Characteristics of Inhibitory Control in Type 2 Diabetic Patients with Different Levels of Dietary Adherence

doi:10.12114/j.issn.1007-9572.2020.00.469

Abstract

Abstract: Background　Diet therapy is the basis of diabetes treatment，but the overall dietary adherence in type 2 diabetics is poor. Inhibitory control，a cognitive function closely related to diet behavior regulation，has been concerned in recent years. It is of great significance to explore its relationship with diet adherence to improve the dietary adherence in such patients. Objective　To explore the characteristics of inhibitory control by dietary adherence and their relationship in type 2 diabetic patients，to develop an inhibitory control training program based on dietary adherence to improve dietary adherence in such patients. Methods　Using convenient sampling method，190 type 2 diabetic patients from Department of Endocrinology，First Affiliated Hospital of Anhui Medical University were selected from May to September 2019. According to the score of the Food Control Behavior Scale（FCBS），they were divided into high，medium and low dietary adherence groups. Stop signal task was used to measure the no-stop signal response time（NSRT） and stop signal response time（SSRT） in three groups under conditions with stimuli from high，medium and low energy food pictures. Results　The average NSRT showed no significant differences across three groups during implementing stop signal tasks with stimuli from different types of pictures（P>0.05）.During implementing stop signal tasks with stimuli from high and low energy food pictures，low dietary adherence group had longer average SSRT than other two groups（P<0.05）. Low dietary adherence group required greater NSRT to implement stop signal tasks with stimuli from medium energy food pictures instead of from high and low energy food pictures（P<0.05）. Low dietary adherence group needed less SSRT to implement stop signal tasks with stimuli from medium energy food pictures instead of other two types of pictures（P<0.05），and so did medium dietary adherence group（P<0.05）. Conclusion　Low dietary adherence may be associated with lower food-specific inhibitory control in type 2 diabetic patients.

Key words: Diabetes mellitus, type 2；Dietary adherence；Inhibitory control；Stop signal task

摘要： 背景　饮食治疗是糖尿病治疗的基础，然而2型糖尿病（T2DM）患者饮食依从行为不佳。抑制控制作为与饮食行为调控存在密切联系的认知功能，近年来得到关注，研究其与饮食依从行为关联对改善患者饮食依从行为具有重要意义。目的　探究不同饮食依从性T2DM患者抑制控制特点，了解T2DM患者抑制控制加工与饮食依从行为关联，为构建T2DM患者饮食依从行为的抑制控制训练方案、提升患者饮食依从行为提供实证依据。方法　采用便利抽样法，选取2019年5—9月于安徽医科大学第一附属医院内分泌科住院的190例T2DM患者为研究对象，根据饮食控制行为量表（FCBS）得分将患者分为高、中、低饮食依从性三组，采用认知行为学范式停止信号任务测量在高、低能量食物图片、中性图片刺激条件下三组患者无停止信号反应时（NSRT）与停止信号反应时（SSRT）。结果　不同类别图片刺激任务中，三组患者NSRT差异无统计学意义（P>0.05）；在高、低能量食物图片刺激任务中，低饮食依从性组SSRT长于中、高饮食依从性组（P<0.05）。低饮食依从性组在高、低能量食物图片刺激任务的NSRT短于中性图片刺激，而SSRT长于中性图片刺激（P<0.05）；中饮食依从性组在高、低能量食物图片刺激任务的SSRT长于中性图片刺激（P<0.05）。结论　低饮食依从性T2DM患者对食物线索抑制控制能力较中、高饮食依从性患者降低。

关键词: 糖尿病, 2型, 饮食依从性, 抑制控制, 停止信号任务

ZHU Guiyue,LIU Annuo,DING Cuilu, et al. Characteristics of Inhibitory Control in Type 2 Diabetic Patients with Different Levels of Dietary Adherence　[J]. Chinese General Practice, 2020, 23(34): 4386-4393. DOI: 10.12114/j.issn.1007-9572.2020.00.469.
朱桂月,刘安诺,丁翠路等. 不同饮食依从性2型糖尿病患者抑制控制特点研究[J]. 中国全科医学, 2020, 23(34): 4386-4393. DOI: 10.12114/j.issn.1007-9572.2020.00.469.

