心血管代谢性疾病共病在饮食行为与轻度认知障碍关联中的作用  

Role of cardiometabolic comorbidities in association between dietary behavior and mild cognitive impairment

作　　者：李春利 曾燕[1] 程桂荣[1] 黄招兰[2] 马容莉 Li Chunli;Zeng Yan;Cheng Guirong;Huang Zhaolan;Ma Rongli(Wuhan University of Science and Technology Medical School,Wuhan 430065,Hubei Province,China)

机构地区：[1]武汉科技大学医学院,430065 [2]武汉科技大学附属老年病医院全科医学科 [3]解放军中部战区总医院干部病房二科

出　　处：《中华老年心脑血管病杂志》2025年第3期274-279,共6页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：武汉市医学科学研究项目(S202401090054)。

摘　　要：目的探讨饮食行为与老年人轻度认知障碍(mild cognitive impairment,MCI)的关联性,并进一步分析心血管代谢性共病在该关联中的作用。方法收集2018年至2023年湖北老年记忆队列研究中3个社区和大悟县48个村的老年认知筛查相关数据6599例,采用食物频率问卷、饮食行为问卷评估并利用潜在类别分析将受试者归类到健康饮食行为(healthy eating behavior,HEB)、亚健康饮食行为(sub-healthy eating behavior,SHEB)和不健康饮食行为(unhealthy eating behavior,UEB),心血管代谢性疾病为经医师诊断的糖尿病、高血压、冠心病和脑血管病,MCI由医师、专家团队根据Peterson标准诊断,多因素logistic回归模型分析心血管代谢性疾病共病在饮食行为与MCI关联性中的作用。结果MCI患病率为24.3%,HEB、SHEB和UEB患病率分别为16.6%、24.3%和31.3%。女性、≥75岁、无配偶、文化程度低、居住在农村、无稳定收入、缺乏体育锻炼、体质量指数异常、心血管代谢性疾病种类、SHEB、UEB的老年人MCI患病率更高(P<0.05,P<0.01)。调整混杂因素后,多因素logistic回归分析显示,UEB(OR=1.220,95%CI:1.004~1.418,P=0.045)和SHEB(OR=1.592,95%CI:1.345~1.883,P=0.001)与老年人MCI风险呈正相关。进一步分析饮食行为和心血管代谢性疾病与MCI关联中的分层发现,在HEB中高血压+糖尿病+冠心病MCI风险最高(OR=4.220,95%CI:1.913~9.309,P=0.001);在SHEB中高血压+糖尿病(OR=1.640,95%CI:1.157~2.322,P=0.005)、高血压+脑血管病(OR=1.454,95%CI:1.041~2.031,P=0.028)、高血压+糖尿病+脑血管病(OR=2.064,95%CI:1.246~3.419,P=0.005)、高血压+糖尿病+冠心病+脑血管病(OR=1.974,95%CI:1.036~3.760,P=0.039)明显增加MCI风险。结论SHEB和UEB老年人MCI患病风险高,心血管代谢性疾病共病进一步增加MCI风险。Objective To investigate the association between dietary behavior and mild cognitive impairment(MCI)in older adults,and to further analyze the role of cardiometabolic comorbidities in this relationship.Methods A total of 6599 older adults were recruited from 3 communities and 48 villages in Dawu County between 2018 and 2023 as part of the Hubei Elderly Memory Cohort Study.Dietary behaviors were assessed using a food frequency questionnaire and a dietary behavior questionnaire,Latent class analysis was performed to categorize the participants into healthy eating behavior(HEB),sub-healthy eating behavior(SHEB),and unhealthy eating behavior(UEB).Cardiovascular-metabolic diseases were diabetes,hypertension,coronary heart disease,and cerebrovascular disease,which all diagnosed by physicians.MCI was diagnosed by a team of clinical experts according to Peterson's criteria.Multivariable logistic regression model was used to analyze the impact of cardiometabolic comorbidities on the association between dietary behavior and MCI.Results The morbidity rate of MCI was 24.3%,and that of HEB,SHEB and UEB was 16.6%,24.3%and 31.3%,respectively.The incidence of MCI was higher in the participants who were female,over≥75 years old,unmarried,and lack physical exercise,SHEB and UEB groups,had low educational level,lived in rural areas,had no stable income,had abnormal BMI,and more types of cardiometabolic diseases(P<0.05,P<0.01).After adjusting for confounders,multivariable logistic regression analysis indicated that both UEB(OR=1.220,95%CI:1.004-1.418,P=0.045)and SHEB(OR=1.592,95%CI:1.345-1.883,P=0.001)were positively correlated with MCI risk in older adults.Further stratified analysis by cardiometabolic comorbidities revealed that for the patients in the HEB group,those suffering from hypertension+diabetes+coronary heart disease had the highest risk for MCI(OR=4.220,95%CI:1.913-9.309,P=0.001),while for the SHEB group,the following comorbidities were significantly associated with increased MCI risk:hypertension+diabetes(OR=1.640,95

关 键 词：营养和代谢性疾病 认知功能障碍 共病现象 调查和问卷 饮食行为 

分 类 号：R749.1[医药卫生—神经病学与精神病学] R54[医药卫生—临床医学]