Evidence map›Paper›PMID 42288890›Full record

ArticleCardiovascular diabetology2026

Association of fat-to-muscle mass ratio with incident coronary artery disease and the potential role of metabolic signatures.

Kaibo Hu, Yanjun Song, Zhangyu Lin, Zechen Liu, Hao Wang, Kefei Dou

Abstract read
In one paragraph

Article in Cardiovascular diabetology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Kaibo Hu *Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167A, Beilishi Road, Xicheng District, Beijing, China.
Yanjun Song *Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167A, Beilishi Road, Xicheng District, Beijing, China.
Zhangyu Lin *Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167A, Beilishi Road, Xicheng District, Beijing, China.
Zechen LiuDepartment of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167A, Beilishi Road, Xicheng District, Beijing, China.
Hao WangDepartment of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167A, Beilishi Road, Xicheng District, Beijing, China. wanghao_fuwai@126.com.
Kefei DouDepartment of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167A, Beilishi Road, Xicheng District, Beijing, China. drdoukefei@126.com.

Funding

Noncommunicable Chronic Diseases-National Science and Technology Major Project 2025ZD0548200
6 · The paper itself

Abstract

backgroundThe fat-to-muscle mass ratio (FMR) reflects the balance between metabolic burden and capacity. However, the associations of total and regional FMR with incident coronary artery disease (CAD) and their underlying metabolic mechanisms remain unclear.

methodsWe included 398,435 UK Biobank participants free of baseline cardiovascular disease, diabetes, or lipid-lowering therapy. Total and regional (trunk, arm, leg) FMR were quantified via bioelectrical impedance analysis. Participants were stratified by sex and classified based on FMR thresholds derived from restricted cubic splines and BMI categories. Primary outcome was incident CAD, defined as myocardial infarction, coronary revascularization, or CAD mortality. Metabolic signatures were constructed using elastic net regression on 251 NMR metabolites.

resultsDuring a median follow-up of 12.61 years, 10,740 incident CAD cases were documented. Higher total and regional FMR were significantly associated with increased CAD risk in both sexes. Leg FMR exhibited the strongest independent association; after mutual adjustment for BMI, it remained a significant predictor in both women (HR: 3.672, 95% CI 1.958-6.887) and men (HR: 2.682, 95% CI 1.682-4.275), whereas associations for other FMR types were attenuated. Mediation analysis suggested that metabolic signatures partially accounted for the association between FMR and CAD, explaining over 70% of the statistical effect. Furthermore, adding leg FMR to standard risk factors significantly improved risk reclassification (NRI: 0.142 for women, 0.081 for men; both p value < 0.001).

conclusionsElevated FMR, particularly leg FMR, is strongly associated with higher CAD risk independent of BMI. These findings suggest that altered body composition may reflect underlying metabolic dysregulations, and assessing leg FMR could provide additive value for risk reclassification, particularly in women.

Indexed as

Adipose TissueAdiposityCoronary Artery DiseaseEnergy MetabolismMetabolomicsMuscle, SkeletalAgedBiomarkersFemaleHumansIncidenceMaleMiddle AgedPrognosisProspective StudiesRisk AssessmentBiomarkersCohort studyCoronary artery diseaseFat-to-muscle mass ratioMetabolic signatures

Identifiers

PMID42288890
PMCPMC13491944

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.