References

［1］中华医学会糖尿病学分会．中国糖尿病医学营养治疗指南（2013）［J］．中华糖尿病杂志，2015，7（2）：73-87．DOI：10.3760/cma.j.issn.1674-5809.2015.02.004．
［2］AJALA O，ENGLISH P，PINKNEY J．Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes［J］．Am J Clin Nutr，2013，97（3）：505-516．DOI：10.3945/ajcn.112.042457．
［3］WHEELER M L，DUNBAR S A，JAACKS L M，et al．Macronutrients，food groups，and eating patterns in the management of diabetes：a systematic review of the literature，2010［J］．Diabetes Care，2012，35（2）：434-445.
［4］刘潇，蔡春凤，余立平．2型糖尿病患者饮食依从性研究进展［J］．中国健康教育，2019，35（6）：538-541．DOI：10.16168/j.cnki.issn.1002-9982.2019.06.013.
［5］BONGER Z，SHIFERAW S，TARIKU E Z．Adherence to diabetic self-care practices and its associated factors among patients with type 2 diabetes in Addis Ababa，Ethiopia［J］．Patient Prefer Adherence，2018，12：963-970．DOI：10.2147/PPA.S156043.
［6］刘莎．2型糖尿病患者饮食自我管理现状分析［D］．南昌：南昌大学，2017.
［7］KUGBEY N，OPPONG A K，ADULAI K．Illness perception，diabetes knowledge and self-care practices among type-2 diabetes patients：a cross-sectional study［J］．BMC Res Notes，2017，10（1）：381．DOI：10.1186/s13104-017-2707-5.
［8］JOHNSON S T，AL SAYAH F，MATHE N，et al．The relationship of diabetes-related distress and depressive symptoms with physical activity and dietary behaviors in adults with type 2 diabetes：a cross-sectional study［J］．J Diabetes Complications，2016，30（5）：967-970．DOI：10.1016/j.jdiacomp.2016.02.019.
［9］刘萍．2型糖尿病患者饮食行为依从性影响因素分析［J］．河南医学研究，2019，28（21）：3873-3874．DOI：10.3969/j.issn.1004-437X.2019.21.014．
［10］VAINIK U，DAGHER A，DUBE L，et al．Neurobehavioural correlates of body mass index and eating behaviours in adults：a systematic review［J］．Neurosci Biobehav Rev，2013，37（3）：279-299．DOI：10.1016/j.neubiorev.2012.11.008.
［11］JASINSKA A J，YASUDA M，BURANT C F，et al．Impulsivity and inhibitory control deficits are associated with unhealthy eating in young adults［J］．Appetite，2012，59（3）：738-747．DOI：10.1016/j.appet.2012.08.001.
［12］韩艳，舍英，高笑．肥胖成因的解释——基于食物奖赏研究的视角［J］．心理科学进展，2017，25（3）：452-462．DOI：10.3724/SP.J.1042.2017.00452.
HAN Y，SHE Y，GAO X．The cause of obesity：an explanation from food reward perspective［J］．Advances in Psychological Science，2017，25（3）：452-462．DOI：10.3724/SP.J.1042.2017.00452.
［13］FARR O M，LI C R，MANTZOROS C S．Central nervous system regulation of eating：insights from human brain imaging［J］．Metabolism，2016，65（5）：699-713．DOI：10.1016/j.metabol.2016.02.002.
［14］CARBINE K A，DURACCIO K M，KIRWAN C B，et al．A direct comparison between ERP and fMRI measurements of food-related inhibitory control：implications for BMI status and dietary intake［J］．NeuroImage，2018，166：335-348．DOI：10.1016/j.neuroimage.2017.11.008.
［15］HARE T A，CAMERER C F，RANGEL A．Self-control in decision-making involves modulation of the vmPFC valuation system［J］．Science，2009，324（5927）：646-648．DOI：10.1126/science.1168450.
［16］HOLLMANN M，HELLRUNG L，PLEGER B，et al．Neural correlates of the volitional regulation of the desire for food［J］．Int J Obes，2012，36（5）：648-655．DOI：10.1038/ijo.2011.125.
［17］ALLOM V，MULLAN B．Individual differences in executive function predict distinct eating behaviours［J］．Appetite，2014，80：123-130．DOI：10.1016/j.appet.2014.05.007.
