Introduction: Little is known of association between sarcopenic obesity (SO) and cognition. We aim to examine body composition, and association between SO and cognitive performance in type 2 diabetes (T2D).

Methods: This was a cross-sectional study on 1,317 patients with mean age 61.7±8.2 years and T2D attending both primary and secondary diabetes care in Singapore. Sarcopenia was defined using multi-frequency bio-impedence estimated appendicular skeletal muscle mass divided by height2 with cut-off for Asians (<5.7 kg/m2 in females; <7 kg/m2 in males). Waist circumference (wc)≥80 cm (females) and 90 cm (males) was used to define abdominal obesity. SO was defined as (1) co-existence of sarcopenia and obesity; or (2) fat mass to fat-free mass (FM/FFM) ratio>0.8. Cognition was assessed using Repeatable Battery for the Assessment of Neuropsychological Status.

Results: The distribution by body composition based on definition muscle mass and wc was: nonsarcopenic nonobese, 20.3%; nonsarcopenic obese, 55.1%; sarcopenic nonobese, 13.2%; sarcopenic obese, 11.4%. In contrast, the prevalence of sarcopenic obesity based on FM/FFM ratio was 20.2%. The sarcopenic obese group had the lowest total and index RBANS scores(p<0.05). Multiple linear regression showed SO defined by FM/FFM ratio was significantly associated with reduced total score even after adjusting for demographics with β=-1.66 (95% CI -2.74 to -0.59; p=0.002), and demographics, education and clinical covariates with β=-1.14 (95% CI -2.14 to -0.14; p=0.026). SO was significantly associated with reduced index scores for immediate memory and language in fully adjusted models with β=-1.81 (95% CI -3.46 to -0.16; p=0.032) and β =-2.34 (95% CI -4.06 to -0.062; p=0.008) respectively.

Conclusions: The differing prevalence of SO based on different measures calls for need to standardize definition. SO was associated with reduced cognitive performance and should be considered in management of cognition in patients with T2D.


K. Low: None. S. Lim: None. K. Ang: None. S. Tavintharan: None. C. Sum: None.


National Medical Research Council of Australia (NMRC/CIRG/1398/2014)

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