The Association between Remnant Cholesterol Levels and Computed Tomography-based Low Bone Mass, Low Muscle Mass, and Osteosarcopenia inOlder Adults

Objective: The associations between remnant cholesterol (RC) and low bone mass and sarcopenia have not been well studied. This study aimed to demonstrate the link between serum RC and the prevalence of low bone mass, low muscle mass, and osteosarcopenia in older adults. Methods: This retrospective study involved 1995 individuals aged 50 and above who received CT scans for lung cancer screening from 2016 to 2020. Remnant cholesterol (RC) was calculated as follows: total cholesterol (TC) - (low-density lipoprotein-cholesterol (LDL-c) + high-density lipoprotein-cholesterol (HDL-c)). Low bone mass was defined as bone CT attenuation < 110 HU. Low muscle mass was defined when the area of the erector spinae muscles was < 20 cm2 in women and < 25 cm2 in men. Osteosarcopenia was defined as bone CT attenuation < 110 HU and muscle area < 20 cm2 in women or < 25 cm2 in men. Results: A total of 469 (23.5%) patients with low bone mass, including 268 women and 201 men, were observed. Serum RC was not associated with low bone mass. Elevated serum RC was associated with a lower prevalence of low muscle mass in both women and men (OR = 0.71, 95% CI: 0.50–1.00; OR = 0.53, 95% CI: 0.38–0.75). Serum RC was also associated with osteosarcopenia in women (OR = 0.59, 95% CI: 0.34–1.00) and men (OR = 0.53, 95% CI: 0.29–0.99). Discussion: RC may be a valuable factor for the early identification and management of sarcopenia or osteosarcopenia. However, further studies are needed to investigate the causal relationships and the mechanisms by which RC affects bone and muscle quality. Conclusion: Serum RC was not associated with low bone mass but was negatively associated with low muscle mass and osteosarcopenia in older adults.