuated after adjustment for BMI,suggesting it may be large-ly confounded by body size or obesity-related factors.These findings should be interpreted with caution,and fu-ture longitudinal studies incorporating direct muscle mass measurements,such as dual-energy X-ray absorptiome-try and bioelectrical impedance analysis,are warranted to clarify the independent role of NHHR in sarcopenia.关键词
非高密度与高密度脂蛋白胆固醇比值/肌少症/中国健康与养老追踪调查Key words
non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio/sarcopenia/China Health and Retirement Longitudinal Study分类
医药卫生引用本文复制引用
李锦江,郝春艳..非高密度与高密度脂蛋白胆固醇比值与中国老年男性肌少症的关联[J].中国医学科学院学报,2026,48(4):660-670,11.基金项目
山西省大健康产业高质量发展科研专项课题(DJKZXKT2023044) （DJKZXKT2023044）
