{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T08:42:12Z","timestamp":1792485732347,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T00:00:00Z","timestamp":1792454400000},"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":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>As weight\u2010loss therapies are increasingly incorporated into clinical practice for MASLD, assessing body composition has become increasingly important. Body muscle\u2010to\u2010fat ratio (BMFR) may provide an intuitive and integrated measure of body composition balance, but its association with long\u2010term prognosis in MASLD remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We studied 83\u2009006 UK Biobank participants with MASLD. BMFR was calculated as whole\u2010body muscle mass divided by whole\u2010body fat mass using bioelectrical impedance analysis. Restricted cubic spline, threshold\u2010effect and two\u2010piecewise Cox models assessed associations with liver\u2010related events (LREs), cardiovascular events (CVEs), cardiovascular mortality and all\u2010cause mortality, adjusting for BMI and other confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>BMFR showed significant non\u2010linear associations with all outcomes. Sex\u2010specific inflection points were identified for each outcome. For LREs, the thresholds were 2.82 in men and 1.45 in women; below these thresholds, each 1\u2010SD increase in BMFR was associated with a lower risk of LREs (men: HR\u2009=\u20090.86, 95% CI: 0.75\u20130.98; women: HR\u2009=\u20090.72, 95% CI: 0.63\u20130.83), whereas above them it was associated with a higher risk (men: HR\u2009=\u20091.21, 95% CI: 1.07\u20131.36; women: HR\u2009=\u20091.33, 95% CI: 1.11\u20131.59). For CVEs, the thresholds were 2.03 in men and 1.48 in women; below these thresholds, each 1\u2010SD increase in BMFR was associated with a lower risk in both sexes (men: HR\u2009=\u20090.77, 95% CI: 0.70\u20130.85; women: HR\u2009=\u20090.85, 95% CI: 0.81\u20130.89), whereas above them the association was not significant in men but was associated with a higher risk in women (HR\u2009=\u20091.19, 95% CI: 1.09\u20131.30). Cardiovascular mortality and all\u2010cause mortality showed sex\u2010specific non\u2010linear patterns similar to those observed for CVEs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In MASLD, BMFR was associated with liver\u2010related and cardiovascular outcomes. Associations were generally U\u2010shaped in women; in men, they were U\u2010shaped for LREs and closer to L\u2010shaped for cardiovascular outcomes and mortality. BMFR may provide complementary information on body composition beyond BMI. Further studies are needed to validate these exploratory findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71456","type":"journal-article","created":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T08:31:45Z","timestamp":1792485105000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nonlinear Associations of Body Muscle\u2010to\u2010Fat Ratio With Long\u2010Term Prognosis in\n                    <scp>MASLD<\/scp>"],"prefix":"10.1111","author":[{"given":"Zhe\u2010Kun","family":"Xiong","sequence":"first","affiliation":[{"name":"Department of Spleen, Stomach and Hepatobiliary Zhongshan Hospital of Traditional Chinese Medicine  Zhongshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6487-7675","authenticated-orcid":false,"given":"Ru\u2010Tao","family":"Lin","sequence":"additional","affiliation":[{"name":"Institute of Liver Diseases Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan\u2010Hua","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Spleen, Stomach and Hepatobiliary Zhongshan Hospital of Traditional Chinese Medicine  Zhongshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Xin","sequence":"additional","affiliation":[{"name":"Institute of Liver Diseases Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine  Shanghai China"},{"name":"Key Laboratory of Liver and Kidney Diseases, Ministry of Education Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian\u2010Dong","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Spleen, Stomach and Hepatobiliary Zhongshan Hospital of Traditional Chinese Medicine  Zhongshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao\u2010Shan","family":"He","sequence":"additional","affiliation":[{"name":"Department of Spleen, Stomach and Hepatobiliary Zhongshan Hospital of Traditional Chinese Medicine  Zhongshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi\u2010Yang","family":"Hu","sequence":"additional","affiliation":[{"name":"Institute of Liver Diseases Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine  Shanghai China"},{"name":"Clinical Research Center Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Ming","family":"Gan","sequence":"additional","affiliation":[{"name":"Department of Spleen, Stomach and Hepatobiliary Zhongshan Hospital of Traditional Chinese Medicine  Zhongshan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4641-1636","authenticated-orcid":false,"given":"Qin","family":"Feng","sequence":"additional","affiliation":[{"name":"Institute of Liver Diseases Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine  Shanghai China"},{"name":"Key Laboratory of Liver and Kidney Diseases, Ministry of Education Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,20]]},"reference":[{"issue":"1","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1186\/s12933-024-02434-5","article-title":"Metabolic Dysfunction\u2010Associated Steatotic Liver Disease and Cardiovascular Risk: A Comprehensive Review","volume":"23","author":"Zheng H.","year":"2024","journal-title":"Cardiovascular 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Composition and Diabetes in Euthyroid Adults","volume":"16","author":"Yao N.","year":"2025","journal-title":"Journal of Cachexia, Sarcopenia and Muscle"},{"key":"e_1_2_13_12_1","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.clnesp.2024.06.040","article-title":"Comparison of Body Composition Measures Assessed by Bioelectrical Impedance Analysis Versus Dual\u2010Energy x\u2010Ray Absorptiometry in the United Kingdom Biobank","volume":"63","author":"Feng Q.","year":"2024","journal-title":"Clinical Nutrition ESPEN"},{"key":"e_1_2_13_13_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.metabol.2024.156057","article-title":"The Impact of Weight Loss on Fat\u2010Free Mass, Muscle, Bone and Hematopoiesis Health: Implications for Emerging Pharmacotherapies Aiming at Fat Reduction and Lean Mass Preservation","volume":"161","author":"Stefanakis K.","year":"2024","journal-title":"Metabolism \u2010 Clinical and 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