Association of high-density lipoprotein cholesterol with sarcopenia in Chinese community-dwelling middle-aged and older adults: Evidence from 4-year longitudinal study from the CHARLS

Introduction There is inconsistent evidence on the associations between high-density lipoprotein cholesterol (HDL-C) and risk of sarcopenia. To determine the evidence existing between HDL-C and sarcopenia in Chinese middle-aged and older adults. Methods We used a panel study design of the China Health and Retirement Longitudinal Study (CHARLS), with 7,415 participants (mean age 57.5 years) from 2011, 2013, and 2015. HDL-C was measured by colormetric test of venous serum samples. Sarcopenia was defined as low muscle mass, plus low muscle strength, or low physical performance. Muscle mass was estimated by anthropometric measures. Muscle strength was measured by handgrip strength using dynamometer. Physical performance was measured by 5-time chair stand test, gait speed test, and short physical performance battery. Results With 961 (13.0%) sarcopenia cases, each 1-unit increase (1 SD = 15.4 mg/dL) of HDL-C levels was associated with 42% increased odds of incident sarcopenia [OR = 1.42, 95% confidence interval (CI) = 1.28 - 1.58] at 4 years follow up. Females with high HDL-C levels (HDL-C > 60 mg/dL) had a higher risk of sarcopenia [OR = 2.49, 95% CI = 1.76 - 3.52]. A J-shaped association between HDL-C and risk of sarcopenia in females. HDL-C was negatively associated with muscle mass [ = -0.23, 95% CI = -0.27 - -0.20] and hand grip strength [ = -0.05, 95% CI = -0.19 - 0.09]. Conclusion High HDL-C levels were associated with higher risk of sarcopenia among middle-aged and older Chinese adults, and appropriate control of its high levels informs the management of sarcopenia.