膳食纤维和血糖负荷与糖代谢异常风险的相关性

Association of dietary fiber and glycemic load with abnormal glucose metabolism

目的调查中老年人群膳食纤维（DF）和膳食血糖负荷（GL）摄人现状，分析DF和GL与糖代谢异常发生风险的相关性。方法选取广州某社区40-79岁居民，采用连续3天24h膳食回顾法调查膳食和营养素摄人状况，按照五分位分类法分别比较DF和GL摄人状况与糖代谢异常的相关性以及DF和GL的相互作用。结果1832名受试者中正常糖耐量990名（54．0％），糖调节受损（IGR）640例（34．9％），新发糖尿病202例（11．0％）。受试者平均每日DF为（11．5±4．5）g，GL为181．0±7．5。最低五分位与最高五分位DF人群相比，糖代谢异常风险增加[OR=1．99，95％C1（1．48，2．67）]，其中IGR和糖尿病风险分别为1．85（1．34，2．57）和2．36（1．50，3．73）；最高五分位GL与最低五分位GL膳食人群相比，糖代谢异常风险增加『OR=1．58，95％CI（1．18，2．13）]，其中IGR和糖尿病风险分别为1．75（1．26，2．42）和1．22（0．77，1．94）。DF最低五分位且GL最高五分位膳食人群糖代谢异常风险增加[OR=3．43，95％C1（1．41，8．36）]。结论糖代谢异常风险与DF呈负相关关系，与GL呈正相关关系。

Objective To investigate the status of dietary fiber （DF） and dietary glycemic load （GL） in middle-aged and elderly population, and to analyze the correlation of DF and GL with abnormal glucose metabolism. Methods Subjects aged 40-79 years came from Guangzhou community. Dietary nutrients intakes were assessed by continuous 24 hours review for 3 days. Correlation of abnormal glucose metabolism with GL and DF and their interaction were analyzed as quintiles of the distribution. Results Of 1 832 subjects, there were 990 subjects （54.0%） with normal glucose tolerance, 640 （34.9%） with IGR, and 202 （ 11.0% ） newly-diagnosed diabetes mellitus （DM）. Average DF intake of subjects was （ 11.5 ± 4.5 ） g/d and average GL intake was （ 181.0 ± 7.5 ）/ d. Compared with the highest quintile group of total DF intake, the risk of abnormal glucose metabolism in the lowest quintile group was increased[ OR= 1.99, 95% CI （ I. 48,2.67 ） ], with increased IGR risk [ OR = 1.85, 95% CI （ 1.34,2.57 ） ] and DM risk [ OR = 2.36, 95% CI （ 1.50,3.73 ） ]. Compared with the lowest quintile group of GL intake, the risk of abnormal glucose metabolism in the highest quintile group was increased [ OR = 1.58, 95% CI （ 1.18,2.13 ） ], and with increased IGR risk[ OR = 1.75,95 % C1 （ 1.26, 2.42） ] and DM risk [ OR = 1.22, 95 % CI （0.77, 1.94 ） ]. The lowest quintile of DF and the highest quintile of GL was associated with the risk of increased abnormal glucose metabolism [ OR = 3.43,95 % CI （ 1.41,8.36 ） ]. Conclusion Abnormal glucose metabolism was negatively related with DF and positively related with GL.