河北省55岁及以上人群维生素E摄入量与轻度认知功能障碍的关联  

Association between vitamin E intake and mild cognitive impairment in people aged 55 years and older in Hebei Province

作　　者：张帆 孙岩 刘万普 黄鑫 周雨天 田浩 朱蕙晨 马玉霞 Zhang Fan;Sun Yan;Liu Wanpu;Huang Xin;Zhou Yutian;Tian Hao;Zhu Huichen;Ma Yuxia(Department of Nutrition and Food Hygiene,School of Public Health,Hebei Medical University,Key Laboratory of Environment and Human Health of Hebei Province,Shijiazhuang 050017,China;Cang County Center for Disease Prevention and Control,Cangzhou 061009,China)

机构地区：[1]河北医科大学公共卫生学院营养与食品卫生学教研室,河北省环境与人群健康重点实验室,石家庄050017 [2]沧县疾病预防控制中心,沧州061009

出　　处：《卫生研究》2023年第6期912-918,共7页Journal of Hygiene Research

基　　金：国家重点研发计划(No.2017YFC0907700)。

摘　　要：目的探讨膳食维生素(vitamin E,VE)摄入量与轻度认知功能障碍(mild cognitive impairment,MCI)的关系。方法于2018年7—12月采用分层多阶段整群随机抽样的方法,在河北省抽取612名55岁及以上人群,均使用膳食频率调查问卷调查膳食VE摄入量,并通过蒙特利尔认知评估量表进行认知功能评估。采用Logistic回归模型和限制性立方样条分析膳食VE摄入量与MCI及其亚型的关系。结果调查对象中,男性260名(42.5%),女性352名(57.5%),年龄(66.8±7.4)岁,膳食VE摄入量(12.17±4.91)mg/d,MCI患病率为41.3%(253人)。Logistic回归结果显示,在调整了年龄、性别、能量摄入、城乡、文化程度、就业状态、体质指数、吸烟、饮酒、体力活动、高血压和糖尿病后,VE摄入量与非遗忘型和单域遗忘型风险无显著相关性(P>0.05),而与多域遗忘型风险有关联(P<0.05)。相比于膳食VE摄入Q1组,Q2、Q3和Q4组多域遗忘型轻度认知障碍的OR(95%CI)值分别为1.628(0.836~3.170)、0.313(0.124~0.791)和0.727(0.330~1.602)。限制性三次立方样条分析结果显示,膳食VE摄入量与多域遗忘型轻度认知功能障碍呈非线性的剂量-反应关系(P=0.02)。VE摄入量在17 mg/d时,多域遗忘型轻度认知功能障碍的发病风险最低。结论膳食VE摄入量与出现MCI、遗忘型MCI和多域遗忘型MCI患病风险之间呈近似“U”型,提示适量的VE摄入对发生轻度认知功能障碍具有预防作用。OBJECTIVE To investigate the relationship between dietary vitamin E(VE)intake and mild cognitive impairment(MCI).METHODS Based on the data of Hebei Province in the 2018 National Key Research and Development Program Nervous system disease CCSNSD,612 subjects were included in this study.All study participants were surveyed for dietary VE intake by the Dietary Frequency Questionnaire and assessed for cognitive function by the Montreal Cognitive Assessment Scale.The relationship between dietary VE intake and MCI and its subtypes was analyzed using logistic regression and restricted cubic splines.RESULTS The study subjects included 260(42.5%)males and 352(57.5%)females,with an average age of(66.8±7.4)years and an average dietary VE intake of(12.17±4.91)mg/d.The prevalence of cognitive impairment in the study population was 41.3%.After adjusting the covariates of age,gender,energy intake,residence,education level,employment status,BMI,smoking,drinking,physical activity,hypertension,diabetes,VE intake was not associated with the risk of non-amnesic(naMCI),single-domain amnesic(aMCI-SD),but relate to the risk of multi-domain amnesic(aMCI-MD).What’s more,compared to dietary vitamin E intake Q1 group,the OR(95%CI)for multi-domain amnesic mild cognitive impairment in Q2,Q3 and Q4 groups were 1.628(0.836-3.170),0.313(0.124-0.791)and 0.727(0.330-1.602),respectively.Using vitamin E intake as a continuous-type variable,a non-linear dose-response relationship was found between VE intake and mild cognitive dysfunction of the multi-domain amnesic type(P=0.02).When VE intake was about 17 mg/d,the risk of aMCI-MD was the lowest.CONCLUSION There is an approximate"U"shaped dose-response relationship between dietary VE intake and the risk of mild cognitive impairment with multi-domain amnesia type.Research suggests that moderate VE intake has a preventive effect on the development of mild cognitive impairment.

关 键 词：维生素E 膳食摄入量 轻度认知功能障碍 轻度认知功能障碍亚型 LOGISTIC回归 限制性立方样条 

分 类 号：R151.4[医药卫生—营养与食品卫生学] R153.3[医药卫生—公共卫生与预防医学] R592