Zhuang Yan, Wang Xinmei, Zhang Xuanrui, Fang Qian, Zhang Xinyi, Song Yan
Medical School (School of Nursing), Nantong University, Nantong, Jiangsu, China.
Blood Purification Center, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
Front Nutr. 2023 Aug 3;10:1218592. doi: 10.3389/fnut.2023.1218592. eCollection 2023.
Dietary patterns were shown to be closely related to inflammation, which was independently associated with cognitive impairment (CI) in patients undergoing hemodialysis (HD). However, it remains unclear the influence of dietary patterns derived from inflammation on CI in this population. This study aimed to examine the association between dietary patterns derived from C-reactive protein (CRP) and interleukin-6 (IL-6) and CI in patients undergoing HD.
Dietary intake was obtained from the simplified quantitative food frequency questionnaire. Reduced rank regression (RRR) was used to extract two dietary patterns, with IL-6 and CRP as response variables. Cognitive function was examined by the Montreal Cognitive Assessment (Beijing version). Venous blood was drawn for measuring IL-6 and CRP levels. Multivariable logistic regression was used to investigate the association between dietary patterns and CI.
Dietary pattern derived from IL-6 was not significantly associated with CI. The third quartile of dietary pattern, which used CRP as the response variable, significantly contributed to the increased risk of CI (AOR 8.62, 95% CI 1.47-50.67) after controlling age, sex, education level, marital status, and residential pattern (-for-trend = 0.028). After considering hypertension and diabetes, physical activity level, anxiety and depression, smoking and drinking status, social support, energy intake, and the dietary pattern derived from IL-6 (-for-trend = 0.026), the relationship between the dietary pattern derived from CRP and CI remained significant (AOR 14.54, 95% CI 1.40-151.13).
Dietary pattern associated with high CRP level, including high intake of rice, liquor, fruit, tea and coffee and low intake of dark vegetables and juice, contributed to the increased risk of CI. The association between the consumption of seafood, sweet beverages, and alcohol and CI is yet to be established. However, they may be dietary contributing factors to inflammation in patients undergoing HD.
饮食模式与炎症密切相关,炎症与接受血液透析(HD)的患者的认知障碍(CI)独立相关。然而,炎症衍生的饮食模式对该人群CI的影响尚不清楚。本研究旨在探讨由C反应蛋白(CRP)和白细胞介素-6(IL-6)衍生的饮食模式与HD患者CI之间的关联。
通过简化的定量食物频率问卷获取饮食摄入量。采用降秩回归(RRR)以IL-6和CRP作为响应变量提取两种饮食模式。通过蒙特利尔认知评估(北京版)检查认知功能。抽取静脉血测量IL-6和CRP水平。采用多变量逻辑回归研究饮食模式与CI之间的关联。
由IL-6衍生的饮食模式与CI无显著关联。以CRP作为响应变量的饮食模式的第三个四分位数在控制年龄、性别、教育水平、婚姻状况和居住模式后显著增加了CI风险(调整后比值比8.62,95%置信区间1.47-50.67)(趋势检验P=0.028)。在考虑高血压和糖尿病、身体活动水平、焦虑和抑郁、吸烟和饮酒状况、社会支持、能量摄入以及由IL-6衍生的饮食模式后(趋势检验P=0.026),由CRP衍生的饮食模式与CI之间的关系仍然显著(调整后比值比14.54,95%置信区间1.40-151.13)。
与高CRP水平相关的饮食模式,包括大米、酒类、水果、茶和咖啡的高摄入量以及深色蔬菜和果汁的低摄入量,增加了CI风险。海鲜、甜饮料和酒精消费与CI之间的关联尚未确立。然而,它们可能是HD患者炎症的饮食促成因素。