{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T18:13:14Z","timestamp":1792519994870,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T00:00:00Z","timestamp":1632960000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["91857117"],"award-info":[{"award-number":["91857117"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009018","name":"Shanghai Municipal Human Resources and Social Security Bureau","doi-asserted-by":"publisher","award":["2020074"],"award-info":[{"award-number":["2020074"]}],"id":[{"id":"10.13039\/501100009018","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["20ZR1432500"],"award-info":[{"award-number":["20ZR1432500"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["19140902400"],"award-info":[{"award-number":["19140902400"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The fat\u2010to\u2010muscle mass ratio (FMR) might be an indicator to assess type 2 diabetes risk independent of general obesity. However, no longitudinal studies have explored the extent to which total and regional FMRs may confer risks. We aimed to measure the sex\u2010specific associations between FMRs of the arm, leg, trunk and whole body and incident type 2 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 464\u00a0817 participants (207\u00a0286 men and 257\u00a0531 women, mean age 56.5\u00a0\u00b1\u00a08.2 and 56.2\u00a0\u00b1\u00a08.0\u00a0years old, respectively) free of diabetes at baseline were included in this prospective cohort study with UK Biobank data. Fat mass and muscle mass were estimated using a bioelectrical impedance assessment device (Tanita BC 418MA). FMR was calculated as fat mass divided by muscle mass in corresponding body parts (total body, arm, leg and trunk). Cox proportional hazard models were used to estimate the aforementioned associations among men and women. Interaction analyses were performed between FMRs and body mass index (BMI) categories (BMI\u00a0&lt;\u00a025\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      and BMI\u00a0\u2265\u00a025\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Over the median 11.0\u00a0years (5\u00a0057\u00a0534 person\u2010years) of follow\u2010up, we documented 11\u00a0618 cases of type 2 diabetes. There was a significantly positive association between total and regional FMR and incident type 2 diabetes, even after adjusting for BMI and other covariates. Compared with other body parts, FMRs of the whole body and leg showed the strongest relationship among men and women, respectively (hazard ratio per 1 SD, 95% confidence interval: 1.67, 1.55\u20131.80; 1.45, 1.39\u20131.53). A significant interaction (\n                      <jats:italic>P<\/jats:italic>\n                      for interaction\u00a0&lt;\u00a00.001) between BMI category and FMRs of different body parts was observed. In the stratified analysis by BMI category and tertiles of FMRs, overweight\/obese individuals with a high FMR tertile tended to have the highest hazard ratio, ranging from 5.91 to 7.94 in whole body and regional areas.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In this large prospective study, higher total and regional FMRs were associated with a higher risk of developing type 2 diabetes, independent of BMI. This association was markedly strengthened in participants with BMI\u00a0\u2265\u00a025\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.12822","type":"journal-article","created":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T02:53:16Z","timestamp":1633056796000},"page":"2154-2162","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Total and regional fat\u2010to\u2010muscle mass ratio measured by bioelectrical impedance and risk of incident type 2 diabetes"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9591-6991","authenticated-orcid":false,"given":"Ningjian","family":"Wang","sequence":"first","affiliation":[{"name":"Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Shanghai JiaoTong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Sun","sequence":"additional","affiliation":[{"name":"Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Shanghai JiaoTong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haojie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Shanghai JiaoTong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi","family":"Chen","sequence":"additional","affiliation":[{"name":"Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Shanghai JiaoTong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuying","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Shanghai JiaoTong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Guangdong Mental Health Center, Guangdong Provincial People's Hospital Guangdong Academy of Medical Sciences  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangzhen","family":"Xia","sequence":"additional","affiliation":[{"name":"Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Shanghai JiaoTong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Benedict","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Neuroscience Uppsala University  Uppsala Sweden"},{"name":"Department of Clinical Neuroscience Karolinska Institute  Solna Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingli","family":"Lu","sequence":"additional","affiliation":[{"name":"Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital Shanghai JiaoTong University School of Medicine  Shanghai 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