{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:36:57Z","timestamp":1760060217802,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Direcci\u00f3n de Investigaci\u00f3n y Desarrollo (DIDE) of the Universidad T\u00e9cnica de Ambato, Ecuador","award":["UTA-CONIN-2025-0044-R"],"award-info":[{"award-number":["UTA-CONIN-2025-0044-R"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Microvascular complications are a major source of disability in type 2 diabetes mellitus (T2DM). We investigated whether body composition indices derived from multifrequency bioelectrical impedance analysis (BIA) independently predict neuropathy, retinopathy, nephropathy, and stroke, and whether they improve risk discrimination beyond the established clinical variables. Methods: In this cross-sectional analytical study (March 2024\u2013February 2025), 124 adults with T2DM \u2265 12 months attending the outpatient diabetes clinic of the Universidad T\u00e9cnica de Ambato (Ecuador) were enrolled. After an overnight fast and 15 min supine rest, thirteen whole-body BIA metrics including skeletal muscle mass (SMM), intracellular water (ICW), phase angle (PhA), and visceral fat area (VFA) were obtained with a segmental analyzer (InBody S10). Complications were ascertained with standard clinical and laboratory protocols. Principal component analysis (PCA) summarized the correlated BIA measures; multivariable logistic regression (adjusted for age, sex, diabetes duration, HbA1c, BMI, and medication use) generated odds ratios (ORs) per standard deviation (SD). Discrimination was assessed with bootstrapped receiver-operating characteristic curves. Results: The first principal component, driven by SMM, ICW, and PhA, accounted for a median 68% (range 65\u201372%) of body composition variance across all complications. Each SD increase in SMM lowered the odds of neuropathy (OR 0.54, 95% CI 0.41\u20130.71) and nephropathy (OR 0.70, 0.53\u20130.92), whereas VFA raised the risk of neuropathy (OR 1.55, 1.22\u20131.97) and retinopathy (OR 1.47, 1.14\u20131.88). PhA protected most strongly against stroke (OR 0.55, 0.37\u20130.82). Composite models integrating SMM, PhA, and adiposity indices achieved AUCs of 0.79\u20130.85, outperforming clinical models alone (all \u0394AUC \u2265 0.05) and maintaining good calibration (Hosmer\u2013Lemeshow p &gt; 0.20). Optimal probability cut-offs (0.39\u20130.45) balanced sensitivity (0.74\u20130.80) and specificity (0.68\u20130.72). Conclusions: A lean tissue BIA signature (higher SMM, ICW, PhA) confers independent protection against neuropathy, retinopathy, nephropathy, and stroke, whereas visceral adiposity amplifies the risk. Because the assessment is rapid, inexpensive, and operator-independent, routine multifrequency BIA can be embedded into diabetes clinics to triage patients for early specialist referral and to monitor interventions aimed at preserving muscle and reducing visceral fat, thereby enhancing microvascular risk management in T2DM.<\/jats:p>","DOI":"10.3390\/diagnostics15162005","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T11:02:09Z","timestamp":1754910129000},"page":"2005","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bioelectrical Impedance Profiling to Estimate Neuropathic and Vascular Risk in Patients with Type 2 Diabetes Mellitus"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5251-5143","authenticated-orcid":false,"given":"Elizabeth","family":"Quiroga-Torres","sequence":"first","affiliation":[{"name":"Carrera de Nutrici\u00f3n y Diet\u00e9tica, Faculta de Ciencias de la Salud, Universidad T\u00e9cnica de Ambato, Ambato 180104, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernanda","family":"Marizande","sequence":"additional","affiliation":[{"name":"Carrera de Medicina, Faculta de Ciencias de la Salud, Universidad T\u00e9cnica de Ambato, Ambato 180104, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Arteaga","sequence":"additional","affiliation":[{"name":"Carrera de Nutrici\u00f3n y Diet\u00e9tica, Faculta de Ciencias de la Salud, Universidad T\u00e9cnica de Ambato, Ambato 180104, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9736-9899","authenticated-orcid":false,"given":"Marcelo","family":"Pilamunga","sequence":"additional","affiliation":[{"name":"Carrera de Dise\u00f1o Gr\u00e1fico, Facultad de Dise\u00f1o y Arquitectura, Universidad T\u00e9cnica de Ambato, Ambato 180207, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4242-3429","authenticated-orcid":false,"given":"Lisbeth Josefina","family":"Reales-Chac\u00f3n","sequence":"additional","affiliation":[{"name":"Carrera de Medicina, Facultad de Ciencias de la Salud, Universidad Nacional de Chimborazo, Riobamba 060108, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Bonilla","sequence":"additional","affiliation":[{"name":"Carrera de Nutrici\u00f3n y Diet\u00e9tica, Faculta de Ciencias de la Salud, Universidad T\u00e9cnica de Ambato, Ambato 180104, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dom\u00e9nica","family":"Robayo","sequence":"additional","affiliation":[{"name":"Carrera de Enfermer\u00eda, Instituto Superior Universitario Stanford, Riobamba 060104, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Buena\u00f1o","sequence":"additional","affiliation":[{"name":"Carrera de Nutrici\u00f3n y Diet\u00e9tica, Faculta de Ciencias de la Salud, Universidad T\u00e9cnica de Ambato, Ambato 180104, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebasti\u00e1n","family":"Camacho","sequence":"additional","affiliation":[{"name":"Carrera de Nutrici\u00f3n y Diet\u00e9tica, Faculta de Ciencias de la Salud, Universidad T\u00e9cnica de Ambato, Ambato 180104, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Galarza","sequence":"additional","affiliation":[{"name":"Carrera de Nutrici\u00f3n y Diet\u00e9tica, Faculta de Ciencias de la Salud, Universidad T\u00e9cnica de Ambato, Ambato 180104, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4409-8113","authenticated-orcid":false,"given":"Alberto","family":"Bustillos","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias Agropecuarias, Universidad T\u00e9cnica de Ambato, Ambato 180650, Ecuador"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"46","DOI":"10.5897\/JPAP2013.0001","article-title":"The Pathogenesis and Pathophysiology of Type 1 and Type 2 Diabetes Mellitus","volume":"4","author":"Ozougwu","year":"2013","journal-title":"J. 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Obes."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/16\/2005\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:24:39Z","timestamp":1760034279000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/16\/2005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,11]]},"references-count":28,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["diagnostics15162005"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15162005","relation":{},"ISSN":["2075-4418"],"issn-type":[{"type":"electronic","value":"2075-4418"}],"subject":[],"published":{"date-parts":[[2025,8,11]]}}}