Association Between Body Composition and Cardiometabolic Outcomes : A Prospective Cohort Study
Authors' conclusion
Artificial intelligence-derived BC proportions were strongly associated with cardiometabolic risk, but after BMI and WC were accounted for, only VAT proportion and SMFF (both sexes) and SM proportion (males only) added prognostic information.
Study context
- Population
- UK Biobank participants without diabetes mellitus (DM), MI or ischemic stroke who underwent whole-body magnetic resonance imaging (MRI); mean age 65.0 years (SD 7.8), mean BMI 25.8 kg/m² (SD 4.2), 52.8% female
- Participants
- 33,432 participants
- Exposure
- Elevated vs other relative body composition (BC) compartments
- Outcome
- Incident DM and MACE
- Follow-up
- Median 4.2 years
Methodological detailssex-stratified analyses, restricted cubic splines, artificial intelligence (AI)-derived MRI body composition
- Sex-stratified analyses
- Restricted cubic splines
- AI-derived MRI body composition
Main finding
As reported in the abstract
Incident DM, adjusted additionally for BMI and WC
Adjusted hazard ratio (95% CI)
Elevated VATfemales
2.16(1.59–2.94)
High SMFFfemales
1.27(0.89–1.80)
Elevated VATmales
1.84(1.48–2.27)
High SMFFmales
1.84(1.43–2.37)
Low SMmales only
1.96(1.45–2.65)
Observational data: associations, not effects.
Further findings
Major adverse cardiovascular events (MACE), adjusted additionally for BMI and waist circumference (WC) · median follow-up 4.2 years
| aHR (CI) | ||
|---|---|---|
| Elevated VATFemales · sex-stratified analyses | 1.37 (1.00–1.88) | |
| High SMFFFemales · sex-stratified analyses | 1.72 (1.23–2.41) | |
| Elevated VATMales · sex-stratified analyses | 1.22 (0.99–1.50) | |
| High SMFFMales · sex-stratified analyses | 1.25 (0.98–1.60) | |
| Low SMMales only · sex-stratified analyses | 1.55 (1.15–2.09) | |
| 0.512Adjusted hazard ratio (log scale) |
BC with age
- Adipose tissue compartments and SM fat fraction (SMFF) increased and skeletal muscle (SM) decreased with age
Original publication
Association Between Body Composition and Cardiometabolic Outcomes : A Prospective Cohort Study. Ann Intern Med. Published 30 September 2025. doi:10.
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