南京市居民膳食模式与2型糖尿病关系的探讨

Investigation of relationship between the dietary patterns and type 2 diabetes among residents of Nanjing

目的探索不同膳食模式与2型糖尿病（T2D）患病风险间的关系。方法采用多阶段分层随机整群抽样的方法，随机抽取南京市年龄≥15岁常住居民，采用南京市慢病防制社区居民健康状况调查表和食物频率调查表，开展问卷调查。采用因子分析法建立膳食模型，并应用多因素非条件logistic回归分析不同膳食模式与T2D患病率的关系。结果有效调查2030名常住居民，T2D患病率为5．5％。经因子分析，最终提取4种膳食模式，其特征根分别为3．630、2．426、1．780、1．754，方差贡献率分别为11．709％、7．827％、5．743％、5．659％（累计30．938％），依据每个公因子所包含的食物特点分别命名为健康模式、谷类及豆类模式、零食模式、传统模式。其中健康膳食模式和零食模式对T2D患病率有影响（P值均〈0．05）。多因素logistic回归分析结果表明，倾向于健康膳食模式的居民患T2D风险较低（OR=0．768，95％CI：0．557～0．863），而倾向于零食模式的居民患T2D风险较高（OR=1．652，95％CI：1．307～1．865）。结论膳食模式与2型糖尿病患病率密切相关，以新鲜水果蔬菜、禽肉类、蛋、奶制品、水产品为主的健康饮食习惯，对预防T2D的发生具有重要意义。

Objective To understand relationship between dietary patterns and type 2 diabetes （T2D） risk. Methods Local residents aged over 15 years in Nanjing were selected by multi-stage cluster randomized sampling method. Health status questionnaire for chronic disease prevention and control community residents in Nanjing and food frequency questionnaire （FFQ） were used for survey. Factor analysis was used to identify dietary patterns, logistic regression was used to analyze relation between dietary patterns and T2D incidence. Results A total of 2 030 permanent residents were surveyed effectively, resulting T2D incidence of 5.5%. Four dietary patterns were identified by factor analysis; the corresponding polynomial roots were 3. 630, 2. 426, 1. 780, 1. 754; the corresponding variance contribution rates were 11. 709%, 7. 827%, 5. 743%, 5. 659% （30. 938% in total）. Healthy pattern, grains and beans pattern, snacks pattern and traditional pattern were named according to food features in factor formulas. Healthy pattern and snack pattern showed significant impact on T2D incidence （P〈0.05） o Multivariate regression analysis showed residents inclined to healthy pattern had lower T2D risk （OR= 0. 768, 95% CI： 0. 557-0. 863） while residents favoring snacks pattern had higher T2D risk（OR= 1. 652,95 % CI： 1. 307-1. 865）. Conclusion Dietary patterns were associated with T2D incidence. Healthy dietary pattern focused on fresh fruit and vegetables, meat, egg ,milk and seafood may play important roles in preventing T2D.