Interaction and overall effects of underweight, low muscle mass, malnutrition, and inflammation on early-onset mild cognitive impairment in type 2 diabetes.

Introduction: This study systematically explores the overall impact and interactions of body composition and nutritional inflammatory indices on early-onset mild cognitive impairment (EOMCI) in type 2 diabetes mellitus (T2DM). Methods: A cross-sectional study included 816 T2DM patients. Body composition indices included body mass index (BMI), waist circumference (WC), a body shape index (ABSI), body roundness index (BRI), visceral fat area (VFA), body fat percentage (BF%), and skeletal muscle mass index (SMMI). Nutritional inflammatory indices included the geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), C-reactive protein-albumin-lymphocyte index (CALLY), and fibrinogen-to-albumin ratio (FAR). K-means clustering and quantile g-computation (QGC) assessed the combined impact, with interactions evaluated by simple slope analysis. Results: K-means clustering revealed two distinct patterns: Low-pattern and High-pattern. The Low-pattern group exhibited significantly lower body composition indices (BMI 24.6 vs. 27.7 kg/m Discussion: The findings suggest that in T2DM patients, the interactions and overall effects of underweight, reduced muscle mass, abdominal obesity, malnutrition, and elevated inflammation are significantly associated with an increased risk of EOMCI. Integrated management of these factors is essential to mitigate EOMCI risk.