PMID- 38183854 OWN - NLM STAT- MEDLINE DCOM- 20240219 LR - 20240508 IS - 1873-460X (Electronic) IS - 1056-8727 (Linking) VI - 38 IP - 2 DP - 2024 Feb TI - Reduced skeletal muscle mass to visceral fat area ratio is independently associated with reduced cognitive function in type 2 diabetes mellitus. PG - 108672 LID - S1056-8727(23)00270-2 [pii] LID - 10.1016/j.jdiacomp.2023.108672 [doi] AB - AIM: Skeletal muscle mass to visceral fat area ratio (SVR) has been recognised as an index of sarcopenic obesity. SVR is associated with type 2 diabetes mellitus (T2DM), metabolic syndrome and arterial stiffness which are known risk factors for cognitive dysfunction. We aimed to investigate association between SVR and cognitive function in patients with T2DM. METHODS: This was a cross-sectional study of 1326 patients with T2DM and mean age 61.3 +/- 8.0 years. SVR was assessed based on bioelectrical impedance measurements of muscle mass and visceral fat area (VFA). Cognitive function was assessed using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Linear regression was used to examine the association between SVR in quartiles and RBANS score, adjusting for demographics, education, presence of depressive symptoms, clinical covariates and medications. RESULTS: The lower SVR quartiles were negatively associated with RBANS total score in the unadjusted analysis. The corresponding coefficients for Quartiles 1 and 2 SVR were -3.79 (95 % CI -5.39 to -2.19; p < 0.001) and -1.47 (95 % CI -2.86 to -0.07; p = 0.039) in fully adjusted analysis. The negative association between Quartile 1 SVR and RBANS score was evident in immediate memory, delayed memory, visuo-spatial construction, language and attention domains. Muscle mass and VFA alone had weaker associations with RBANS scores. CONCLUSION: Our study demonstrated, for the first time, an independent association between reduced SVR and lower cognitive function. This is evident in global and multiple cognitive domains. The synergistic effects of reduced muscle mass and visceral obesity may be more pronounced than their independent effects on cognitive function. CI - Copyright (c) 2023. Published by Elsevier Inc. FAU - Low, Serena AU - Low S AD - Diabetes Centre, Admiralty Medical Centre, Block 676, Level 4, Kampung Admiralty, Woodlands Drive 71, 730676, Singapore; Clinical Research Unit, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore. FAU - Ng, Tze Pin AU - Ng TP AD - Department of Geriatric Medicine, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore. FAU - Goh, Kiat Sern AU - Goh KS AD - Department of Geriatric Medicine, Changi General Hospital, 2 Simei Street 3, 529889, Singapore. FAU - Moh, Angela AU - Moh A AD - Clinical Research Unit, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore. FAU - Khoo, Jonathon AU - Khoo J AD - Clinical Research Unit, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore. FAU - Ang, Keven AU - Ang K AD - Clinical Research Unit, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore. FAU - Yap, Philip AU - Yap P AD - Department of Geriatric Medicine, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore. FAU - Cheong, Chin Yee AU - Cheong CY AD - Department of Geriatric Medicine, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore. FAU - Tang, Wern Ee AU - Tang WE AD - National Healthcare Group Polyclinics, 3 Fusionopolis Link, Nexus@one-north, South Tower, 138543, Singapore. FAU - Lim, Ziliang AU - Lim Z AD - National Healthcare Group Polyclinics, 3 Fusionopolis Link, Nexus@one-north, South Tower, 138543, Singapore. FAU - Subramaniam, Tavintharan AU - Subramaniam T AD - Diabetes Centre, Admiralty Medical Centre, Block 676, Level 4, Kampung Admiralty, Woodlands Drive 71, 730676, Singapore. FAU - Sum, Chee Fang AU - Sum CF AD - Diabetes Centre, Admiralty Medical Centre, Block 676, Level 4, Kampung Admiralty, Woodlands Drive 71, 730676, Singapore. FAU - Lim, Su Chi AU - Lim SC AD - Diabetes Centre, Admiralty Medical Centre, Block 676, Level 4, Kampung Admiralty, Woodlands Drive 71, 730676, Singapore; Clinical Research Unit, Khoo Teck Puat Hospital, 90 Yishun Central, 768828, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, 117549, Singapore. Electronic address: lim.su.chi@ktph.com.sg. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20240103 PL - United States TA - J Diabetes Complications JT - Journal of diabetes and its complications JID - 9204583 SB - IM MH - Humans MH - Middle Aged MH - Aged MH - *Diabetes Mellitus, Type 2/diagnosis MH - Intra-Abdominal Fat MH - Cross-Sectional Studies MH - Cognition MH - *Cognitive Dysfunction/complications/epidemiology MH - Muscle, Skeletal OTO - NOTNLM OT - Cognitive decline OT - Skeletal muscle mass OT - Type 2 diabetes OT - Visceral fat area COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper. EDAT- 2024/01/07 06:44 MHDA- 2024/02/19 06:43 CRDT- 2024/01/06 18:07 PHST- 2023/06/06 00:00 [received] PHST- 2023/10/21 00:00 [revised] PHST- 2023/12/21 00:00 [accepted] PHST- 2024/02/19 06:43 [medline] PHST- 2024/01/07 06:44 [pubmed] PHST- 2024/01/06 18:07 [entrez] AID - S1056-8727(23)00270-2 [pii] AID - 10.1016/j.jdiacomp.2023.108672 [doi] PST - ppublish SO - J Diabetes Complications. 2024 Feb;38(2):108672. doi: 10.1016/j.jdiacomp.2023.108672. Epub 2024 Jan 3.