ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Endocrinology of Aging
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1600431
This article is part of the Research TopicExploring the Dynamics of Tissue Flexibility: Molecular Changes and Their Implications for Metabolic DisordersView all 4 articles
Associations between high-density lipoprotein cholesterol levels and computed tomography-defined low muscle mass in older adults and sex-related differences
Provisionally accepted
- 1BenQ Medical Center, Nanjing, Jiangsu Province, China
- 2Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Background: 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.Methods: 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.Results: An increased HDL-C level was associated with a greater risk of lower muscle area overall (β=-1.91, 95% CI: -2.95--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 (P > 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.Conclusions: 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.
Keywords: Low muscle mass, Sarcopenia, Muscle area, High-density lipoprotein cholesterol, Chest CT
Received: 03 Apr 2025; Accepted: 16 May 2025.
Copyright: © 2025 Zhang, Liu, Zhang, Zhang, Wang and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiao Chen, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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