In conclusion, the current study shows that the independent risk factors for sarcopenia in middle-aged and older patients are serum AST/ALT >1.14, INS*PA <1,833 μU/ml*g/L, FT3 <4.48 pmol/L, VitD <18.5 ng/ml (in male participants), PTC >336 nmol/L, and DBP <81 mmHg (in female participants). Here, INS is linked to sarcopenia.