摘要
目的探讨叶酸、维生素B_(12)多维度营养评价指标与社区老年人认知功能轻度受损之间的相关关系。方法横断面研究,在石家庄市3个平行社区招募60岁及以上老年人,进行基本情况和过去1年的半定量膳食频数问卷(FFQ)调查,采用蒙特利尔认知评估量表(MoCA)评估认知功能水平,按照《2018中国痴呆与认知障碍诊治指南》推荐的以教育程度分类的评价标准分为认知功能正常和轻度认知障碍两组。采用电化学发光免疫检测技术测定血清叶酸、维生素B_(12)和红细胞叶酸的水平,采用循环酶法测定血清同型半胱氨酸浓度,并结合FFQ调查和食物成分表计算FFQ调查中膳食叶酸和维生素B_(12)的摄入量。采用Logistic回归模型分析叶酸、维生素B_(12)多维度营养状况指标与轻度认知障碍的相关性。结果共纳入研究对象537例,其中认知正常老年人379例(70.6%),轻度认知障碍老年人158例(29.4%)。轻度认知障碍老年人膳食维生素B_(12)摄入量和红细胞叶酸浓度低于正常认知老年人[中位数(四分位数):18.9(11.0,32.9)μg/d比20.1(14.2,34.8)μg/d,Z=2.010,P=0.044;359.4(304.2,413.4)μg/L比378.4(322.5,433.1)μg/L,Z=2.168,P=0.031]。轻度认知障碍老年人体内叶酸缺乏率高于正常认知老年人[17(10.8%)比22(5.8%),χ^(2)=4.065,P=0.044]。校正年龄、性别、能量摄入量后,膳食维生素B_(12)摄入量和红细胞叶酸浓度对老年人轻度认知受损的OR(95%CI)值分别为0.99(0.987~0.996)(P=0.039)和0.98(0.974~0.993)(P=0.021),叶酸缺乏对轻度认知受损的OR(95%CI)值为1.96(1.009~3.795)(P=0.046)。结论长期的高膳食维生素B_(12)摄入和较好的叶酸体内营养储备状态与社区老年人的轻度认知功能受损风险呈负向关联,而反映叶酸、维生素B_(12)短期营养状况的指标可能与轻度认知功能损伤的关系不大。
Objective To explore the correlation between multidimensional nutritional evaluation indexes of folate and vitamin B_(12) and mild cognitive impairment in community-dwelling older adults.Methods In this study,cross-sectional study design was used,and the elderly people aged 60 years and above were recruited from three parallel communities in Shijiazhuang City.The survey was conducted including basic information questionnaire and semi-quantified food frequency questionnaires(FFQ)in the past year.The Montreal Cognitive Assessment Scale(MoCA)assessed the cognitive function.The subjects were divided into two groups of normal cognition and mild cognitive impairment according to the criteria categorized by education levels recommended by the 2018 China Dementia and Cognitive Impairment Diagnosis and Treatment Guidelines.Serum folate,vitamin B_(12) and erythrocyte folate levels were measured by electrochemiluminescence immunoassay,serum homocysteine concentrations were measured by circulating enzyme assay,dietary folate and vitamin B_(12) intake was calculated by FFQ survey and food composition tables.Logistic regression models were used to analyze the association between multidimensional nutritional indicators of folate and vitamin B_(12) and mild cognitive impairment.Results A total of 537 subjects were included in the study,involving 379(70.6%)with normal cognition and 158(29.4%)with mild cognitive impairment.Dietary vitamin B_(12) intake and erythrocyte folate concentration was significantly lower in the elderly with mild cognitive impairment than in those with normal cognition[median(interguartile):18.9(11.0,32.9)μg/d vs.20.1(14.2,34.8)μg/d,Z=2.010,P=0.044;median:359.4(304.2,413.4)μg/L vs.378.4(322.5,433.1)μg/L,Z=2.168,P=0.031].The elderly with mild cognitive impairment had a higher prevalence of folate deficiency than those with normal cognition[17(10.8%)vs.22(5.8%),χ^(2)=4.065,P=0.044].After adjusting for age,sex,and energy intake,the OR(95%CI)values for dietary vitamin B_(12) intake and erythrocyte folate concentration in relation to mild cognitive impairment in the elderly were 0.99(0.987,0.996)(P=0.039)and 0.98(0.974,0.993)(P=0.021),respectively.The OR(95%CI)values for folate deficiency for mild cognitive impairment was 1.96(1.009,3.795)(P=0.046).Conclusions Long-term high dietary vitamin B_(12) intake and better in vivo nutritional deposition of folate were negatively associated with mild cognitive impairment in community-dwelling elderly adults,whereas indicators reflecting the short-term nutritional status of folate and vitamin B_(12) may be less associated with mild cognitive impairment.
作者
柳桢
贾珊珊
满青青
秦斌
张坚
Liu Zhen;Jia Shanshan;Man Qingqing;Qin Bin;Zhang Jian(National Institute for Nutrition and Health,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Key Laboratory of Trace Element Nutrition of National Health Commission,Beijing 102206,China;Department of Neurology,Beijing Hospital,National Genter of Gerontology/Institute of Geriatric Medicine,Chinese Acadcmy of Medical Sciences,Beijing 100730,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2024年第10期1331-1337,共7页
Chinese Journal of Geriatrics
基金
国家自然科学基金(81372991)。
