Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, USA 29208.
Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, 13123 E 16th Ave, Aurora, CO, USA 80045.
Pediatr Diabetes. 2023;2023. doi: 10.1155/2023/6382663. Epub 2023 Sep 14.
We evaluated the association of household food insecurity (FI) with cognition in youth and young adults with type 1 diabetes (T1D) or type 2 diabetes (T2D).
In this cross-sectional study, age-adjusted scores for composite Fluid Cognition, and sub-domain scores for Receptive Language and Inhibitory Control and Attention, were modeled stratified by diabetes-type using linear regression, with FI in the past year as the predictor, controlling for covariates. Tests for processing speed, inhibitory control/attention, working memory, episodic memory, and cognitive flexibility were administered to measure composite Fluid Cognition score. The NIHT-CB Picture Vocabulary Test was used to assess Crystallized Cognition score and rapid identification of congruent versus noncongruent items were used to assess Inhibitory Control and Attention score.
The SEARCH for Diabetes in Youth study, representative of 5 U.S. states.
Included 1574 youth and young adults with T1D or T2D, mean age of 21 years, mean diabetes duration of 11 years, 51% non-Hispanic white, and 47% had higher HbA1c levels (>9% HbA1c).
Approximately 18% of the 1,240 participants with T1D and 31% of the 334 with T2D experienced FI. The food-insecure group with T1D had a lower composite Fluid Cognition score (β= -2.5, 95% confidence interval (CI)= -4.8, -0.1) and a lower Crystallized Cognition score (β= -3.4, CI= -5.6, -1.3) than food-secure peers. Findings were attenuated to non-significance after adjustment for demographics. Among T2D participants, no associations were observed. In participants with T1D effect modification by glycemic levels were found in the association between FI and composite Fluid Cognition score but adjustment for socioeconomic characteristics attenuated the interaction (p=0.0531).
Food-insecure youth and young adults with T1D or T2D did not have different cognition compared to those who were food-secure after adjustment for confounders. Longitudinal research is needed to further understand relations amongst these factors.
我们评估了家庭食物不安全（FI）与 1 型糖尿病（T1D）或 2 型糖尿病（T2D）青年和年轻成人认知之间的关联。
在这项横断面研究中，使用线性回归按糖尿病类型分层，对综合流体认知的年龄调整评分，以及接受性语言和抑制控制和注意力的子域评分进行建模，过去一年的 FI 作为预测因子，控制协变量。进行处理速度、抑制控制/注意力、工作记忆、情景记忆和认知灵活性测试，以测量综合流体认知评分。使用 NIH 基于图片的词汇测验（NIHT-CB）评估晶体认知评分，使用快速识别一致与不一致项目来评估抑制控制和注意力评分。
SESEARCH for Diabetes in Youth 研究，代表美国 5 个州。
纳入 1574 名患有 T1D 或 T2D 的青年和年轻成年人，平均年龄 21 岁，平均糖尿病病程 11 年，51%为非西班牙裔白人，47%糖化血红蛋白水平较高（>9%HbA1c）。
大约 18%的 1240 名 T1D 参与者和 31%的 334 名 T2D 参与者经历了食物不安全。T1D 组的食物不安全人群的综合流体认知评分较低（β= -2.5，95%置信区间[CI] = -4.8，-0.1），晶体认知评分较低（β= -3.4，CI = -5.6，-1.3）比食物安全的同龄人。在调整人口统计学因素后，发现结果不再具有统计学意义。在 T2D 参与者中，未观察到相关性。在 T1D 参与者中，发现 FI 与综合流体认知评分之间的关联存在血糖水平的效应修饰，但调整社会经济特征减弱了这种相互作用（p=0.0531）。
在调整混杂因素后，与食物安全的 T1D 或 T2D 青年和年轻成年人相比，食物不安全的 T1D 或 T2D 青年和年轻成年人的认知没有差异。需要进行纵向研究以进一步了解这些因素之间的关系。
