膳食模式与老年人血清同型半胱氨酸水平的相关性

Objective To explore the effects of sociodemographic factors, dietary patterns and folate biochemical levels on the serum homocysteine (HCY) level in the elderly. Methods A total of 4,319 elderly people aged ≥60 years in Baodi District, Tianjin were selected as the research objects. Serum HCY > 15 μmol/L was defined as hyperhomocysteinemia (HHCY). According to the serum HCY level, they were divided into the HHCY group (1,477 cases) and the normal group (2,842 cases). Dietary information was collected by the food frequency method, and dietary patterns were extracted by principal component analysis to analyze the effects of different dietary patterns on the serum folate and HCY levels. SPSS 25.0 statistical software was used for data analysis. According to the data type, t-test, one-way ANOVA or χ² test was used for comparison between groups respectively. Results Compared with the normal group, the HHCY group was older, had more males, a higher BMI and a lower serum folate level, and the differences were all statistically significant (all P < 0.05). Three dietary patterns were extracted by principal component analysis. Among them, the ovo-lacto-vegetarian dietary pattern was beneficial for reducing the serum HCY level and increasing the serum folate level (both P < 0.001). The animal dietary pattern was related to the decrease in the serum folate level (P < 0.001), and had no significant relationship with the serum HCY level. The legume dietary pattern was related to the decrease in the serum HCY level (P < 0.05), and had no significant relationship with the serum folate level. Conclusion It is recommended that the rural elderly in Tianjin appropriately increase the intake of vegetables, fruits, eggs, dairy products, nuts and seeds, soybeans and other legumes in their daily diet; at the same time, moderately limit the intake of animal foods and fried foods, which is beneficial for reducing the HCY level and protecting the cardiovascular and cerebrovascular health.

目的 探讨社会人口因素、膳食模式、叶酸生化水平对老年人血清同型半胱氨酸（HCY）水平的影响。方法 选择天津市宝坻区4 319例年龄≥60岁的老年人作为研究对象。血清HCY＞15μmol/L判定为高同型半胱氨酸血症（HHCY）。根据血清HCY水平分为HHCY组（1 477例）和正常组（2 842例）。采用食物频率法收集饮食信息，主成分分析法提取膳食模式，分析不同膳食模式对血清叶酸和HCY水平的影响。采用SPSS 25.0统计软件进行数据分析。根据数据类型，分别采用t检验、单因素方差分析或者χ~2检验进行组间比较。结果 与正常组相比，HHCY组年龄更大，男性更多，BMI更高，血清叶酸水平更低，差异均有统计学意义（均P＜0.05）。主成分分析提取了三种膳食模式，其中蛋奶素食膳食模式有利于降低血清HCY水平，升高血清叶酸水平（均P＜0.001）。动物膳食模式与血清叶酸水平降低有关（P＜0.001）,与血清HCY水平无显著关系。豆类膳食模式与血清HCY水平降低有关（P＜0.05）,与血清叶酸水平无显著关系。结论 建议天津市农村老年人在日常的膳食中适量增加蔬菜、水果、蛋类、奶制品、坚果种子、大豆及其他豆类等的摄入；同时适度限制动物性食品及油炸食品摄入，有利于降低HCY水平，保护心脑血管健康。