Wang Ruizhi, Xu Yudi, Zhang Yuyuan, Wu Yushuai, Zuo Anning, Liu Shutong, Ba Yuhao, Xu Hui, Weng Siyuan, Zhou Zhaokai, Ma Hongxuan, Luo Peng, Cheng Quan, Han Xinwei, Liu Zaoqu
Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China.
Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China.
BMC Med. 2025 May 28;23(1):296. doi: 10.1186/s12916-025-04102-1.
The fat-to-muscle mass ratio (FMR) has served as a marker for various diseases. This study aimed to explore sex-specific associations between FMR in different body regions (whole body, trunk, arm, and leg) and cancer incidence.
We included 435,986 cancer-free participants (203,133 men and 232,853 women) from the UK Biobank at baseline. FMR was calculated as the ratio of fat mass to muscle mass in each body region. Multivariable Cox proportional hazards models, along with Cox models incorporating restricted cubic splines (RCS) function, were employed to examine both linear and non-linear associations between FMR and cancer risk in men and women. Additionally, a combined grouping of body mass index (BMI) and FMR was used to assess the joint impact of body composition on cancer incidence.
During the follow-up period, 62,060 new cancer cases were recorded. Our analysis showed significant associations between both total and regional FMR and the risk of several cancers. In men, higher whole body FMR was associated with an increased risk of esophagus, stomach, colorectal, liver, pancreas, and kidney cancers, while a decreased risk was observed for prostate and non-melanoma skin cancers (FDR < 0.05). In women, higher FMR was associated with a higher incidence of gallbladder, pancreas, kidney, thyroid, breast, and uterus cancers (FDR < 0.05). Non-linear associations were observed for several cancer types, with specific FMR cut-off points presented using RCS curves. The analysis by combining BMI and FMR suggested potential interaction patterns, revealing some masked risks; for example, a significant increase in cancer incidence was also observed in individuals exhibiting high FMRs despite having low BMI.
Our findings suggested that both total and regional FMR may serve as potential biomarkers for assessing the risk of overall and site-specific cancers.
脂肪与肌肉质量比（FMR）已作为多种疾病的一个标志物。本研究旨在探讨不同身体部位（全身、躯干、手臂和腿部）的FMR与癌症发病率之间的性别特异性关联。
我们纳入了英国生物银行基线时435,986名无癌症参与者（203,133名男性和232,853名女性）。FMR计算为每个身体部位脂肪质量与肌肉质量的比值。采用多变量Cox比例风险模型以及纳入受限立方样条（RCS）函数的Cox模型，来检验男性和女性中FMR与癌症风险之间的线性和非线性关联。此外，使用体重指数（BMI）和FMR的联合分组来评估身体成分对癌症发病率的联合影响。
在随访期间，记录了62,060例新癌症病例。我们的分析显示，总FMR和区域FMR与几种癌症的风险均存在显著关联。在男性中，较高的全身FMR与食管癌、胃癌、结直肠癌、肝癌、胰腺癌和肾癌风险增加相关，而前列腺癌和非黑色素瘤皮肤癌风险降低（FDR＜0.05）。在女性中，较高的FMR与胆囊癌、胰腺癌、肾癌、甲状腺癌、乳腺癌和子宫癌发病率较高相关（FDR＜0.05）。观察到几种癌症类型存在非线性关联，并使用RCS曲线给出了特定的FMR切点。BMI和FMR联合分析提示了潜在的相互作用模式，揭示了一些隐藏的风险；例如，尽管BMI较低，但FMR较高的个体中癌症发病率也显著增加。
我们的研究结果表明，总FMR和区域FMR均可作为评估总体和特定部位癌症风险的潜在生物标志物。
