# The risk assessment of sleep duration on geriatric sarcopenia and its regulatory role in the effect of BMI index on geriatric sarcopenia based on the CHARLS database

**Authors:** Yan Chen, Xue-Ke Shi, Nan-Nan Liu, Zhihai Feng

PMC · DOI: 10.1371/journal.pone.0345257 · 2026-03-20

## TL;DR

This study finds that abnormal sleep durations increase the risk of sarcopenia in older adults and that BMI effects on sarcopenia vary depending on sleep patterns.

## Contribution

The study identifies sleep duration as a moderator in the relationship between BMI and sarcopenia risk in older adults.

## Key findings

- Abnormal sleep durations like sleep deprivation and oversleeping are linked to higher sarcopenia risk in older adults.
- Overweight and obesity are associated with reduced sarcopenia risk in individuals with abnormal sleep patterns.
- Underweight is linked to increased sarcopenia risk in specific sleep duration subgroups.

## Abstract

The effect of sleep duration on geriatric sarcopenia remains unclear, and evidence of the combined impact of it and BMI on geriatric sarcopenia is scarce.

To conduct the risk assessment of sleep duration on geriatric sarcopenia and explore its moderating role in the effect of BMI on geriatric sarcopenia based on the CHARLS database.

Data were extracted from the China Health and Retirement Longitudinal Study (CHARLS) 2011, 2013, and 2015 waves respectively. Logistic regression and Cox regression analyses were conducted to assess the risk of sleep duration for geriatric sarcopenia, and the regulatory effect of sleep duration on the association between BMI and sarcopenia. Subgroup analysis was conducted to enhance the stability of the results.

The four abnormal types of sleep duration were significantly associated with sarcopenia. A significant association between obesity and decreased risk of sarcopenia was observed in sufficient sleep and sleep deprivation groups after the full adjustment of covariates (Adjusted HR = 0.25, 95%CI: 0.10–0.64, P < 0.001; Adjusted HR = 0.13, 95%CI: 0.03–0.53, P = 0.004; Adjusted HR = 0.26, 95%CI: 0.10–0.66, P = 0.005), and relationships of underweight and overweight with sarcopenia were observed in sufficient sleep, sleep deprivation, and mild oversleeping groups. In the group of oversleeping, the associations were not significant.

Abnormal sleep durations including sleep deprivation and oversleeping are linked to a heightened risk of sarcopenia among older adults. Underweight is associated with the increased sarcopenia risk, and overweight is correlated with the decreased risk of sarcopenia, especially in females with abnormal sleep duration except for severe oversleeping, and obesity is associated with the decreased risk of sarcopenia, especially in adults aged over 65 with sleep deprivation.

## Full-text entities

- **Genes:** SLC2A4 (solute carrier family 2 member 4) [NCBI Gene 6517] {aka GLUT4}, JAK2 (Janus kinase 2) [NCBI Gene 3717] {aka JTK10}, MSTN (myostatin) [NCBI Gene 2660] {aka GDF8, MSLHP}, SOCS3 (suppressor of cytokine signaling 3) [NCBI Gene 9021] {aka ATOD4, CIS3, Cish3, SOCS-3, SSI-3, SSI3}, PPARA (peroxisome proliferator activated receptor alpha) [NCBI Gene 5465] {aka NR1C1, PPAR, PPAR-alpha, PPARalpha, hPPAR}, IGF1 (insulin like growth factor 1) [NCBI Gene 3479] {aka IGF, IGF-I, IGFI, MGF}, IRS1 (insulin receptor substrate 1) [NCBI Gene 3667] {aka HIRS-1}, INS (insulin) [NCBI Gene 3630] {aka IDDM, IDDM1, IDDM2, ILPR, IRDN, MODY10}, GGH (gamma-glutamyl hydrolase) [NCBI Gene 8836] {aka GATD10, GH}, MAPK8 (mitogen-activated protein kinase 8) [NCBI Gene 5599] {aka JNK, JNK-46, JNK1, JNK1A2, JNK21B1/2, PRKM8}, GH1 (growth hormone 1) [NCBI Gene 2688] {aka GH, GH-N, GHB5, GHN, IGHD1A, IGHD1B}, CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}, NR3C1 (nuclear receptor subfamily 3 group C member 1) [NCBI Gene 2908] {aka GCCR, GCR, GCRST, GR, GRL}, LEP (leptin) [NCBI Gene 3952] {aka LEPD, OB, OBS}, PTK2B (protein tyrosine kinase 2 beta) [NCBI Gene 2185] {aka CADTK, CAKB, FADK2, FAK2, PKB, PTK}, DDIT4 (DNA damage inducible transcript 4) [NCBI Gene 54541] {aka Dig2, REDD-1, REDD1}, STAT3 (signal transducer and activator of transcription 3) [NCBI Gene 6774] {aka ADMIO, ADMIO1, APRF, HIES}, PRKAA2 (protein kinase AMP-activated catalytic subunit alpha 2) [NCBI Gene 5563] {aka AMPK, AMPK2, AMPKa2, PRKAA}, FOXO3 (forkhead box O3) [NCBI Gene 2309] {aka AF6q21, FKHRL1, FKHRL1P2, FOXO2, FOXO3A}, ADIPOQ (adiponectin, C1Q and collagen domain containing) [NCBI Gene 9370] {aka ACDC, ACRP30, ADIPQTL1, ADPN, APM-1, APM1}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, AKT1 (AKT serine/threonine kinase 1) [NCBI Gene 207] {aka AKT, PKB, PKB-ALPHA, PRKBA, RAC, RAC-ALPHA}, NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, FOXO1 (forkhead box O1) [NCBI Gene 2308] {aka FKH1, FKHR, FOXO1A}
- **Diseases:** HPA axis (MESH:D007029), adiposity (MESH:D018205), diminished muscle strength (MESH:D015354), hypokinesia (MESH:D018476), fractures (MESH:D050723), inflammation (MESH:D007249), Underweight (MESH:D013851), Overweight (MESH:D050177), impaired physical function (MESH:D059445), low muscle (MESH:D009800), CHARLS (OMIM:603663), reduced muscle mass (MESH:D009135), Sleep deprivation (MESH:D012892), decline in muscle mass (MESH:C536030), mitochondrial dysfunction (MESH:D028361), Muscle (MESH:D019042), sleep (MESH:D012893), muscle wasting (MESH:D009133), Sarcopenia (MESH:D055948), obese (MESH:D009765), insulin resistance (MESH:D007333)
- **Chemicals:** glucose (MESH:D005947), amino acid (MESH:D000596), 17beta-estradiol (MESH:D004958), creatinine (MESH:D003404), TG (MESH:D014280), lipids (MESH:D008055), fatty acid (MESH:D005227), catecholamine (MESH:D002395), cortisol (MESH:D006854)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC13004363/full.md

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Source: https://tomesphere.com/paper/PMC13004363