Moh Mei Chung, Low Serena, Ng Tze Pin, Wang Jiexun, Ang Su Fen, Tan Clara, Ang Keven, Tavintharan Subramaniam, Sum Chee Fang, Kwan Pek Yee, Lee Simon Biing Ming, Tang Wern Ee, Lim Su Chi
Clinical Research Unit, Khoo Teck Puat Hospital, Singapore, Singapore.
Diabetes Centre, Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore, Singapore.
Clin Obes. 2020 Apr;10(2):e12352. doi: 10.1111/cob.12352. Epub 2020 Feb 4.
Literature evaluating the relationship between central obesity and cognitive deficits in type 2 diabetes (T2DM) remains scarce. This cross-sectional analysis explored the association of novel and traditional central obesity measures with cognitive performance in older (aged ≥60 years) non-demented multi-ethnic Asians with T2DM, including a stratified analysis by body mass index (BMI). Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status. Central obesity measures including visceral fat area (VFA), waist circumference, waist:hip ratio, waist:height ratio, abdominal volume index, body roundness index and conicity index were measured and/or computed. In our cohort (N = 677; mean age = 67 ± 5 years, 51.7% men), VFA emerged as an associate of overall cognitive performance after covariate adjustment and Bonferroni correction (β = -.10, 95% CI = -0.18, -0.03), outperforming the other adiposity indices. Specifically, VFA was inversely associated with delayed memory and language scores. Additionally, compared with normal-weight individuals, excess visceral obesity (VFA ≥100 cm ) was independently associated with lower cognitive scores to a greater extent in normal BMI (<23 kg/m ) adults than in those with high BMI (≥23 kg/m ). Assessment and management of visceral adiposity may help to prevent cognitive decline in older people with T2DM, and reduce the global burden of dementia in ageing populations.
评估2型糖尿病（T2DM）患者中心性肥胖与认知缺陷之间关系的文献仍然很少。这项横断面分析探讨了新型和传统中心性肥胖测量指标与年龄较大（≥60岁）、非痴呆、多民族的亚洲T2DM患者认知表现之间的关联，包括按体重指数（BMI）进行分层分析。使用可重复神经心理状态评估量表评估认知功能。测量和/或计算了包括内脏脂肪面积（VFA）、腰围、腰臀比、腰高比、腹部容积指数、身体圆度指数和锥度指数在内的中心性肥胖测量指标。在我们的队列中（N = 677；平均年龄 = 67±5岁，51.7%为男性），经过协变量调整和Bonferroni校正后，VFA成为总体认知表现的一个相关因素（β = -0.10，95%CI = -0.18，-0.03），优于其他肥胖指数。具体而言，VFA与延迟记忆和语言得分呈负相关。此外，与体重正常的个体相比，内脏肥胖过多（VFA≥100 cm²）在正常BMI（<23 kg/m²）的成年人中比在高BMI（≥23 kg/m²）的成年人中更能独立地与较低的认知得分相关。评估和管理内脏脂肪过多可能有助于预防老年T2DM患者的认知衰退，并减轻老龄化人口中痴呆症的全球负担。
