Association of fat-to-muscle mass ratio with incident coronary artery disease and the potential role of metabolic signatures
Authors' conclusion
Elevated 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.
Study context
- Population
- UK Biobank participants free of baseline CVD, DM or lipid-lowering therapy; FMR by bioelectrical impedance analysis10,740 incident coronary artery disease (CAD) cases
- Participants
- 398,435 participants
- Exposure
- Higher vs lower total and regional FMR
- Outcome
- Incident CAD (MI, coronary revascularization or CAD mortality)
- Follow-up
- Median 12.61 years
Methodological detailspopulation-based, sex-stratified, mediation analysis
- Population-based
- Sex-stratified
- Mediation analysis
Main finding
As reported in the abstract
Incident CAD by leg FMR, mutually adjusted for BMI
Leg FMR, women, HR
3.672 (1.958-6.887) (95% CI)
Leg FMR, men, HR
2.682 (1.682-4.275) (95% CI)
Observational data: associations, not effects.
Further findings
Mediation by metabolic signatures (elastic net on 251 NMR metabolites)
- Metabolic signatures partially accounted for FMR–CAD association, explaining over 70% of the statistical effect
Risk reclassification adding leg FMR to standard risk factors
- NRI, women
- 0.142
- NRI, men
- 0.081
- P (both)
- P < 0.001
Original publication
Association of fat-to-muscle mass ratio with incident coronary artery disease and the potential role of metabolic signatures. Cardiovasc Diabetol. Published 13 June 2026. doi:10.
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