2型糖尿病轻度认知障碍患者膳食摄入状况及影响因素分析

DIETARY INTAKES AND INFLUENCING FACTORS OF MILD COGNITIVE IMPAIREMENT IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

目的探究2型糖尿病(Type 2 diabetes mellitus,T2DM)轻度认知障碍(Mild cognitive impairment,MCI)患者膳食摄入状况及影响因素。方法选取潍坊市某三甲医院确诊T2DM患者300(18~80岁)例,采用半定量食物频率法调查患者膳食摄入并计算营养素摄入量,蒙特利尔认知评估量表和简易智能精神状态检查量表评估患者认知功能。采用t检验、χ^(2)检验和Logistic回归分析对调查数据进行统计分析。结果在300名T2DM患者中,130(43.3%)人患有MCI,170(56.7%)人认知功能正常。与非MCI组比,MCI组谷薯类、蔬菜、水果、水产品、奶及奶制品摄入量较低(P<0.05),畜禽肉、油脂类摄入量较高(P<0.05)。此外,与非MCI组相比,MCI组脂肪摄入量较高(P<0.05),蛋白质、碳水化合物、膳食纤维、维生素B_(1)、维生素C、维生素E、钾及铁摄入量较低(P<0.05)。T2DM患者脂肪、碳水化合物和蛋白质平均供能比分别为36.5%、47.2%和15.4%,MCI组脂肪供能比较高(P<0.05),碳水化合物供能比较低(P<0.05);植物性食物提供脂肪百分比和动物性食物提供脂肪百分比分别为46.8%和53.2%,MCI组动物性食物提供脂肪较高,植物性食物提供脂肪较低(P<0.05)。高龄、T2DM病程长和高脂肪摄入量是MCI的危险因素,OR值分别为12.711、3.291和5.192,教育程度高、锻炼和适量碳水化合物摄入量是MCI的保护因素,OR值分别为0.222、0.283和0.206。结论T2DM合并MCI患者膳食摄入不合理,而具有脂肪、碳水化合物和蛋白质供能比适宜特征的饮食可能有利于维持T2DM患者认知功能;高龄、教育程度低、T2DM病程长、缺乏锻炼均可加大T2DM患者发生MCI风险,需早发现,并积极防治。

Objective To investigate the dietary intakes and influencing factors of mild cognitive impairment(MCI)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 300 T2DM patients(aged 18 to 80)diagnosed in a first ranking hospital in Weifang were selected.The dietary intakes were investigated using the semi-quantitative food frequency method and their nutrient intakes were calculated.The cognitive function was evaluated by Montreal Cognitive Assessment Scale and mini mental state examination.Results Among the 300 T2DM patients,130(43.3%)had MCI and 170(56.7%)had normal cognitive function.The intakes of cereals and tubers,vegetables,fruits,aquatic products,milk and milk products in the MCI group were lower than in the non-MCI group(P<0.05),while the intakes of livestock and poultry meat and oil were higher(P<0.05).In addition,the intake of fat(P<0.05)was higher,and intakes of protein,carbohydrates,dietary fiber,vitamin B_(1),vitamin C,vitamin E,potassium and iron were lower than in the non-MCI group(P<0.05).The contributing ratio of fat,protein and carbohydrate to total energy among the T2DM patients averaged 36.5%,15.4%and 47.2%,respectively.The contributing percentages of fat from plant foods and animal foods were 46.8%and 53.2%.In the MCI group,the contributing percentage of fat from animal foods was higher(P<0.05).Advanced age,a long course of T2DM and high fat intake were risk factors for MCI,and OR values were 12.711,3.291 and 5.192,respectively.High levels of education,exercise and moderate carbohydrate intake could help protect against MCI,and OR values were 0.222,0.283 and 0.206,respectively.Conclusion The dietary intakes of patients with T2DM suffered with MCI are improper.Diets with appropriate ratios of fat,carbohydrates and protein can help maintain the cognitive function of T2DM patients.Advanced age,poor education,long courses of T2DM and lack of exercise can increase the risk of MCI in T2DM patients.Early detection and active prevention are required.