基于降秩回归的膳食模式与中国四省55岁及以上人群抑郁症状的关联性

Association between dietary patterns and depressive symptom based on reduced rank regression in people aged 55 and above in 4 provinces of China

目的通过降秩回归法了解中国55岁及以上人群抑郁症状相关膳食模式及其与抑郁症状关联程度。方法采用分层多阶段整群随机抽样的方法,于2018—2019年在河北、浙江、陕西及湖南四省选取11497名参加"神经系统疾病专病社区队列研究"基线调查的55岁及以上人群作为研究对象[年龄为(67.3±7.6)岁,其中男性占43.1%],收集人口学特征、行为生活方式、疾病史及用药情况等个人信息,利用食物频率表收集膳食摄入信息,利用老年抑郁量表筛查是否具有抑郁症状,切点值为11。采用降秩回归法,分性别提取抑郁相关膳食模式,通过Logistic回归分析膳食模式与抑郁症状的关联程度。结果在男性中,抑郁症状相关膳食模式以油炸面食、畜肉、加工肉制品、动物内脏、松花蛋摄入频率较高,液态奶/奶粉/奶酪、蛋类(除松花蛋)、坚果摄入频率较低为特征。在女性中,抑郁症状相关膳食模式以油炸面食、畜肉、加工肉制品、动物内脏、松花蛋摄入频率较高,杂粮、水果、液态奶/奶粉/奶酪、蛋类(除松花蛋)摄入频率较低为特征。该膳食模式评分最高的四分位组有抑郁症状的风险显著高于最低的四分位组(男性:OR=3.498,95%CI 2.624~4.663,P<0.001;女性:OR=3.853,95%CI 3.002~4.944,P<0.001)。结论2018—2019年中国55岁及以上人群抑郁症状相关膳食模式以油炸面食、畜肉、加工肉制品、动物内脏、松花蛋摄入频率较高,液态奶/奶粉/奶酪、蛋类(除松花蛋)摄入频率较低为特征,该膳食模式得分与抑郁症状呈显著正相关。

OBJECTIVE To investigate the dietary patterns related to depressive symptoms based on reduced rank regression in people aged 55 and above in 4 provinces of China and the degree of association between this dietary pattern and depressive symptoms.METHODS Stratified,multi-stage,cluster and random sampling method was used to collect personal information such as demographic characteristics,behavioral lifestyles,disease history and medicine use in Chinese aged 55 and above who participated in the baseline survey of"Community-based Cohort Study on Nervous System Diseases"project conducted in 2018 and 2019 in Hebei,Zhejiang,Shaanxi and Hunan Provinces.Food frequency questionnaire was used to obtain dietary data.Depressive symptom was assessed by geriatric depression scale with a cut-off of 11.Participants who have incomplete demographic information,dietary data or scores of geriatric depression scale,and those whose intake frequency of each food-group>99.5%were excluded.A total of 11497 participants,43.1%of whom were male,were involved in this study with average age of(67.3±7.6)years.The reduced rank regression method was used to extract depressive symptoms-related dietary patterns by gender,and the degree of association between dietary patterns and depressive symptom was analyzed by logistic regression.RESULTS Among males,the depressive symptoms-related dietary pattern was characterized by the higher intake frequency of fried flour-made food,meat,processed meat,animal offal,and preserved eggs,and the lower intake frequency of liquid milk/milk power/cheese,fresh eggs(except preserved eggs)and nut.Among females,the depressive symptoms-related dietary pattern was characterized by the higher intake frequency of fried flour-made food,meat,processed meat,animal offal and preserved eggs,and the lower intake frequency of coarse cereals,fruits,liquid milk/milk power/cheese and fresh eggs(except preserved eggs).The highest quartile group of the dietary pattern score had a significantly higher risk of depressive symptom than the lowest quartile group(OR=3.498,95%CI 2.624-4.663,P<0.001 for males;OR=3.853,95%CI 3.002-4.944,P<0.001 for females).CONCLUSION The depressive symptoms-related dietary pattern is characterized by the higher intake frequency of fried flour-made food,meat,processed meat,animal offal and preserved eggs,and the lower intake frequency of liquid milk/milk power/cheese and fresh eggs(except preserved eggs)in the Chinese aged 55 and above.The score of this dietary pattern is significantly positively correlated with depressive symptom.