Higher white blood cell to HDL ratio links to sarcopenia
Higher ln(WHR) was associated with sarcopenia in NHANES adults with an adjusted odds ratio of 2.50 and in KNHANES adults at 1.85.
Geriatrics & Gerontology International
Researchers analyzed data from 10,131 US adults in NHANES (2011–2018) and 7,872 Korean adults in KNHANES (2010–2011) to assess whether the white blood cell to HDL-cholesterol ratio relates to sarcopenia. Sarcopenia was diagnosed through dual-energy X-ray absorptiometry using FNIH and AWGS criteria.
Higher natural log-transformed white blood cell to HDL-cholesterol ratio was independently associated with sarcopenia in both populations. In NHANES, the adjusted odds ratio was 2.50 (95% CI: 2.01–3.10), and the association was confirmed in KNHANES with an odds ratio of 1.85 (95% CI: 1.49–2.29). Machine learning models, including LASSO and XGBoost, ranked the ratio among their top predictive features. Stratified analyses indicated the association appeared stronger in participants exposed to hepatitis B virus, though a formal interaction test was not statistically significant.
Why it matters
Sarcopenia is driven in part by chronic systemic inflammation and altered lipid metabolism. Combining routine white blood cell counts and HDL-cholesterol levels may offer an accessible metric to evaluate biological pathways underlying age-related muscle loss.
Caveats
The findings are based on cross-sectional observational cohorts, precluding conclusions about cause and effect. Furthermore, the observed interaction with hepatitis B virus status was exploratory and not statistically significant.
The paper
Tianjin University
Geriatrics & Gerontology International · 28 Sep 2026
