Sex Differences in the Association Between Body Composition and Cognitive Performance in Adolescents With Type 1 Diabetes.

Girls with type 1 diabetes had significantly lower muscle-to-fat ratio (MFR) z-scores than boys despite similar BMI z-scores.

• Mean MFR z-scores were -0.60 ± 0.84 in girls versus 0.25 ± 1.00 in boys (p < 0.001)
• Mean BMI z-scores did not differ significantly between sexes
• Sample included 64 adolescents (39 boys), mean age 15.9 ± 2.2 years
• Body composition was assessed via bioelectrical impedance analysis

In boys, diabetes duration predicted longer time-to-first move in spatial navigation tasks.

• Diabetes duration was a statistically significant predictor of time-to-first move (B = 0.064, p = 0.009)
• Boys' longer time-to-first move was positively correlated with lower MFR z-scores and higher HbA1c levels
• Additional correlates included greater time in marked hypoglycemia and in severe hyperglycemia
• Spatial navigation was assessed using the Virtual Morris Water Maze Task (vMWMT)

In boys, both diabetes duration and lower MFR z-score jointly predicted longer time-to-platform in the spatial navigation task.

• The combined model for time-to-platform had R2 = 0.457, p < 0.001
• Both diabetes duration and lower MFR z-score were independent predictors of longer time-to-platform
• This suggests that relative muscle deficiency (lower MFR) is associated with poorer spatial navigation performance in boys

In girls, higher BMI z-scores predicted longer time-to-platform in the spatial navigation task.

• Higher BMI z-score was a significant predictor of longer time-to-platform (B = 9.33, p = 0.022)
• Girls' longer time-to-platform was positively correlated with higher BMI z-scores in correlation analyses
• This indicates that weight status, rather than muscle-to-fat ratio, is the key body composition predictor in girls

In girls, HbA1c levels at diabetes onset predicted longer time-to-first move.

• HbA1c at diabetes onset was a statistically significant predictor of time-to-first move (B = -3.46, p = 0.018)
• This association was specific to girls and was not identified as a significant predictor in boys
• Time-to-first move reflects initial decision-making latency in the Virtual Morris Water Maze Task

Adolescents with type 1 diabetes are at increased risk of impaired cognitive function, and excess adiposity may impair cognition through metabolic and inflammatory pathways.

• Cognitive impairment risk is noted particularly in tasks requiring memory, attention, and executive functioning
• The study investigated spatial navigation as a cognitive outcome using the Virtual Morris Water Maze Task (vMWMT)
• Glycaemic control was evaluated through HbA1c measurement and continuous glucose monitoring metrics
• The study design was observational with sex-stratified correlation and multivariable linear regression models