［18］SCHMAJUK M，LOTTI M，BUSSE L，et al．Electrophysiological activity underlying inhibitory control processes in normal adults［J］．Neuropsychologia，2006，44（3）：384-395．DOI：10.1016/j.neuropsychologia.2005.06.005.
［19］CHEN S，JIA Y，WOLTERING S．Neural differences of inhibitory control between adolescents with obesity and their peers［J］．Int J Obes（Lond），2018，42（10）：1753-1761．DOI：10.1038/s41366-018-0142-x.
［20］MANASSE S M，GOLDSTEIN S P，WYCKOFF E，et al．Slowing down and taking a second look：inhibitory deficits associated with binge eating are not food-specific［J］．Appetite，2016，96：555-559．DOI：10.1016/j.appet.2015.10.025.
［21］陈方，胡朦，杜贯涛，等．2型糖尿病认知障碍发生机制研究进展［J］．神经药理学报，2013，3（3）：27-33.
CHEN F，HU M，DU G T，et al．Research advances on mechanism of cognitive impairment in type 2 diabetes mellitus［J］．Acta Neuropharmacologica，2013，3（3）：27-33.
［22］RUCKER J L，MCDOWD J M，KLUDING P M．Executive function and type 2 diabetes：putting the pieces together［J］．Phys Ther，2012，92（3）：454-462．DOI：10.2522/ptj.20100397.
［23］VERBRUGGEN F，LOGAN G D．Response inhibition in the stop-signal paradigm［J］．Trends Cogn Sci，2008，12（11）：418-424．DOI：10.1016/j.tics.2008.07.005.
［24］WATSON T D，GARVEY K T．Neurocognitive correlates of processing food-related stimuli in a Go/No-go paradigm［J］．Appetite，2013，71：40-47．DOI：10.1016/j.appet.2013.07.007.
［25］CARBINE K A，CHRISTENSEN E，LECHEMINANT J D，et al．
Testing food-related inhibitory control to high- and low- calorie food stimuli：electrophysiological responses to high-calorie food stimuli predict calorie and carbohydrate intake［J］．Psychophysiology，2017，54（7）：982-997．DOI：10.1111/psyp.12860.
［26］JOORMANN J，GOTLIB I H．Emotion regulation in depression：relation to cognitive inhibition［J］．Cogn Emot，2010，24（2）：281-298．DOI：10.1080/02699930903407948.
［27］BASTEN U，STELZEL C，FIEBACH C J．Trait anxiety modulates the neural efficiency of inhibitory control［J］．J Cogn Neurosci，2011，23（10）：3132-3145．DOI：10.1162/jocn_a_00003.
［28］HOUBEN K，NEDERKOORN C，JANSEN A．Eating on impulse：the relation between overweight and food-specific inhibitory control［J］．Obesity （Silver Spring），2014，22（5）：e6-8．DOI：10.1002/oby.20670.
［29］LOEBER S，GROSSHANS M，HERPERTZ S，et al．Hunger modulates behavioral disinhibition and attention allocation to food-associated cues in normal-weight controls［J］．Appetite，2013，71：32-39．DOI：10.1016/j.appet.2013.07.008.
［30］FAUL F，ERDFELDER E，BUCHNER A，et al．Statistical power analyses using G* Power 3.1：tests for correlation and regression analyses［J］．Behav Res Methods，2009，41（4）：1149-1160．DOI：10.3758/BRM.41.4.1149.
［31］钱荣立．关于糖尿病的新诊断标准与分型［J］．中国糖尿病杂志，2000，8（1）：4-5．
［32］李格，沈渔邨，陈昌惠，等．简易精神状态检查表在不同人群中的试测研究［J］．中国心理卫生杂志，1989，3（4）：148-151．
［33］王璟璇，王瑞霞，林秋菊．门诊诊断初期非胰岛素依赖型糖尿病患者的自我照顾行为及其相关因素之探讨［J］．护理杂志（台湾），1998，45（2）：60-74．DOI：10.6224/JN.45.2.60．
［34］ZIGMOND A S，SNAITH R P．The hospital anxiety and depression scale［J］．Acta Psychiatr Scand，1983，67（6）：361-370．DOI：10.1111/acp.1983.67.issue-6.
［35］孔繁昌．限制性饮食者对食物线索注意偏向的神经机制［D］．重庆：西南大学，2012.
［36］秦婧雪．限制性饮食者对食物线索的记忆偏向［D］．重庆：西南大学，2015.
［37］GUERRIERI R，NEDERKOORN C，SCHROOTEN M，et al．Inducing impulsivity leads high and low restrained eaters into overeating，whereas current dieters stick to their diet［J］．Appetite，2009，53（1）：93-100．DOI：10.1016/j.appet.2009.05.013.
