The mediating role of body surface area-adjusted basal metabolic rate: effects of low muscle mass and central obesity on cognitive impairment in Chinese patients with type 2 diabetes mellitus
BackgroundThis 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.MethodsA cross-sectional study inc...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2024.1513035/full |
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| author | Ya-Jie Zhai Ya-Jie Zhai Fang Li Chen-Ying Lin Chen-Ying Lin Fan Wu Hui-Na Qiu Jing-Bo Li Jing-Na Lin |
| author_facet | Ya-Jie Zhai Ya-Jie Zhai Fang Li Chen-Ying Lin Chen-Ying Lin Fan Wu Hui-Na Qiu Jing-Bo Li Jing-Na Lin |
| author_sort | Ya-Jie Zhai |
| collection | DOAJ |
| description | BackgroundThis 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.MethodsA 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.ResultsPatients 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%.ConclusionLow 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. |
| format | Article |
| id | doaj-art-ed28263d8ab34d0f82a5c33b2260ad9c |
| institution | Kabale University |
| issn | 1664-2392 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj-art-ed28263d8ab34d0f82a5c33b2260ad9c2025-01-24T05:21:15ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-01-011510.3389/fendo.2024.15130351513035The mediating role of body surface area-adjusted basal metabolic rate: effects of low muscle mass and central obesity on cognitive impairment in Chinese patients with type 2 diabetes mellitusYa-Jie Zhai0Ya-Jie Zhai1Fang Li2Chen-Ying Lin3Chen-Ying Lin4Fan Wu5Hui-Na Qiu6Jing-Bo Li7Jing-Na Lin8School of Medicine, Nankai University, Tianjin, ChinaDepartment of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, ChinaDepartment of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, ChinaDepartment of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, ChinaTianjin Union Medical Center, Tianjin Medical University, Tianjin, ChinaDepartment of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, ChinaDepartment of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, ChinaDepartment of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, ChinaDepartment of Endocrinology, Tianjin Union Medical Center, Nankai University Affiliated Hospital, Tianjin, ChinaBackgroundThis 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.MethodsA 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.ResultsPatients 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%.ConclusionLow 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.https://www.frontiersin.org/articles/10.3389/fendo.2024.1513035/fullbasal metabolic ratebody compositionmiddle-aged and older peoplecognitive impairmentobesitytype 2 diabetes mellitus |
| spellingShingle | Ya-Jie Zhai Ya-Jie Zhai Fang Li Chen-Ying Lin Chen-Ying Lin Fan Wu Hui-Na Qiu Jing-Bo Li Jing-Na Lin The mediating role of body surface area-adjusted basal metabolic rate: effects of low muscle mass and central obesity on cognitive impairment in Chinese patients with type 2 diabetes mellitus Frontiers in Endocrinology basal metabolic rate body composition middle-aged and older people cognitive impairment obesity type 2 diabetes mellitus |
| title | The mediating role of body surface area-adjusted basal metabolic rate: effects of low muscle mass and central obesity on cognitive impairment in Chinese patients with type 2 diabetes mellitus |
| title_full | The mediating role of body surface area-adjusted basal metabolic rate: effects of low muscle mass and central obesity on cognitive impairment in Chinese patients with type 2 diabetes mellitus |
| title_fullStr | The mediating role of body surface area-adjusted basal metabolic rate: effects of low muscle mass and central obesity on cognitive impairment in Chinese patients with type 2 diabetes mellitus |
| title_full_unstemmed | The mediating role of body surface area-adjusted basal metabolic rate: effects of low muscle mass and central obesity on cognitive impairment in Chinese patients with type 2 diabetes mellitus |
| title_short | The mediating role of body surface area-adjusted basal metabolic rate: effects of low muscle mass and central obesity on cognitive impairment in Chinese patients with type 2 diabetes mellitus |
| title_sort | mediating role of body surface area adjusted basal metabolic rate effects of low muscle mass and central obesity on cognitive impairment in chinese patients with type 2 diabetes mellitus |
| topic | basal metabolic rate body composition middle-aged and older people cognitive impairment obesity type 2 diabetes mellitus |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2024.1513035/full |
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