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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

王丽丽, 赵海峰. 膳食炎症指数与中老年人认知障碍发生风险的Meta分析[J]. 中华疾病控制杂志, 2024, 28(2): 209-214. doi: 10.16462/j.cnki.zhjbkz.2024.02.013
引用本文: 王丽丽, 赵海峰. 膳食炎症指数与中老年人认知障碍发生风险的Meta分析[J]. 中华疾病控制杂志, 2024, 28(2): 209-214. doi: 10.16462/j.cnki.zhjbkz.2024.02.013
WANG Lili, ZHAO Haifeng. Dietary inflammatory index and the risk of cognitive impairment in middle-aged and elderly people: a meta-analysis[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(2): 209-214. doi: 10.16462/j.cnki.zhjbkz.2024.02.013
Citation: WANG Lili, ZHAO Haifeng. Dietary inflammatory index and the risk of cognitive impairment in middle-aged and elderly people: a meta-analysis[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(2): 209-214. 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
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

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

Funds: 

National Natural Science Foundation of China 81973047

More Information
  • 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。
  • 图  1  文献筛选流程图

    Figure  1.  Literature screening flow chart

    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

    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

    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 /DII 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).
    下载: 导出CSV

    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".
    下载: 导出CSV
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  • 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

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