脂肪肌肉比率与卵巢良性肿瘤风险的关联性

doi:10.19723/j.issn.1671-167X.2026.01.022

摘要/Abstract

摘要：

目的: 探讨全身、手臂、腿部及躯干脂肪肌肉比率(fat-to-muscle mass ratio，FMR)与卵巢良性肿瘤风险的关联性。方法: 使用英国生物样本库(United Kingdom biobank，UKB)前瞻性队列研究的数据，在卵巢良性肿瘤风险关联性研究中纳入255 412例研究对象。采用Cox比例风险模型分别评估全身、手臂、腿部及躯干FMR与卵巢良性肿瘤风险的关联性。根据体重指数(body mass index，BMI)进行先验分层分析，评估全身、手臂、腿部及躯干FMR分别在BMI＜25 kg/m²和BMI≥25 kg/m²人群中与卵巢良性肿瘤风险的关联性。采用限制性立方图进一步探讨FMR与卵巢良性肿瘤风险关联的变化趋势，最后根据研究对象的年龄(＜50岁、50~59岁、≥60岁)进行亚组分析，探究在不同年龄组FMR与卵巢良性肿瘤风险关联。结果: 中位随访时间为8.77年，共追踪到卵巢良性肿瘤1 643例。在调整人口学因素、生殖因素、遗传因素、生活方式和激素相关因素后，全身、手臂、腿部和躯干FMR与卵巢良性肿瘤的发病风险均呈显著正相关，且高于BMI与卵巢良性肿瘤的发病风险，其中全身FMR与卵巢良性肿瘤风险关联性最强(HR：2.16; 95%CI：1.67~2.79)。根据BMI分层分析FMR与卵巢良性肿瘤风险显示，相比BM I≥25 kg/m²人群，BMI＜25 kg/m²人群的全身、手臂、腿部和躯干FMR与卵巢良性肿瘤风险的关联更强(P_interaction＜0.05)。限制性立方图显示全身、手臂、躯干FMR与卵巢良性肿瘤风险关联在BMI＜25 kg/m²和BMI≥25 kg/m²人群间整体呈相反趋势。亚组分析可见全身、腿部FMR与卵巢良性肿瘤风险关联随着年龄组增长而降低(P＜0.05)，其中＜50岁年龄组人群的腿部FMR与卵巢良性肿瘤关联性最强(HR：2.38; 95%CI：1.39~4.08)。结论: FMR升高会增加卵巢良性肿瘤发病风险，其关联性在BMI＜25 kg/m²人群和40~50岁女性中更强。

关键词: 脂肪肌肉比率, 卵巢良性肿瘤, 体重指数

Abstract:

Objective: To investigate the association between fat-to-muscle mass ratio (FMR) of whole body, arm, leg and trunk and the risk of benign ovarian neoplasm. Methods: A total of 255 412 participants from the prospective cohort study United Kingdom biobank (UKB) were enrolled in the risk-related study of benign ovarian neoplasm. Cox proportional hazard model was used to evaluate the correlation between total and regional FMR and the risk of benign ovarian neoplasm. A priori stratified analysis was performed according to the body mass index (BMI) category to evaluate the correlation between FMR of whole body, arm, leg and trunk and the risk of benign ovarian neoplasm in people with BMI < 25 kg/m²and BMI≥25 kg/m², respectively. The restricted cubic plot was used to further explore the curve of FMR associated with the risk of benign ovarian neoplasm. Finally, subgroup analysis was performed on the age of the subjects (< 50 years, 50-59 years, ≥60 years) to explore the association between FMR and the risk of benign ovarian neoplasm at different ages. Results: During a median 8.77 years of follow-up, we recruited 1 643 cases of benign ovarian neoplasms. After adjusting for demographic, reproductive, genetic, lifestyle, and hormone-related factors, total, arm, leg and trunk FMR were significantly positively correlated with the risk of benign ovarian neoplasm and higher than BMI with the risk of benign ovarian neoplasm, among which the whole body FMR had the strongest correlation with the risk of benign ovarian neoplasm (HR: 2.16; 95%CI: 1.67-2.79). Stratified analysis of FMR and the risk of benign ovarian neoplasm based on BMI showed that compared with people with BMI≥25 kg/m², people with BMI < 25 kg/m² had a stronger association between whole body, arm, leg and trunk FMR and the risk of benign ovarian neoplasm (P_interaction < 0.05). The restricted cubic plot showed that the association between FMR of the whole body, arm and trunk and the risk of benign ovarian neoplasm had an opposite trend between normal weight and overweight/obese people. Subgroup analysis showed that the association between the whole body and leg FMR and the risk of benign ovarian neoplasm decreased with age (P < 0.05). Among them, leg FMR was associated with benign ovarian neoplasm in people younger than 50 years (HR: 2.38; 95%CI: 1.39-4.08). Conclusion: There is a positive correlation between the total, arm, trunk FMR and the risk of benign ovarian neoplasm, and the correlation is stronger in people with BMI < 25 kg/m² and women aged 40-50 years.

Key words: Fat-to-muscle mass ratio, Benign ovarian neoplasm, Body mass index

中图分类号:

R181.3

李宏杨, 黄涛, 王琳琳. 脂肪肌肉比率与卵巢良性肿瘤风险的关联性[J]. 北京大学学报（医学版）, 2026, 58(1): 169-174.

