膳食炎症指数与中老年人认知障碍发生风险的Meta分析

王丽丽; 赵海峰

doi:10.16462/j.cnki.zhjbkz.2024.02.013

膳食炎症指数与中老年人认知障碍发生风险的Meta分析

doi: 10.16462/j.cnki.zhjbkz.2024.02.013

王丽丽,
赵海峰^,

山西医科大学公共卫生学院营养与食品卫生学教研室，太原 030001

基金项目:

国家自然科学基金 81973047

详细信息

通讯作者:
赵海峰，E-mail: haifengzao75@163.com

中图分类号: R151.41
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- 被引次数: 0
出版历程
- 收稿日期: 2022-08-29
- 修回日期: 2022-10-28
- 网络出版日期: 2024-03-30
- 刊出日期: 2024-02-10

Dietary inflammatory index and the risk of cognitive impairment in middle-aged and elderly people: a meta-analysis

WANG Lili,
ZHAO Haifeng^,

Department of Nutrition and Food Hygiene, School of Public Health, Shanxi Medical University, Taiyuan 030001, China

Funds:

National Natural Science Foundation of China 81973047

More Information

Corresponding author: ZHAO Haifeng, E-mail: haifengzao75@163.com

摘要

摘要: 目的系统评价膳食炎症指数(dietary inflammatory index, DII)与中老年人认知障碍发生风险的关系。方法检索中国知网、万方、维普、生物医学文献、PubMed、Science Direct、Springer、Cochrane Library、Embase等数据库从建库至2022年6月20日发表的关于DII与中老年人认知障碍的文献，按照纳入、排除标准严格筛选。采用纽卡斯尔-渥太华(Newcastle-Ottawa scale, NOS)量表及美国卫生保健质量和研究机构(Agency for Healthcare Research and Quality, AHRQ)推荐的横断面研究质量评价量表评估筛选后的文献质量，采用Revman 5.4软件和Stata 15.1软件进行Meta分析，随机效应模型汇总OR值和95% CI。结果共纳入7项研究，包含15 428名参与者。Meta分析显示，与最低位数DII相比，最高位数DII与中老年人认知障碍风险增加相关(OR=1.62，95% CI：1.27~2.05，P < 0.01)，尤其是在使用食物频率问卷调查膳食数据(OR=1.46，95% CI：1.21~1.77，P=0.17)及计算能量调整后的DII的研究(OR=1.71，95% CI：1.26~2.33，P=0.07)中。结论与低DII饮食相比，高DII饮食可能与中老年人认知障碍的风险增加有关，受纳入研究数量和质量的限制，未来仍需更多高质量研究予以验证。
- 膳食炎症指数 /
- 认知障碍 /
- Meta分析
Abstract: Objective To evaluate the relationship between dietary inflammatory index (DII) and the risk of cognitive impairment in middle-aged and elderly people. Methods We systematically searched CNKI, Cqvip, Wanfang Data, SinoMed, PubMed, Science Direct, Springer, Cochrane Library and Embase databases from inception to June 20, 2022, screened studies based on the inclusion and exclusion criteria. The quality of the studies included was assessed by the Newcastle-Ottawa scale and the Agency for Healthcare Research and Quality methodology checklist. Revman 5.4 and Stata 15.1 software were used for meta-analysis. The pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated using random-effects model. Results A total of 7 articles with 15 428 participants were included. In the present meta-analysis, the DII was associated with the risk of cognitive impairment (OR=1.62, 95% CI: 1.27-2.05, P < 0.01), especially in studies that used food frequency questionnaire (FFQ) (OR=1.46, 95% CI: 1.21-1.77, P=0.17) and adjusted energy intake (OR=1.71, 95% CI: 1.26-2.33, P=0.07). Conclusions Compared with the low DII diet, the high DII diet is associated with an increased risk of cognitive impairment. Due to limited number and quality of included studies, the above-mentioned conclusion still needs to be verified by more high-quality studies.
- Dietary inflammation index /
- Cognitive impairment /
- Meta-analysis

