社区老年人群膳食中锰摄入水平与痴呆发病风险的关联研究

Relationship between Dietary Manganese Intake and Incidence Risk of Dementia in Community Elderly

目的探讨社区老年人膳食中锰摄入量与痴呆发病风险间的关联。方法纳入1 483例符合入选标准的上海市静安区社区老年居民,平均随访5.3年。根据基线膳食频率问卷计算锰日均摄入量,将研究对象按照锰日均摄入量分为:<3.2 mg·d^-1组、3.2~3.7 mg·d^-1组、3.7~4.16 mg·d^-1组和> 4.6 mg·d^-1组。依据美国精神病协会精神障碍与统计手册(DSM-IV)确立痴呆诊断。使用COX多因素比例风险模型比较不同锰摄入量对痴呆发生风险的影响。结果锰日均摄入量由低至高的4组痴呆年发病率依次为2.61%、1.21%、0.65%和0.91%(P <0.001)。与锰日均摄入量3.7~4.16 mg·d^-1组比较,锰日均摄入量> 4.16 mg·d^-1组人群痴呆发病风险较高(HR=2.54)。在锰摄入量较低的两个组痴呆发病风险也有增高的趋势(<3.2 mg·d^-1,HR=1.81;3.2~3.7 mg·d^-1,HR=1.52)。结论膳食中锰摄入量与痴呆发病间存在U型效应曲线,社区老年人日常生活中锰摄入量过高或过低都可能增加痴呆发病风险。

Aim To explore the association between dietary manganese intake and the risk of dementia in community elderly.Methods 1483 people who meet inclusion and exclusion criteria were recruited,and were followed for averagely 5.3 years.The average daily intake of manganese was calculated by Dietary Frequency Questionnaire.Study subjects were divided into four groups by daily manganese intake: a ≤3.2 mg·d^-1 group,a( 3.2-3.7) mg·d^-1 group,a( 3.7-4.16) mg·d^-1 group,a > 4.16 mg·d^-1 group.Dementia was diagnosed by Diagnostic and Statistical Manual of Mental Disorders Ⅳ.Cox proportional hazards model was used to compare the effects of different manganese intakes on the risk of dementia.Results The annual incidence rates of dementia in 4 groups with average daily intake of manganese from low to high were 2.61%,1.21%,0.65% and 0.91%( P < 0.001).Subgroup with daily average intake of manganese greater than 4.16 mg·d^-1 had a higher dementia risk( HR = 2.54) than the control group( with daily average intake of 3.7 mg·d^-1 to 4.16 mg·d^-1).The estimated HRs for the two groups with lower manganese intake have the same trend(< 3.2 mg·d^-1,HR =1.81;3.2-3.7 mg·d^-1,HR = 1.52).Conclusion The association between dietary manganese intake and dementia incidence risk may be a U-shaped curve.Community elderly who intake too much or too little high-manganese foods might have higher risk of dementia.