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Basic Science and Pathogenesis.

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Higher phase angle (PhA), a marker of nutritional status, is linked to better cognitive function in type 2 diabetes patients. Reduced arterial stiffness may mediate this association, suggesting PhA as a potential target for preventing cognitive decline.

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Area of Science:

  • Biomedical science
  • Nutritional science
  • Neuroscience

Background:

  • Phase angle (PhA) reflects cellular health and muscle mass, with higher levels indicating better nutritional status.
  • While higher PhA correlates with improved clinical outcomes, its relationship with cognitive function and the underlying mechanisms, particularly in type 2 diabetes (T2D), remain unclear.
  • Arterial stiffness is a known risk factor for cognitive impairment, especially in T2D, due to its impact on cerebral blood flow.

Purpose of the Study:

  • To investigate the association between PhA and cognitive function in patients with T2D.
  • To explore arterial stiffness (measured by pulse wave velocity, PWV) as a potential mediator in the relationship between PhA and cognitive function.

Main Methods:

  • A prospective cohort study of 908 T2D patients from the SMART2D cohort.
  • Baseline PhA measured by bioelectrical impedance analysis; cognitive function assessed using the Repeatable Battery for Assessment of Neuropsychological Status (RBANS).
  • Arterial stiffness measured by carotid-femoral pulse wave velocity (PWV); statistical analyses included linear regression and linear mixed models.

Main Results:

  • Higher PhA was significantly associated with higher RBANS total scores cross-sectionally (adjusted coefficient 1.17) and longitudinally (adjusted coefficient 1.18).
  • Longitudinal analyses showed positive associations between PhA and cognitive domains including visuospatial-construction, attention, and delayed memory.
  • Mediation analysis indicated that PWV accounted for 10% of the association between PhA and cognitive function (p=0.044).

Conclusions:

  • This study reveals a significant longitudinal association between higher PhA and better cognitive function in T2D patients.
  • Arterial stiffness, measured by PWV, partially mediates this relationship, highlighting its role in cognitive health.
  • PhA may represent a modifiable target for interventions aimed at preventing cognitive impairment in individuals with type 2 diabetes.