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Biomarkers / Obesity · Journal article
Annals of Medicine · September 2, 2026
Encouraging direction, but not yet definitive.
This cross-sectional analysis of two large nationally representative cohorts demonstrates that a novel composite index (UHR-BRI), integrating uric acid-to-HDL ratio and body roundness index, is significantly associated with sarcopenia risk and its comorbidities. The oxidative balance score appears to mediate these associations, but the observational design and lack of prospective follow-up preclude causal inference.
Cross-sectional analysis of two nationally representative cohorts. CHARLS: Chinese residents aged 45 years and older from urban and rural regions; NHANES: U.S. nationally representative population. Inclusion based on complete data for UHR, BRI, and sarcopenia diagnosis.. Compared with: Comparison of quartiles of UHR-BRI composite index (highest vs. lowest); comparison with other indices for AUC assessment. n = 17,047. CHARLS: 150 counties across 28 provinces in China; NHANES: United States.
In CHARLS, participants in the highest UHR-BRI quartile had significantly increased sarcopenia risk (OR: 3.01, 95% CI: 2.45–3.72) versus lowest quartile Finding validated in NHANES (OR: 17.14, 95% CI: 11.55–26.60) Area under the curve (AUC) value of UHR-BRI index was higher than other indices in both cohorts
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Clinicians should recognize UHR-BRI as a potential risk stratification tool for sarcopenia in populations with obesity and metabolic abnormalities, but the cross-sectional nature means this cannot yet guide interventions. Prospective validation and intervention trials are needed before adoption in practice.
Two large nationally representative cohorts with consistent associations between a novel composite index and sarcopenia, but findings are observational and cross-sectional, relying on surrogate endpoints without intervention or hard clinical outcomes.
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Quoted from the source exactly as published.
Clinicians should recognize UHR-BRI as a potential risk stratification tool for sarcopenia in populations with obesity and metabolic abnormalities, but the cross-sectional nature means this cannot yet guide interventions. Prospective validation and intervention trials are needed before adoption in practice.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
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.
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