Age‐specific and sex‐specific associations of visceral adipose tissue mass and fat‐to‐muscle mass ratio with risk of mortality

Abstract Background Limited studies have explored the association between visceral adipose tissue (VAT) mass and fat‐to‐muscle mass ratio (FMR) and mortality. We aimed to evaluate the sex‐specific association of VAT and FMR with all‐cause and cause‐specific mortality by age. Methods A total of 438 896 participants (49.8% men, mean age ± standard deviation: 57 ± 8 years for men; 56 ± 8 years for women) were included from the UK Biobank cohort. The nature of VAT was predictive, as obtained by sex‐stratified, non‐linear prediction models. Fat and muscle mass were estimated using a bioelectrical impedance assessment device. FMR was calculated as the fat mass divided by the muscle mass in the whole body. VAT and FMRs were divided into quintiles in ascending order, and the 3rd quintile was used as the reference. Cox regression analyses were used to estimate the associations between VAT, FMR and mortality. Results During a median of 12.4 years of follow‐up, we documented 29 903 deaths. After adjusting for various covariates, the individuals in the highest quintiles of VAT and FMR had the highest hazard ratios (HRs) of all‐cause mortality [1.24 (95% confidence interval: 1.17–1.33) for VAT and 1.24 (1.17–1.31) for FMR in men; and 1.11 (1.03–1.21) for VAT in women], except that the 1st quintile of FMR in women had the greatest HR [1.18 (1.09–1.27)]. Significant interactions were observed in both sexes according to age category (P for interaction