Total and regional fat-to-muscle ratio, frailty status, and multi-organ proteomic age-acceleration patterns: Evidence from the UK Biobank.

Authors

Zhouyang Sun, Tingyi Jia, Meng Li, Xinru Guo, Songyu Wu, Yixin Ouyang, Yangyu Gao, Chenxu Su, Shuran Yu, Pin Han, Changgui Kou, Wei Bai

Published in

Maturitas. Volume 214. Pages 109127. Sep 17, 2026. Epub Sep 17, 2026.

Abstract

Fat-to-muscle ratio reflects the imbalance between fat accumulation and estimated muscle mass, but its associations with frailty and multi-organ proteomic age acceleration remain unclear.
This cross-sectional analysis included 445,317 UK Biobank participants, with 39,782 in proteomic analyses. Whole-body, trunk, leg, and arm fat-to-muscle ratios were derived from bioelectrical impedance. Sex-stratified multinomial logistic regression assessed associations with pre-frailty and frailty and incremental value beyond body mass index.
Frailty status was defined using an adapted Fried phenotype. Organ-specific proteomic age-acceleration measures were derived using published ageing models, and concordance between fat-to-muscle ratio-related and frailty-related age-acceleration patterns was evaluated.
Higher total and regional fat-to-muscle ratios were associated with greater odds of pre-frailty and frailty in both sexes, with arm ratio showing the most pronounced regional associations. Per one-standard-deviation higher arm ratio, the odds ratios for frailty were 1.86 (95% confidence interval 1.79-1.92) in men and 2.95 (95% confidence interval 2.75-3.18) in women. Adding arm ratio to body mass index-based models increased the area under the receiver operating characteristic curve by 0.0137 in men and 0.0068 in women. Higher fat-to-muscle ratios and frailty status were associated with multi-organ proteomic age acceleration, with the clearest concordance for arm ratio-related and frailty-related patterns.
Regional fat-muscle imbalance, particularly in the arms, may provide complementary information on frailty-related body composition beyond body mass index and is associated with multi-organ proteomic age-acceleration patterns.

PMID:
42777331
Bibliographic data and abstract were imported from PubMed on 24 Sep 2026.

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