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.

中文翻译：

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骨骼肌质量与内脏脂肪面积比率降低与 2 型糖尿病认知功能降低独立相关

目的

骨骼肌质量与内脏脂肪面积之比（SVR）已被公认为是肌肉减少性肥胖的指标。SVR 与 2 型糖尿病 (T2DM)、代谢综合征和动脉硬化有关，这些都是认知功能障碍的已知危险因素。我们的目的是研究T2DM 患者 SVR 与认知功能之间的关联。

方法

这是一项横断面研究，纳入了 1326 名 T2DM 患者，平均年龄为 61.3 ± 8.0 岁。SVR 是根据肌肉质量和内脏脂肪面积 (VFA) 的生物电阻抗测量值进行评估的。使用可重复电池评估神经心理状态（RBANS）来评估认知功能。使用线性回归来检查四分位数的 SVR 与 RBANS 评分之间的关​​联，并根据人口统计、教育程度、抑郁症状的存在、临床协变量和药物进行调整。

结果

在未经调整的分析中，较低的 SVR 四分位数与 RBANS 总分呈负相关。在完全调整分析中，四分位数 1 和 2 SVR 的相应系数分别为 -3.79（95% CI -5.39 至 -2.19；p < 0.001）和 -1.47（95% CI -2.86 至 -0.07；p = 0.039）。第一四分位数 SVR 与 RBANS 评分之间的负相关在即时记忆、延迟记忆、视觉空间构建、语言和注意力领域中很明显。仅肌肉质量和 VFA 与 RBANS 评分的相关性较弱。

结论

我们的研究首次证明了 SVR 降低与认知功能降低之间存在独立关联。这在全球和多个认知领域中很明显。肌肉质量减少和内脏肥胖的协同效应可能比它们对认知功能的独立影响更明显。