广州市40～59岁居民膳食模式与胰岛素抵抗关系的研究

Relation between dietary patterns and insnlin resistance in 40 -59 years old Guangzhou adults

目的调查分析广州市成人膳食与肥胖和胰岛素抵抗危险性的关系。方法用连续3d24h膳食回顾法调查40-59岁广州居民每日摄入食物种类和数量；用中国膳食平衡指数法（oai）分析处理膳食调查结果；测定对象身高、体重、腰围、臀围、空腹血糖和胰岛素，计算体质指数、腰臀比和胰岛素抵抗指数（HOMA—IR）。结果纳入调查对象540名，DBI指标的负端分为16．1～17．5，正端分为7．6～8．2，膳食质量距为23．6～25．7，均优于全国平均水平。谷类、奶类和豆类摄入量低于适宜范围的人数比例分别为34．2％和71．1％，动物性食物、盐、油类摄入超过推荐量的人数比例分别为13．7％、53．4％、78．7％。E模式人群的体质指数和腰臀比显著高于A模式（F=3．76，F=4．79，P〈0．05），E模式人群发生胰岛素抵抗的OR值是A模式的3倍（F=1．73，P=0．018）。结论总体而言，广州市40～59岁成人的膳食结构较全国平均水平更为均衡、合理；但部分人群谷类、奶类和豆类仍存在一定程度的摄人不足和动物性食物、盐、油类存在一定程度的摄入过量；符合膳食指南推荐的、富含蔬菜水果的平衡膳食（A模式）有利于降低发生胰岛素抵抗的危险。

Objective To evaluate the overall diet quality of adults in Guangzhou and investigate whether adherence to the Dietary Guidelines for Chinese Residents could help to reduce the risk of obesity and insulin resistance. Methods All 540 adults aged 40 - 59 years completed 3 consecutive 24-hour diet recalls. Diet quality were evaluated by using Chinese Diet Balance Index （DBI） scoring and evaluating system. Anthropometric parameters, fast glucose and fast insulin were measured. Insulin resistance was defined as the highest quartile of the homeostasis model assessment scores. Results The DBI-Lower Bound Score（ DBI-LBS）, DBI-Higher Bound Score （DBI-HBS） and DBI-Diet Quality Distance （DBI-DQD） were 16. 1 - 17. 5, 7. 6 - 8. 2, 23.6 - 25.7 relatively. The intake of cereals, beans and diefary products were insufficient in the population, while the intake of animal food, salt and edible oils were excessive. Subjects in model A had a lower body mass index （ BMI, P = 0. 022） and waist-to-hip ratio （ WHR, P = 0. 001 ） than those in model E. Compared with model A, subjects in model E had greater odds ratio for insulin resistance （ odds ratio ：3.00; 95 % CI： 1.21,7. 67）. Conclusion The dietary structure of the residents in Guangzhou was relatively balanced and reasonable, but the problems such as inadequate food intake and excessive food intake still co-exisL Adherence to the Dietary Guidelines for Chinese Residents could help to reduce the risk of insulin resistance.