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图 1 文献筛选流程图

Figure 1. Literature screening flow chart

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图 2 膳食炎症指数与中老年人认知障碍发生风险的Meta分析森林图

Figure 2. Forest plot showing the association between the dietary inflammatory index and the risk of cognitive impairment in middle-aged and elderly peoples

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图 3 所有纳入研究的漏斗图及敏感性分析

Figure 3. Funnel and sensitivity analysis plots of all included studies

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表 1 纳入研究的基线特征及质量评估

Table 1. Baseline characteristics and quality assessment of the studies included in the systematic review

作者，年份，国家 Author, Year, Country	研究类型 Study type	研究对象 Study participants		病例数/总样本量 Number of case/total sample	随访时间/年 Follow-up/Year
Sun等^[12], 2022, 中国 Sun et al^[12]，2022，China	横断面研究 Cross-sectional study	2011―2014年美国国家健康与营养调查，≥ 60岁 National health and nutrition examination survey，USA (2011-2014)，≥ 60 years		597/1 198	NA
Shin等^[13], 2018, 美国 Shin et al^[13], 2018, USA	横断面研究Cross- sectional study	2012年韩国首尔、京畿道和仁川地区老年人的研究，≥ 65岁 Korea elderly study of the Seoul, Gyeonggi Province, and Incheon (2012)，≥ 65 years		77/239	NA
Skoczek-Rubińska A等^[14], 2021, 波兰 Skoczek-Rubińska A et al^[14], 2021, Poland	横断面研究Cross- sectional study	2014―2020年波兰绝经后妇女研究，（61.0±0.4）岁 Study of the postmenopausal women from the Poland (2014-2020)，（61.0±0.4）years		25/222	NA
Liu等^[15], 2021, 中国 Liu et al^[15], 2021, China	横断面研究Cross- sectional study	2018―2019年天津老年营养与认知队列研究，≥ 60岁 Tianjin elderly nutrition and cognition cohort study (2018-2019)，≥ 60 years		332/3 386	NA
Charisis等^[16], 2021, 希腊 Charisis et al^[16], 2021, Greece	队列研究Cohort study	希腊老龄化和饮食纵向调查，（73.1±5.0）岁 Hellenic longitudinal investigation of aging and diet study，（73.1±5.0）years		62/1 059	3.0
Hayden等^[17], 2017, 美国 Hayden et al^[17], 2017, USA	队列研究Cohort study	美国妇女健康倡议记忆研究，65~79岁 Women′s health initiative memory study, USA, 65-79 years		1 081/7 085	9.7
Zhang等^[18], 2021, 中国 Zhang et al^[18], 2021, China	队列研究Cohort study	2014―2018年中国胆固醇和氧固醇对阿尔茨海默病的作用和机制研究，50~70岁 Effects and mechanism investigation of cholesterol and oxysterol on Alzheimer′s disease study (2014-2018), China, 50-70 years		946/2 239	2.3

