膳食叶黄素和玉米黄质与老年人低认知功能的剂量-反应关系

Dose-response relationship between dietary lutein and zeaxanthin intake and low cognitive function in the elderly

目的 使用限制性立方样条回归模型探讨膳食叶黄素和玉米黄质摄入量与老年人低认知功能的剂量-反应关系。方法 基于美国国家健康与营养调查(National Health and Nutrition Examination Survey, NHANES)数据库,选取年龄≥60岁且具有完整认知功能测试的老年人群。应用Logistic回归模型和限制性立方样条回归模型评估膳食叶黄素和玉米黄质摄入量与老年人低认知功能的关联和剂量-反应关系。结果 共纳入2 695名研究对象,其中认知功能正常组1 629例,低认知功能组1 066例。与认知功能正常组比较,低认知功能组年龄在70~<80岁和≥80岁的人群所占比例明显较高,糖尿病及中风发生比例也明显增高,此外,膳食叶黄素和玉米黄质摄入量以及叶黄素和玉米黄质总摄入量明显降低,差异均有统计学意义(P<0.05)。限制性立方样条回归分析显示,以性别分层,随着叶黄素和玉米黄质总摄入量的持续增加,男性和女性认知功能下降风险均呈近似“L”形的非线性变化(P非线性<0.01),但是在同样“L”形趋势的情况下,叶黄素和玉米黄质总摄入量是男性认知功能下降的易感因素。结论 叶黄素和玉米黄质总摄入量与老年人认知功能下降风险呈近似“L”形的非线性剂量-反应关系。

Objective To explore the dose-response relationship between dietary lutein and zeaxanthin intake and low cognitive function in the elderly using a restricted cubic spline regression model.Methods Based on the National Health and Nutrition Examination Survey(NHANES)database,the subjects aged≥60 years with complete cognitive function tests were included.Logistic regression model and restricted cubic spline regression model were used to evaluate the association and the dose-response relationship between dietary lutein and zeaxanthin intake and low cognitive function in the elderly.Results A total of 2695 subjects were included,including 1629 cases in normal cognitive function group and 1066 cases in low cognitive function group.The proportions of subjects aged 70-<80 years and≥80 years were significantly higher in low cognitive function group than in normal cognitive function group(P<0.05),and the incidences of diabetes and stroke were also significantly higher(P<0.05),while the intake of dietary lutein and zeaxanthin and the total intake of dietary lutein and zeaxanthin were significantly lower(P<0.05).The restricted cubic spline regression analysis showed that the risk of cognitive function decline in both male and female showed an approximate"L-shaped"nonlinear change with the continuous increase of total lutein and zeaxanthin intake after gender stratification(P non-linearity<0.01).However,under the same"L-shaped"trend,the cognitive function decline was more susceptible to the total intake of lutein and zeaxanthin in the male.Conclusion The total dietary lutein and zeaxanthin intake is associated with the risk of cognitive function decline in the elderly in a nonlinear"L-shaped"dose-response relationship.