Joint Assessment of Sarcopenia and Lipid Parameters on Cardiovascular Diseases in Middle‐Aged and Older Adults in China With Different Glucose Metabolism Status

ABSTRACT Background Sarcopenia and dyslipidemia are established as independent risk factors for cardiovascular disease (CVD). Aims The study aims to investigate the joint effect of sarcopenia and lipid parameters on the risk of self‐reported cardiovascular disease in individuals with different stages of glucose metabolism. Methods This study included 9053 China Health and Retirement Longitudinal Study (CHARLS) 2015 participants aged ≥ 45 years without baseline CVD. Using multivariable logistic regression, it assessed sarcopenia‐lipid‐CVD event links, stratified by glucose metabolism. Risk reclassification used combined sarcopenia‐lipid status. Restricted cubic splines detected non‐linear lipid‐CVD relationships. Receiver operating characteristic curves (ROC) evaluated lipid metric accuracy. Results A total of 1074 participants (11.9%) reported new‐onset CVD. Joint exposure analysis identified synergistic effects: sarcopenia combined with elevated lipid parameters (except HDL‐C) conferred the highest CVD risk, particularly in normoglycemic (NGR) and prediabetic (Pre‐DM) subgroups ( p 0.05). ROC analysis revealed modest discriminative ability of non‐traditional indices compared with conventional parameters across glycometabolic strata. Atherogenic Coefficient demonstrated relatively consistent, yet limited, predictive capability across glycometabolic states and may warrant consideration as a potential lipid biomarker for CVD risk assessment. Conclusions The findings highlight the coexposure effects between sarcopenia and lipid parameters on cardiovascular diseases, especially for individuals with normal glucose regulation and prediabetes.