| 刘一兵,杜文雯,曹秋野,王惠君,苏畅,何宇纳,汲金刚,李静,贾小芳.中老年人膳食胆碱摄入量轨迹与认知功能的关联[J].Chinese journal of Epidemiology,2025,46(2):210-217 |
| 中老年人膳食胆碱摄入量轨迹与认知功能的关联 |
| Association between dietary choline intake trajectories and cognitive function in middle-aged and older population |
| Received:September 06, 2024 |
| DOI：10.3760/cma.j.cn112338-20240906-00559 |
| KeyWord: 胆碱 认知功能 中老年人 队列研究 变化轨迹 |
| English Key Word: Choline Cognitive function Middle-aged and older population Cohort study Trajectory |
| FundProject:美国国立卫生研究院经费（1989-2019年：R01-HD30880、DK056350、R24-HD050924、R01-HD38700）；国家财政经费（2015-2017年：13103110700015005） |
| Author Name | Affiliation | E-mail | | Liu Yibing | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | Du Wenwen | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Key Laboratory of Public Nutrition and Health, National Health Commission, Beijing 100050, China | | | Cao Qiuye | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Key Laboratory of Public Nutrition and Health, National Health Commission, Beijing 100050, China | | | Wang Huijun | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Key Laboratory of Public Nutrition and Health, National Health Commission, Beijing 100050, China | | | Su Chang | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Key Laboratory of Public Nutrition and Health, National Health Commission, Beijing 100050, China | | | He Yuna | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Key Laboratory of Public Nutrition and Health, National Health Commission, Beijing 100050, China | | | Ji Jingang | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | Li Jing | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | Jia Xiaofang | National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Key Laboratory of Public Nutrition and Health, National Health Commission, Beijing 100050, China | jiaxf@ninh.chinacdc.cn |
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| Abstract: |
| 目的 识别中老年人膳食胆碱摄入量轨迹，并分析其与认知功能的纵向关联。方法 选取中国健康与营养调查1997-2018年至少具有2轮人口经济学、生活方式、疾病史、认知功能、膳食调查及体格测量数据且1991-2015年至少具有3轮膳食调查的55~79岁居民的完整调查数据。膳食调查采取3天24小时膳食回顾结合家庭称重记账法。认知评估采用认知功能电话筛查量表的部分条目。采用基于群组的单变量轨迹模型识别胆碱摄入量变化轨迹，采用三水平线性混合效应模型或三水平logistic混合效应模型分析轨迹组与认知功能的关系。按性别和基线年龄进行亚组分析。结果 全人群识别了4条膳食胆碱摄入量轨迹，依次命名为低摄入量平稳组（61.0%）、中等摄入量平稳组（23.9%）、中等摄入量缓慢下降组（11.2%）和高摄入量平稳组（3.9%）。各亚组均识别出3条轨迹。低摄入量平稳组在全人群及不同亚组均占60%以上，尤其是女性和55~59岁组。调整协变量后，与低摄入量平稳组相比，全人群中等摄入量平稳组、中等摄入量缓慢下降组和高摄入量平稳组总体认知功能评分分别高0.54（95%CI：0.26~0.82）、0.77（95%CI：0.36~1.18）和0.85（95%CI：0.21~1.48）分。全人群膳食胆碱中等摄入量平稳组、男性中等摄入量平稳组、女性中等摄入量略微升高组、基线55~59岁中等摄入量缓慢升高组发生认知功能低下的可能性与低摄入量平稳组相比降低18.4%（OR=0.816，95%CI：0.709~0.939）、17.6%（OR=0.824，95%CI：0.680~0.998）、24.4%（OR=0.756，95%CI：0.589~0.970）、22.4%（OR=0.776，95%CI：0.623~0.968）。结论 55~79岁中老年人膳食胆碱摄入量普遍较低。长期较低的胆碱摄入量对中老年总体认知功能具有不利影响，可能增加认知功能减退的风险。建议中老年人适当增加富含胆碱的食物摄入。 |
| English Abstract: |
| Objective To identify the trajectories of dietary choline intake in middle-aged and older population, and to analyze its longitudinal association with cognitive function. Methods Subjects aged 55 to 79 years with at least two rounds of completed population economics, lifestyle, disease history, cognitive function, dietary assessments and physical measurements in 1997-2018 and those with at least three rounds of dietary measures in 1991-2015 were selected from the China Health and Nutrition Survey. Dietary survey was conducted using three consecutive 24-hour dietary recalls combined with a weighing inventory at the household level. Cognitive assessment was performed using part of the Telephone Interview for Cognitive Status Scale. Group-based univariate trajectory modeling was used to identify trajectory of choline intake, and three-level linear mixed-effects models or three-level logistic mixed-effects models was employed to analyze the relationship between trajectory groups and cognitive function. Subgroup analyses were conducted by gender and age at baseline. Results Four trajectories of dietary choline intake were identified in the whole population, named as low-intake-stable group (61.0%), medium-intake-stable group (23.9%), medium-intake-slowly-declined group (11.2%), and high-intake-stable group (3.9%). Three trajectories were identified for each subgroup. Low-intake-stable group accounted for more than 60% in total population as well as each subgroup, especially in women and 55-59 years group. After adjusting for covariates, global cognitive scores were 0.54 (95%CI: 0.26-0.82), 0.77 (95%CI: 0.36-1.18), and 0.85 (95%CI: 0.21-1.48) points higher in medium-intake-stable, medium-intake- slowly-declined and high-intake-stable groups in the whole population, respectively, compared with the low-intake-stable group. The likelihoods of cognitive decline were 18.4% (OR=0.816,95%CI: 0.709-0.939), 17.6% (OR=0.824, 95%CI: 0.680-0.998), 24.4% (OR=0.756, 95%CI: 0.589-0.970) and 22.4% (OR=0.776,95%CI: 0.623-0.968) lower in medium-intake-stable group of dietary choline in the whole population, medium-intake-stable group in males, medium-intake-slightly-increased group in females and medium-intake-slowly-increased group in 55-59 years at baseline than in low-intake-stable group, respectively. Conclusions Dietary choline intake is generally lower in the Chinese population aged 55-79 years. Long-term lower choline intake has a negative impact on cognitive function in middle-aged and older adults and may increase the risk of cognitive decline. The increment in the consumption of choline-enriched foods should be recommended. |
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