膳食炎症指数与中老年人认知障碍发生风险的Meta分析

Dietary inflammatory index and the risk of cognitive impairment in middle-aged and elderly people:a meta-analysis

目的系统评价膳食炎症指数(dietary inflammatory index,DII)与中老年人认知障碍发生风险的关系。方法检索中国知网、万方、维普、生物医学文献、PubMed、Science Direct、Springer、Cochrane Library、Embase等数据库从建库至2022年6月20日发表的关于DII与中老年人认知障碍的文献,按照纳入、排除标准严格筛选。采用纽卡斯尔-渥太华(Newcastle-Ottawa scale,NOS)量表及美国卫生保健质量和研究机构(Agency for Healthcare Research and Quality,AHRQ)推荐的横断面研究质量评价量表评估筛选后的文献质量,采用Revman 5.4软件和Stata 15.1软件进行Meta分析,随机效应模型汇总OR值和95%CI。结果共纳入7项研究,包含15428名参与者。Meta分析显示,与最低位数DII相比,最高位数DII与中老年人认知障碍风险增加相关(OR=1.62,95%CI:1.27~2.05,P<0.01),尤其是在使用FFQ调查膳食数据(OR=1.46,95%CI:1.21~1.77,P=0.17)及计算能量调整后的DII的研究(OR=1.71,95%CI:1.26~2.33,P=0.07)中。结论与抗炎饮食相比,高促炎饮食可能与中老年人认知障碍的风险增加有关,受纳入研究数量和质量的限制,未来仍需更多高质量研究予以验证。

Objective To evaluate the relationship between dietary inflammatory index(DII)and the risk of cognitive impairment in middle-aged and elderly people.Methods We systematically searched CNKI,Cqvip,Wanfang Data,SinoMed,PubMed,Science Direct,Springer,Cochrane Library and Embase databases from inception to June 20,2022,screened studies based on the inclusion and exclusion criteria.The quality of the studies included was assessed by the Newcastle-Ottawa scale and the Agency for Healthcare Research and Quality methodology checklist.Revman 5.4 and Stata 15.1 software were used for meta-analysis.The pooled odds ratio(OR)and 95%confidence intervals(CI)were calculated using random-effects model.Results A total of 7 articles with 15428 participants were included.In the present meta-analysis,the DII was associated with the risk of cognitive impairment(OR=1.62,95%CI:1.27-2.05,P<0.01),especially in studies that used food frequency questionnaire(FFQ)(OR=1.46,95%CI:1.21-1.77,P=0.17)and adjusted energy intake(OR=1.71,95%CI:1.26-2.33,P=0.07).Conclusions Compared with the low DII diet,the high DII diet is associated with an increased risk of cognitive impairment.Due to limited number and quality of included studies,the above-mentioned conclusion still needs to be verified by more high-quality studies.