Interaction and overall effects of underweight, low muscle mass, malnutrition, and inflammation on early-onset mild cognitive impairment in type 2 diabetes

IntroductionThis study systematically explores the overall impact and interactions of body composition and nutritional inflammatory indices on early-onset mild cognitive impairment (EOMCI) in type 2 diabetes mellitus (T2DM).MethodsA cross-sectional study included 816 T2DM patients. Body composition...

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Main Authors: Chen-Ying Lin, Ya-Jie Zhai, Fan Wu, Hao-Hua An, Tong Chen, Hui-Na Qiu, Jing-Bo Li, Jing-Na Lin
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Aging Neuroscience
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Online Access:https://www.frontiersin.org/articles/10.3389/fnagi.2025.1498478/full
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author Chen-Ying Lin
Chen-Ying Lin
Ya-Jie Zhai
Fan Wu
Hao-Hua An
Tong Chen
Hui-Na Qiu
Jing-Bo Li
Jing-Na Lin
author_facet Chen-Ying Lin
Chen-Ying Lin
Ya-Jie Zhai
Fan Wu
Hao-Hua An
Tong Chen
Hui-Na Qiu
Jing-Bo Li
Jing-Na Lin
author_sort Chen-Ying Lin
collection DOAJ
description IntroductionThis study systematically explores the overall impact and interactions of body composition and nutritional inflammatory indices on early-onset mild cognitive impairment (EOMCI) in type 2 diabetes mellitus (T2DM).MethodsA cross-sectional study included 816 T2DM patients. Body composition indices included body mass index (BMI), waist circumference (WC), a body shape index (ABSI), body roundness index (BRI), visceral fat area (VFA), body fat percentage (BF%), and skeletal muscle mass index (SMMI). Nutritional inflammatory indices included the geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), C-reactive protein-albumin-lymphocyte index (CALLY), and fibrinogen-to-albumin ratio (FAR). K-means clustering and quantile g-computation (QGC) assessed the combined impact, with interactions evaluated by simple slope analysis.ResultsK-means clustering revealed two distinct patterns: Low-pattern and High-pattern. The Low-pattern group exhibited significantly lower body composition indices (BMI 24.6 vs. 27.7 kg/m2; WC 88 vs. 99 cm; ABSI 0.081 vs. 0.084; BRI 3.89 vs. 5.02; VFA 91 vs. 112; BF% 29% vs. 31%; SMMI 9.38 vs. 10.48 kg/m2; all P < 0.001) and poorer nutritional status with higher inflammation (GNRI 97.9 vs. 104.6; PNI 47.9 vs. 53.1; CALLY index 4 vs. 5; FAR 0.082 vs. 0.072; all P < 0.05). This group had a higher prevalence of EOMCI (32% vs. 23%, P = 0.006). After adjusting for confounders, the Low-pattern group had a 1.45-fold increased risk of EOMCI (OR 1.45, 95% CI 1.01–2.08). QGC analysis demonstrated that the combined overall effect of body composition and nutritional inflammatory indices was negatively associated with EOMCI risk. A one-quintile increase in all indices was linked to a significant 31.3% reduction in EOMCI risk (95% CI −44.4%, −15.0%). Interaction analysis revealed that abdominal obesity (ABSI > 0.08), combined with malnutrition (low GNRI), significantly increased EOMCI risk (Pinteraction = 0.018). Similarly, low muscle mass (SMMI < 11.33 kg/m2), when combined with malnutrition and high inflammation (low CALLY index), further exacerbated EOMCI risk (Pinteraction = 0.028).DiscussionThe findings suggest that in T2DM patients, the interactions and overall effects of underweight, reduced muscle mass, abdominal obesity, malnutrition, and elevated inflammation are significantly associated with an increased risk of EOMCI. Integrated management of these factors is essential to mitigate EOMCI risk.
