Sarcopenia was associated with modest increases in LDL-C and significant increases in HDL-C in females, while no significant changes were observed for triglycerides, total cholesterol, adiponectin, leptin, or inflammatory markers, highlighting the need for sex-targeted interventions in sarcopenia management.
Key Findings
Results
Sarcopenia was associated with a modest but significant increase in LDL-C overall, with a stronger effect observed in females.
Overall SMD for LDL-C = 0.13; P = .0022
Sex-specific analysis revealed a notably larger effect in females (SMD = 0.46)
Analysis based on 52 studies with N > 30,000 participants
Random-effects meta-analyses were used to pool estimates
Results
HDL-C levels were significantly increased in females with sarcopenia compared to non-sarcopenic females.
SMD for HDL-C in females = 6.71; P = .03
No significant overall change in HDL-C was reported across both sexes combined
This was identified through sex-specific subgroup analyses
The finding was highlighted as one of the most clinically notable results of the review
Results
No significant associations were observed between sarcopenia and triglycerides, total cholesterol, adiponectin, or leptin.
Triglycerides, total cholesterol, adiponectin, and leptin all showed non-significant results in meta-analyses
Adipokines adiponectin and leptin were specifically assessed as part of the adipose dysfunction analysis
Studies were drawn from publications between January 2015 and December 2024
These null findings persisted despite inclusion of over 30,000 participants across 52 studies
Results
Waist circumference was significantly increased in sarcopenic individuals, while muscle indices were lower.
Waist circumference SMD = 5.82 cm; P = .25 (noted as significant increase despite the P-value reported)
Muscle indices including SMI (skeletal muscle index), ASMI (appendicular skeletal muscle mass index), and SMM (skeletal muscle mass) were all lower in sarcopenia
Adiposity markers were included alongside lipid and adipokine measures in the systematic review
Results
Inflammatory markers TNF-α, IL-6, and IL-8 showed no significant associations with sarcopenia in the meta-analysis.
TNF-α, IL-6, and IL-8 were all assessed as inflammatory markers
None of the three markers reached statistical significance in the pooled analyses
Heterogeneity was assessed using I² statistics across all marker analyses
Publication bias was evaluated using funnel plots and Trim-and-Fill procedures
Results
Subgroup analyses revealed that sex, measurement methods, and sarcopenia definitions significantly influenced lipid marker changes, as confirmed by meta-regression.
Meta-regression identified sex, measurement methods, and sarcopenia definitions as significant moderators of lipid marker changes
Different sarcopenia definitions (e.g., EWGSOP, AWGS) contributed to between-study heterogeneity
Subgroup analyses were pre-specified and the protocol was registered on PROSPERO (CRD42024626636)
PRISMA 2020 guidelines were followed for the systematic review
Methods
The systematic review included 52 studies with more than 30,000 participants, searching seven databases for studies published between January 2015 and December 2024.
Databases searched: PubMed, Scopus, Web of Science, Cochrane Library, CNKI, WanFang, and VIP
Inclusion criteria required studies to compare lipid panels, adipokines, adiposity, muscle indices, and inflammatory markers in sarcopenic versus non-sarcopenic adults
Random-effects meta-analyses were performed for all outcomes
The protocol was prospectively registered on PROSPERO (CRD42024626636)
Arthur Vithran D, Hassan M, Rahmati M, Boyer L, Wehliye A, Xiao W, et al.. (2026). Adipose dysfunction, lipid dysregulation, and adipokines in sarcopenia: a systematic review and meta-analysis with sex-specific analyses.. Age and ageing. https://doi.org/10.1093/ageing/afag020