{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T02:02:15Z","timestamp":1789437735406,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"abstract":"ABSTRACT<\/jats:title>\n \n Aims<\/jats:title>\n To investigate the sex\u2010stratified associations of DXA\u2010derived adiposity, regional fat distribution and muscle power with incident hospitalised cardiovascular disease (CVD) in older Chinese adults.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n This prospective cohort included 3168 community\u2010dwelling older adults (1548 men and 1620 women; median age 72.0\u2009years). DXA assessed body composition and regional fat,\u00a0and the sit\u2010to\u2010stand (STS) test assessed muscle power. Incident hospitalised CVD was ascertained through hospital records. We used sex\u2010stratified multivariable Cox models as primary analysis, with Fine\u2013Gray models as sensitivity analyses.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n During a median follow\u2010up of 5.7\u2009years, 330 participants developed\n CVD<\/jats:styled-content>\n (199 men, 131 women). In fully adjusted models, higher adiposity (body fat percentage, fat mass index and waist circumference) was significantly associated with increased\n CVD<\/jats:styled-content>\n risk in men (\n HRs<\/jats:styled-content>\n per 1\u2010\n SD<\/jats:styled-content>\n : 1.24\u20131.25). Similarly, trunk fat measures, including trunk\n FMR<\/jats:styled-content>\n and trunk\n FMI<\/jats:styled-content>\n , were significantly associated with\n CVD<\/jats:styled-content>\n risk in men, with sex interactions retaining significance after multiple\u2010comparison correction (both\n q<\/jats:italic>\n interaction <\u20090.05). By contrast, no such associations were observed in women. Higher muscle power was associated with lower\n CVD<\/jats:styled-content>\n risk in women only (\n HRs<\/jats:styled-content>\n per 1\u2010\n SD<\/jats:styled-content>\n : 0.77\u20130.79). The leg\u2010to\u2010total fat ratio was inversely associated with cardiometabolic risk factors in both sexes (all\n p<\/jats:italic>\n \u2009<\u20090.05). Results remained robust in sensitivity analyses.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In this cohort of community\u2010dwelling older adults, central adiposity was associated with higher CVD risk in men, while greater muscle power was associated with lower risk in women. These exploratory findings highlight the importance of sex\u2010stratified cardiometabolic risk assessment and warrant future validation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dom.71360","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T01:07:17Z","timestamp":1789434437000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex\u2010Stratified Associations of\n DXA<\/scp>\n \u2010Derived Adiposity, Regional Fat Distribution and Muscle Power With Incident Hospitalised Cardiovascular Disease in Older Adults: A Prospective Cohort Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1589-9536","authenticated-orcid":false,"given":"Ting","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Medicine and Therapeutics Faculty of Medicine, The Chinese University of Hong Kong Hong Kong China"},{"name":"Department of Geriatrics Renji Hospital, Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Gao","sequence":"additional","affiliation":[{"name":"Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yafei","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics Faculty of Medicine, The Chinese University of Hong Kong Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Leung","sequence":"additional","affiliation":[{"name":"Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9253-3549","authenticated-orcid":false,"given":"Timothy","family":"Kwok","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics Faculty of Medicine, The Chinese University of Hong Kong Hong Kong China"},{"name":"Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"issue":"25","key":"e_1_2_13_2_1","first-page":"2982","article-title":"Global Burden of Cardiovascular Diseases and Risk Factors, 1990\u20102019: Update From the GBD 2019 Study","volume":"76","author":"Roth G. 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