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spelling doaj-art-a0ea3a0ae2b449e4b3791d85ef0aeadc2025-08-20T02:49:44ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652025-03-011710.3389/fnagi.2025.14984781498478Interaction and overall effects of underweight, low muscle mass, malnutrition, and inflammation on early-onset mild cognitive impairment in type 2 diabetesChen-Ying Lin0Chen-Ying Lin1Ya-Jie Zhai2Fan Wu3Hao-Hua An4Tong Chen5Hui-Na Qiu6Jing-Bo Li7Jing-Na Lin8Tianjin Union Medical Center, Tianjin Medical University, Tianjin, ChinaDepartment of Endocrinology, Health Management Center, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin, ChinaSchool of Medicine, Nankai University, Tianjin, ChinaDepartment of Endocrinology, Health Management Center, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin, ChinaDepartment of Clinical Laboratory, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin, ChinaSchool of Medicine, Nankai University, Tianjin, ChinaDepartment of Endocrinology, Health Management Center, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin, ChinaDepartment of Endocrinology, Health Management Center, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin, ChinaDepartment of Endocrinology, Health Management Center, Tianjin Union Medical Center, The First Affiliated Hospital of Nankai University, Tianjin, ChinaIntroductionThis study systematically explores the overall impact and interactions of body composition and nutritional inflammatory indices on early-onset mild cognitive impairment (EOMCI) in type 2 diabetes mellitus (T2DM).MethodsA cross-sectional study included 816 T2DM patients. Body composition indices included body mass index (BMI), waist circumference (WC), a body shape index (ABSI), body roundness index (BRI), visceral fat area (VFA), body fat percentage (BF%), and skeletal muscle mass index (SMMI). Nutritional inflammatory indices included the geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), C-reactive protein-albumin-lymphocyte index (CALLY), and fibrinogen-to-albumin ratio (FAR). K-means clustering and quantile g-computation (QGC) assessed the combined impact, with interactions evaluated by simple slope analysis.ResultsK-means clustering revealed two distinct patterns: Low-pattern and High-pattern. The Low-pattern group exhibited significantly lower body composition indices (BMI 24.6 vs. 27.7 kg/m2; WC 88 vs. 99 cm; ABSI 0.081 vs. 0.084; BRI 3.89 vs. 5.02; VFA 91 vs. 112; BF% 29% vs. 31%; SMMI 9.38 vs. 10.48 kg/m2; all P < 0.001) and poorer nutritional status with higher inflammation (GNRI 97.9 vs. 104.6; PNI 47.9 vs. 53.1; CALLY index 4 vs. 5; FAR 0.082 vs. 0.072; all P < 0.05). This group had a higher prevalence of EOMCI (32% vs. 23%, P = 0.006). After adjusting for confounders, the Low-pattern group had a 1.45-fold increased risk of EOMCI (OR 1.45, 95% CI 1.01–2.08). QGC analysis demonstrated that the combined overall effect of body composition and nutritional inflammatory indices was negatively associated with EOMCI risk. A one-quintile increase in all indices was linked to a significant 31.3% reduction in EOMCI risk (95% CI −44.4%, −15.0%). Interaction analysis revealed that abdominal obesity (ABSI > 0.08), combined with malnutrition (low GNRI), significantly increased EOMCI risk (Pinteraction = 0.018). Similarly, low muscle mass (SMMI < 11.33 kg/m2), when combined with malnutrition and high inflammation (low CALLY index), further exacerbated EOMCI risk (Pinteraction = 0.028).DiscussionThe findings suggest that in T2DM patients, the interactions and overall effects of underweight, reduced muscle mass, abdominal obesity, malnutrition, and elevated inflammation are significantly associated with an increased risk of EOMCI. Integrated management of these factors is essential to mitigate EOMCI risk.https://www.frontiersin.org/articles/10.3389/fnagi.2025.1498478/fullmild cognitive impairmenttype 2 diabetes mellitussarcopeniamalnutritioninflammationinteraction
spellingShingle Chen-Ying Lin
Chen-Ying Lin
Ya-Jie Zhai
Fan Wu
Hao-Hua An
Tong Chen
Hui-Na Qiu
Jing-Bo Li
Jing-Na Lin
Interaction and overall effects of underweight, low muscle mass, malnutrition, and inflammation on early-onset mild cognitive impairment in type 2 diabetes
Frontiers in Aging Neuroscience
mild cognitive impairment
type 2 diabetes mellitus
sarcopenia
malnutrition
inflammation
interaction
title Interaction and overall effects of underweight, low muscle mass, malnutrition, and inflammation on early-onset mild cognitive impairment in type 2 diabetes
title_full Interaction and overall effects of underweight, low muscle mass, malnutrition, and inflammation on early-onset mild cognitive impairment in type 2 diabetes
title_fullStr Interaction and overall effects of underweight, low muscle mass, malnutrition, and inflammation on early-onset mild cognitive impairment in type 2 diabetes
title_full_unstemmed Interaction and overall effects of underweight, low muscle mass, malnutrition, and inflammation on early-onset mild cognitive impairment in type 2 diabetes
title_short Interaction and overall effects of underweight, low muscle mass, malnutrition, and inflammation on early-onset mild cognitive impairment in type 2 diabetes
title_sort interaction and overall effects of underweight low muscle mass malnutrition and inflammation on early onset mild cognitive impairment in type 2 diabetes
topic mild cognitive impairment
type 2 diabetes mellitus
sarcopenia
malnutrition
inflammation
interaction
url https://www.frontiersin.org/articles/10.3389/fnagi.2025.1498478/full
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