江苏省居民不同膳食模式对四类血脂异常的影响

INFLUENCE OF DIFFERENT DIETARY PATTERNS ON FOUR TYPES OF DYSLIPIDEMIA AMONG ADULTS IN JIANGSU PROVINCE

目的探讨江苏省≥18岁居民不同膳食模式与血脂异常之间的关系,为血脂异常的预防和控制提供参考。方法采用多阶段分层整群随机抽样的方法,抽取8400例18岁及以上的常驻居民,采用问卷调查和体格检查方法了解居民的基本情况,并检测空腹血糖和血脂水平。以食物频率表法进行膳食调查,并用因子分析法建立动物型、淀粉类植物型、蛋类、蔬果类健康型等四类模膳食模式,每类膳食模式按照因子得分的四分位数由低到高分为G1、G2、G3、G4四个亚组。膳食模式与四类血脂异常的相关关系用Logistic回归分析。结果调查对象的血脂异常患病率为32.16%,其中高TC、高TG、低HDL-C和高LDL-C血症患病率分别为4.79%、13.43%、21.13%、1.70%,四类血脂异常的患病率在不同年龄、不同BMI、是否高血压情况下的差异均有统计学意义(P<0.001)。多因素Logistic回归分析结果显示,蛋类膳食模式因子得分处于G4水平的高TC血症和高TG血症的患病风险分别为处于G1水平的0.706倍(OR=0.706,95%CI:0.523~0.952)和0.755倍(OR=0.755,95%CI:0.627~0.910);淀粉类植物型膳食模式G4水平的高LDL-C血症患病风险是G1水平的0.479倍(OR=0.479,95%CI:0.280~0.819);动物型膳食模式的G3、G4水平的低HDL-C血症患病风险分别是G1的1.318倍(OR=1.318,95%CI:1.121~1.550)、1.232倍(OR=1.232,95%CI:1.044~0.453)。结论膳食模式与四类血脂异常密切相关,推荐以全谷物粗粮为主要碳水化合物来源,合理摄入肉类,每天一个全蛋,坚持果蔬多样化以防治血脂异常的发生.

Objective To explore the association between different dietary patterns and dyslipidemia among residents aged≥18 years in Jiangsu province and provide evidence-based guideline for the prevention and control of dyslipidemia.Methods Multistage stratified cluster random sampling method was used to select 8400 residents.Questionnaire survey,physical examination and clinical tests of fasting blood glucose and blood lipid levels were conducted among the residents to collect their essential information.Dietary survey was carried out by food frequency questionnaire,factor analysis was adopted to identify the dietary patterns in four types,which were animal type,starch plants type,egg type and vegetable and fruit type.Each dietary pattern was divided into G1-G4 subgroups according to the quartiles of factor scores.Logistic regression analysis was applied to analyze the correlation between dietary patterns and four types of dyslipidemia.Results The overall prevalence of dyslipidemia was 32.16%;and more specifically,4.79%for high TC,13.43%for high TG,21.13%for low HDL-C and 1.70%for high LDL-C.There were statistically significant differences for four types dyslipidemia among different age,BMI and hypertension groups(P<0.001).The results of multivariate logistic regression analysis indicated that the risks of high TC and high TG in egg dietary pattern factor score at the G4 level were 0.706(95%CI:0.523-0.952)and 0.755(95%CI:0.627-0.910)compared to the G1 level,respectively.The risk of high LDL-C in starch plant-based dietary pattern at the G4 level was 0.479(95%CI:0.280-0.819)compared to the G1 level.The risk of low HDL-C in animal dietary pattern at the G3 and G4 levels were 1.318(95%CI:1.121-1.550)and 1.232(95%CI:-0.453)compared to the G1 level,respectively.Conclusion Dietary patterns are closely related to the types of dyslipidemia.It is recommended to take whole grains as the main source of carbohydrates,consume an adequate proportion of red meats,eat a full egg every day,and a variety of fruits and vegetables to prevent dyslipidemia.[ACTA NUTRIMENTA SINICA,2020,42(4):331-337]