The multiple composite risk index estimates the risks of sarcopenia and comorbidities: unveiling the role of oxidative balance score

Abstract

Abstract Background Obesity, purine metabolism disorders, and dyslipidemia are recognized risk factors for sarcopenia, yet reliable biomarkers for risk stratification in this population are lacking. We integrated the uric acid to high-density lipoprotein cholesterol ratio (UHR) with the body roundness index (BRI) to construct a multiple composite risk index, UHR-BRI, and evaluated its associations with sarcopenia and its comorbidities. Methods We analyzed two nationally representative cohorts: the China Health and Retirement Longitudinal Study (CHARLS) and the National Health and Nutrition Examination Survey (NHANES). The association between UHR-BRI and sarcopenia was evaluated using weighted logistic regression. Subgroup and mediation analyses were performed to investigate the interactions across subgroups, and the mediating role of oxidative balance score (OBS). Results A total of 8,537 participants from CHARLS and 8,510 from NHANES were included, among whom 1,082 and 716 were diagnosed with sarcopenia. The area under the curve (AUC) value of the UHR-BRI index was higher than that of the other indices in both cohorts. In fully adjusted models, participants in the highest UHR-BRI quartile exhibited a significantly increased risk of sarcopenia (OR:3.01, 95% CI:2.45–3.72) compared to those in the lowest quartile in CHARLS. This finding was validated in NHANES (OR:17.14, 95% CI:11.55–26.60). Subgroup analyses further demonstrated robustness across different subgroups. Furthermore, UHR-BRI was also significantly associated with sarcopenia comorbidities. Mediation analyses confirmed that OBS mediated the associations between UHR-BRI and sarcopenia and its comorbidities. Conclusion UHR-BRI is significantly associated with sarcopenia and its common comorbidities, and OBS was identified as a potential mediator.