Mild cognitive impairment (MCI) is increasingly recognized among patients with diabetes, yet tools for identifying individuals at higher risk remain limited in routine practice. A retrospective analysis published in Diabetes, Obesity and Metabolism evaluated the association between visceral obesity indices and MCI risk in patients with diabetes and identified the most effective visceral obesity measure for developing an MCI risk assessment nomogram.

The analysis included 1,080 patients treated at Nanjing Drum Tower Hospital and evaluated the association between visceral obesity indices and MCI diagnosed according to criteria from the National Institute on Aging-Alzheimer’s Association Workgroup. Logistic regression models were used to identify factors independently associated with MCI. External validation was performed using a multicenter retrospective cohort and a prospective cohort with follow-up extending up to 10 years.

A positive but non-linear dose-response association was observed between visceral obesity indices and MCI risk. Among the indices evaluated, including a body shape index (ABSI), visceral adiposity index (VAI), lipid accumulation product (LAP), and Chinese visceral adiposity index (CVAI), body roundness index (BRI) showed the highest discriminative ability for identifying MCI, with an area under the curve (AUC) of 0.734 (95% CI, 0.703-0.764).

A nomogram incorporating BRI, age, education level, and hemoglobin A1c (HbA1c) achieved an AUC of 0.804 (95% CI, 0.777-0.830) in internal validation. Performance remained consistent across external cohorts, with AUC values of 0.756 (95% CI, 0.722-0.790) in the multicenter retrospective cohort and 0.762 (95% CI, 0.727-0.797) in the 10-year prospective cohort.

Overall, higher visceral obesity indices were associated with MCI risk among patients with diabetes, and BRI-based assessment demonstrated consistent predictive performance across validation cohorts.