［38］GANOR-MOSCOVITZ N，WEINBACH N，CANETTI L，et al．
The effect of food-related stimuli on inhibition in high vs. low restrained eaters［J］．Appetite，2018，131：53-58．DOI：10.1016/j.appet.2018.08.037.
［39］CONGDON E，MUMFORD J A，COHEN J R，et al．Measurement and reliability of response inhibition［J］．Front Psychol，2012，3：37．DOI：10.3389/fpsyg.2012.00037.
［40］MOHAMMED M A，SHAREW N T．Adherence to dietary recommendation and associated factors among diabetic patients in Ethiopian teaching hospitals［J］．Pan Afr Med J，2019，33：260．DOI：10.11604/pamj.2019.33.260.14463.
［41］BROWN S A，GARCIA A A，BROWN A，et al．Biobehavioral determinants of glycemic control in type 2 diabetes：a systematic review and meta-analysis［J］．Patient Educ Couns，2016，99（10）：1558-1567．DOI：10.1016/j.pec.2016.03.020.
［42］MENDES R，MARTINS S，FERNANDERS L．Adherence to medication，physical activity and diet in older adults with diabetes：its association with cognition，anxiety and depression［J］．J Clin Med Res，2019，11（8）：583-592．DOI：10.14740/jocmr3894.
［43］王芳，袁丽，李饶，等．住院2型糖尿病患者焦虑抑郁状况及影响因素分析［J］．护理学报，2015，22（14）：28-31．DOI：10.16460/j.issn1008-9969.2015.14.028.
WANG F，YUAN L，LI R，et al．Current status of anxiety and depression of type 2 diabetes inpatients and its influence factors［J］．Journal of Nursing，2015，22（14）：28-31．DOI：10.16460/j.issn1008-9969.2015.14.028.
［44］CHECHLACZ M，ROTSHTEIN P，KLAMER S，et al．Diabetes dietary management alters responses to food pictures in brain regions associated with motivation and emotion：a functional magnetic resonance imaging study［J］．Diabetologia，2009，52（3）：524-533．DOI：10.1007/s00125-008-1253-z.
［45］HOFMANN W，FRIESE M，STRACK F．Impulse and self-control from a dual-systems perspective［J］．Perspect Psychol Sci，2009，4（2）：162-176．DOI：10.1111/j.1745-6924.2009.01116.x.
［46］JAWORSKI M，PANCZYK M，CEDRO M，et al．Adherence to dietary recommendations in diabetes mellitus：disease acceptance as a potential mediator［J］．Patient Prefer Adherence，2018，12：163-174．DOI：10.2147/PPA.S147233.
［47］翁春燕，陈红，朱岚．限制性饮食者对食物线索的注意偏向：基于目标矛盾理论模型［J］．心理学报，2012，44（5）：680-689．DOI：10.3724/SP.J.1041.2012.00680.
WENG C Y，CHEN H，ZHU L．Attentional biases toward food-related information among restrained eaters based on the goal conflict model of eating［J］．Acta Psychologica Sinica，2012，44（5）：680-689．DOI：10.3724/SP.J.1041.2012.00680.
［48］程改平，游倩．2019年美国《成年人糖尿病或糖尿病前期营养治疗共识报告》解读［J］．中国全科医学，2019，22（29）：3527-3532．DOI：10.12114/j.issn.1007-9572.2019.00.431.
CHENG G P，YOU Q．Interpretation of nutrition therapy for adults with diabetes or prediabetes：a consensus report［J］．Chinese General Practice，2019，22（29）：3527-3532．DOI：10.12114/j.issn.1007-9572.2019.00.431.
［49］董军，付淑英，卢山，等．自我控制失败的理论模型与神经基础［J］．心理科学进展，2018，26（1）：134-143．DOI：10.3724/SP.J.1042.2018.00134.
DONG J，FU S Y，LU S，et al．The theoretical framework and neural mechanisms of self-control failure［J］．Advances in Psychological Science，2018，26（1）：134-143．DOI：10.3724/SP.J.1042.2018.00134.
［50］任子楠.冲动控制的无意识目标对行为抑制控制的积极影响［D］．重庆：西南大学，2019.

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