膳食模式与2型糖尿病肾病患病风险关联性

Study on the association between dietary patterns and the risk of diabetic nephropathy in patients with type 2 diabetes mellitus

目的探讨膳食模式与2型糖尿病(T2DM)患者糖尿病肾病(DN)患病风险的关联性。方法选取2018-2019年在河南大学第一附属医院内分泌科住院的T2DM患者1099例,根据是否合并DN分为单纯T2DM患者(659例)和合并DN患者(440例)。收集两组患者的临床资料,采用针对糖尿病患者设计的简化版食物摄入频率问卷调查患者近3个月的膳食情况。采用非条件Logistic回归分析膳食模式与T2DM患者DN患病风险的关联性。结果合并DN患者和单纯T2DM患者膳食模式合理的比例分别为43.41%和61.91%,蛋白质摄入合理比例分别为45.45%和61.91%,脂肪摄入合理比例分别为48.41%和68.89%,碳水化合物摄入合理比例分别为55.45%和59.94%;合并DN患者膳食模式合理的比例、蛋白质摄入合理比例及脂肪摄入合理比例均低于单纯T2DM患者(P<0.05)。Logistics回归分析发现,膳食模式合理是T2DM患者发生DN的独立影响因素(P<0.05)。结论T2DM合并DN患者普遍存在膳食模式不合理的情况;膳食模式不合理可能与DN的患病风险有关。

Objective To explore the relationship between dietary patterns and the risk of diabetic nephropathy in patients with type 2 diabetes mellitus(T2 DM).Methods A total of 1099 type 2 diabetic patients admitted in endocrinology department from January 2018 to December 2019 were divided into only T2 DM patients(OT2 DMP)(n=659)and type 2 diabetic patients with diabetic nephropathy(T2 DPWDN)(n=440).The clinical data were collected,and the dietary status in the last 3 months were investigated with a simplified food intake frequency questionnaire designed for diabetics.Unconditional logistic regression model was used to analyze the association between dietary patterns and the risk of diabetic nephropathy in patients with T2 DM.Results In this survey,the proportions of reasonable dietary pattern in T2 DPWDN and OT2 DMP was 43.41%and 61.91%,respectively;the proportions of reasonable protein intake in T2 DPWDN and OT2 DMP were 45.45%and 61.91%,respectively;the proportions of reasonable fat intake in T2 DPWDN and OT2 DMP were 48.41%and 68.89%,respectively;and the proportions of reasonable carbohydrate intake were 55.45%and 59.94%,respectively;the proportions of reasonable dietary pattern,protein intake,fat intake and carbohydrate intake in patients with diabetic nephropathy were lower than those in the only T2 DM patients(P<0.05).Logistics regression analysis showed that reasonable dietary pattern was an independent influencing factor for diabetic nephropathy in T2 DM patients(P<0.05).Conclusion Unreasonable dietary patterns are common in T2 DM patients with diabetic nephropathy;unreasonable dietary patterns may be associated with the risk of diabetic nephropathy.