Relationship of the neutrophil-to-high-density lipoprotein cholesterol ratio with sarcopenia: A cross-sectional study

Objective Sarcopenia 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. Methods A 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. Results Multivariable 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). Conclusions An 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.