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Journal of Peking University (Health Sciences) ›› 2026, Vol. 58 ›› Issue (1): 169-174. doi: 10.19723/j.issn.1671-167X.2026.01.022

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Total and regional fat-to-muscle mass ratio and risk of incident benign ovarian neoplasm

Hongyang LI1,2, Tao HUANG1, Linlin WANG1,2,*()   

  1. 1. Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing 100191, China
    2. Institute of Reproductive and Child Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
  • Received:2023-05-23 Online:2026-02-18 Published:2024-02-06
  • Contact: Linlin WANG

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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 (Pinteraction < 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

CLC Number: 

  • R181.3

Table 1

Baseline characteristics for participants"

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

Table 2

Multivariable-adjusted for benign ovarian neoplasm by total, arm, leg, trunk FMR and BMI"

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)

Table 3

Multivariable-adjusted for benign ovarian neoplasm among normal weight and overweight/obese participants by FMR"

Characteristics Normal weight HR (95%CI) Overweight/obese HR (95%CI) Pinteraction
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

Table 4

Cox analysis of FMR and risk of benign ovarian neoplasm in different age groups"

Characteristics HR (95%CI) Pinteraction
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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