Front. Endocrinol.

Sec. Clinical Diabetes

Volume 15 - 2024 | doi: 10.3389/fendo.2024.1513035

This article is part of the Research Topic Tissue Crosstalk in Obesity and Diabetes: A Focus on Skeletal Muscle View all 6 articles

Provisionally accepted

Ya-Jie Zhai 1*Fang Li 2*Chen-Ying Lin 3*Fan Wu 2*Hui-Na Qiu 2*Jing- Bo Li 2*Jing-Na Lin 2* 1 School of Medicine, Nankai University, Tianjin, China2 Tianjin Union Medical Centre, Nankai University, Tianjin, China3 Tianjin Union Medical Center, Tianjin Medical University, Tianjin, China

The final, formatted version of the article will be published soon.

You have multiple emails registered with Frontiers:

Please enter your email address:

If you already have an account, please login

You don't have a Frontiers account ? You can register here

Background: This study investigates the relationship between basal metabolic rate (BMR), body composition, obesity indices, and cognitive impairment (CI) in middle-aged and older type 2 diabetes mellitus (T2DM) patients, assessing their potential role in CI screening. Methods: A cross-sectional study included 1243 T2DM patients over 45 years old. CI was assessed using the Montreal Cognitive Assessment. BMR and body composition indices were measured through bioelectrical impedance analysis. The associations and predictions related to CI were explored using multivariable-adjusted logistic regression, restricted cubic spline (RCS) models, and receiver operating characteristic (ROC) curve analyses. Mediation analysis explored the role of BMR adjusted by body surface area (BMR/BSA) in CI risk. Results: Patients with CI showed significantly lower BMR, BMR adjusted for height squared (BMR/Height²), BMR/BSA, appendicular skeletal muscle mass (ASM), and fat-free mass (FFM), alongside higher waist circumference (WC) and percentage of body fat. Logistic regression showed that participants in the fourth quartile of BMR, BMR/Height2, and BMR/BSA had approximately a 54% reduced risk of CI (odds ratio range 0.457 to 0.463). RCS analysis indicated a linear decrease in CI risk with increasing BMR metrics. ROC analysis indicated high predictive efficacy for CI with combined indicators, particularly BMR and FFM (area under the curve 0.645). Mediation analysis suggested that BMR/BSA played a significant mediating role in WC, ASM and FFM on CI risk, with a mediation proportion ranging from 45.73% to 50.87%. Conclusion: Low energy expenditure assessed by BMR/BSA is an independent risk factor for increased CI risk in middle-aged and elderly T2DM patients. Central obesity, low muscle mass, and low energy expenditure significantly elevate CI risk in this population.

Keywords: basal metabolic rate, Body Composition, Middle-aged and older people, cognitive impairment, Obesity, type 2 diabetes mellitus

Received: 18 Oct 2024; Accepted: 31 Dec 2024.

Copyright: © 2024 Zhai, Li, Lin, Wu, Qiu, Li and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Ya-Jie Zhai, School of Medicine, Nankai University, Tianjin, 300192, China
Fang Li, Tianjin Union Medical Centre, Nankai University, Tianjin, China
Chen-Ying Lin, Tianjin Union Medical Center, Tianjin Medical University, Tianjin, China
Fan Wu, Tianjin Union Medical Centre, Nankai University, Tianjin, China
Hui-Na Qiu, Tianjin Union Medical Centre, Nankai University, Tianjin, China
Jing- Bo Li, Tianjin Union Medical Centre, Nankai University, Tianjin, China
Jing-Na Lin, Tianjin Union Medical Centre, Nankai University, Tianjin, China

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.