作者，年份，国家 Author, Year, Country	膳食评估工具 Dietaryassessment	E-DII ^①/DII ^②	认知评估工具 Cognitive functionassessment	OR/HR/RR值 value（95% CI）	文献质量/分 Quality of study/score
Sun等^[12], 2022，中国 Sun et al^[12], 2022，China	24 h膳食回顾调查 24 h dietary record	27（< 0；≥0）	DSST, CERAD-immediate/CERAD-delayed, 动物流畅性测试Animal fluency test	1.48（1.01~2.17）	8
Shin D等^[13], 2018, 美国 Shin D et al^[13], 2018, USA	24 h膳食回顾调查 24 h dietary record	32（-1.1 ± 1.0）	MMSE	6.32（1.18~33.78）	8
Skoczek-Rubińska A等^[14], 2021, 波兰 Skoczek-Rubińska A et al^[14], 2021, Poland	3 d膳食记录 3 day dietary record	45(-5.02~7.92）	MMSE	11.10（2.22~55.56）	8
Liu等^[15], 2021, 中国 Liu et al^[15], 2021, China	FFQ	22（< -0.26; -0.26~1.39; >1.39）	Petersen’s标准criteria	1.65（1.23~2.21）	9
Charisis等^[16], 2021, 希腊 Charisis et al^[16], 2021, Greece	FFQ	36（< -1.76; -1.76~0.21; >0.21）	DSM-IV-TR	2.89（1.20~6.96）	9
Hayden等^[17], 2017, 美国 Hayden et al^[17], 2017, USA	FFQ	32（< -2; -2~ < 0; 0~2; >2）	3MS, TMT A-B, CERAD, GDS-15	1.27（1.06~1.52）	8
Zhang等^[18], 2021, 中国 Zhang et al^[18], 2021, China	FFQ	24（< -1.53; -1.53~ < 0.21; 0.21~1.87; >1.87）	MMSE, MoCA	1.46（1.14~1.87）	8
注：DII，膳食炎症指数；E-DII，经能量调整的膳食炎症指数；DSST，数字符号替换测验；CERAD-immediate/CERAD-delayed，建立阿尔茨海默病注册中心的联盟(CERAD)Word学习子测试；MMSE，简易精神状态量表；DSM-IV-TR，美国精神疾病诊断与统计手册第四版修订版；3MS，改良的简易精神状态量表；MoCA，蒙特利尔认知评估量表；TMT A-B，连线测试A部分和B部分；GDS-15，老年抑郁量表-15；NA，缺乏有效值。 ①表示E-DII所含食物参数种类(得分范围); ②表示DII所含食物参数种类(得分范围)。 Note: DII, dietary inflammatory index; E-DII, energy-adjusted dietary inflammatory index; DSST, digit symbol substitution test; CERAD-immediate/CERAD-delayed, the consortium to establish a registry for Alzheimer′s disease word learning sub-test; MMSE, mini-mental state examination; DSM-IV-TR, diagnostic and statistical manual of mental disorders, 4th Edition, Text Revision; 3MS, modified mini-mental state examination; MoCA, Montreal cognitive assessment; TMT A-B, trail making test parts A and B; GDS-15, 15-item geriatric depression scale-short form; NA, not available. ①Category of food parameters in E-DII(range of score); ②Category of food parameters in DII(range of score).

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表 2 DII与认知障碍风险关系的亚组分析结果

Table 2. Subgroup analyses of the association between the DII score and the risk of cognitive impairment in middle-aged and elderly people

亚组 Subgroup	研究数量 Number of study	OR值value (95% CI)	I²值/% value	P(异质性)值 P (heterogeneity) value
总体 Total	7	1.62(1.27~2.05)	58	0.03
研究类型 Type of study
横断面研究 Cross-sectional study	4	2.07(1.24~3.48)	63	0.04
队列研究 Cohort study	3	1.42(1.12~1.79)	46	0.16
膳食评估工具 Dietary assessment tool
食物频率问卷 Food frequency questionnaire	4	1.46(1.21~1.77)	40	0.17
24 h膳食回顾法 24 h dietary record	2	2.41(0.63~9.22)	63	0.10
3 d膳食记录 3 day dietary record	1	11.10(2.22~55.50)	―	―
纳入DII计算的食物参数类别 The category of food parameters included in the DII
≥30	4	3.15(1.19~8.36)	77	＜0.05
< 30	3	1.52(1.29~1.81)	0	0.81
DII是否经能量调整 Whether the energy was adjusted in the DII
未调整 Unadjusted	2	1.70(0.79~3.69)	69	0.07
调整 Adjusted	5	1.71(1.26~2.33)	55	0.07
注：DII，膳食炎症指数；E-DII，经能量调整的膳食炎症指数。 1. “―”表示“不适用”。 Note: DII，dietary inflammatory index; E-DII, energy-adjusted dietary inflammatory index. 1. "―" stands for"not applicable".

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