Hongyang LI, Tao HUANG, Linlin WANG. Total and regional fat-to-muscle mass ratio and risk of incident benign ovarian neoplasm[J]. Journal of Peking University (Health Sciences), 2026, 58(1): 169-174.

图/表 4

表1

研究对象的基线特征"

Characteristics	Total (n=255 412)	Diagnosed as benign ovarianneoplasm (n=1 643)	Undiagnosed as benign ovarian neoplasm (n=253 769)	P value
Age/years，$\bar x \pm s$	56.34±7.98	55.81±7.98	56.35±7.98	0.006
Caucasian，n (%)	210 139 (82.27)	1 338 (81.44)	208 801 (82.28)	0.373
University or college degree，n (%)	80 797 (31.63)	479 (29.15)	80 318 (31.65)	0.030
Townsend deprivation index，$\bar x \pm s$	-1.37±3.01	-1.09±3.15	-1.38±3.01	＜0.001
Menopause，n (%)	155 348 (60.82)	930 (56.60)	154 418 (60.85)	＜0.001
Age of menarche/years，$\bar x \pm s$	12.96±1.59	12.92±1.63	12.97±1.59	0.203
Gave birth，n (%)	207 660 (81.30)	1 320 (80.34)	206 340 (81.31)	0.313
Ever had stillbirth, spontaneous miscarriage or termination，n (%)	83 148 (32.55)	546 (33.23)	82 602 (32.55)	0.554
Family history，n (%)	28 259 (11.06)	217 (13.21)	28 041 (11.05)	0.005
Smoking status，n (%)
Never	152 127 (59.56)	931 (56.67)	151 196 (59.58)	0.004
Previous	80 678 (31.59)	538 (32.74)	80 140 (31.58)
Current	22 582 (8.85)	174 (10.59)	22 408 (8.83)
Drinking status，n (%)
Never	14 201 (5.57)	91 (5.54)	14 110 (5.56)	0.355
Previous	9 163 (3.59)	78 (4.75)	9 085 (3.58)
Current	232 023 (90.84)	1 474 (89.71)	230 549 (90.85)
Physical activity at goal，n (%)	65 503 (25.65)	386 (23.49)	65 117 (25.66)	0.045
Healthy diet，n (%)	76 905 (30.11)	470 (28.61)	76 435 (30.12)	0.182
Used HRT，n (%)	97 369 (38.12)	734 (44.67)	96 635 (38.08)	＜0.001
Ever taken oral contraceptive pill，n (%)	207 842 (81.38)	1 376 (83.75)	206 466 (81.36)	0.013
BMI/(kg/m²)，$\bar x \pm s$	27.07±5.17	27.90±5.40	27.05±5.16	＜0.001
FMR of total，$\bar x \pm s$	0.63±0.19	0.66±0.19	0.63±0.19	＜0.001
FMR of arm，$\bar x \pm s$	0.65±0.26	0.69±0.27	0.65±0.26	＜0.001
FMR of leg，$\bar x \pm s$	0.73±0.17	0.76±0.17	0.73±0.17	＜0.001
FMR of trunk，$\bar x \pm s$	0.56±0.20	0.59±0.19	0.56±0.20	＜0.001

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Characteristics	Model 1 HR (95%CI)	Model 2 HR (95%CI)	Model 3 HR (95%CI)
FMR of total	2.16 (1.67-2.79)	2.10 (1.62-2.72)	1.46 (0.85-2.51)
FMR of arm	1.68 (1.41-2.00)	1.67 (1.40-1.99)	1.27 (0.65-2.47)
FMR of leg	2.17 (1.64-2.88)	2.09 (1.57-2.79)	0.89 (0.42-1.84)
FMR of trunk	1.53 (1.34-1.73)	1.53 (1.34-1.75)	1.25 (0.95-1.66)
BMI	1.03 (1.02-1.04)	1.03 (1.02-1.04)

Characteristics	Normal weight HR (95%CI)	Overweight/obese HR (95%CI)	P_interaction
FMR of total	2.47 (1.08-5.65)	1.66 (1.14-2.42)	0.007
FMR of arm	2.52 (1.16-5.48)	1.43 (1.12-1.82)	0.023
FMR of leg	2.17 (0.84-5.60)	1.57 (1.02-2.39)	0.016
FMR of trunk	1.69 (1.07-2.69)	1.34 (1.06-1.70)	0.003

Characteristics	HR (95%CI)	P_interaction
FMR of total
＜50 years old	2.30 (1.42-3.73)	0.043
50-59 years old	2.14 (1.39-3.30)
≥60 years old	1.71 (1.11-2.64)
FMR of arm
＜50 years old	1.67 (1.21-2.30)	0.154
50-59 years old	1.68 (1.25-2.25)
≥60 years old	1.54 (1.14-2.09)
FMR of leg
＜50 years old	2.38 (1.39-4.08)	0.028
50-59 years old	2.24 (1.39-3.61)
≥60 years old	1.56 (0.97-2.52)
FMR of trunk
＜50 years old	1.80 (1.32-2.45)	0.125
50-59 years old	1.45 (1.18-1.77)
≥60 years old	1.48 (1.08-2.03)

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