云南省迪庆州藏区居民膳食模式及对2型糖尿病的影响

The influence of dietary patterns on type 2 diabetes mellitus in residents of Diqing Tibetan areas in Yunnan Province

目的研究云南省迪庆州藏区居民膳食模式,探讨膳食模式对2型糖尿病的影响。方法于2012年9月至2013年6月采用多阶段分层整群随机抽样方法,从迪庆州藏区3个县中随机抽取3 586名15岁以上常住居民开展问卷调查、食物频率法膳食调查、体格测量和血糖检测。用SPSS 20.0进行统计分析,用因子分析方法建立膳食模式,用logistic回归分析膳食模式对2型糖尿病的影响。结果 3 586名调查对象中糖尿病患者661例,总患病率为18.4%,其中藏族、傈僳族和纳西族糖尿病患病率分别为14.1%(192/1 366)、18.6%(105/565)和14.9%(121/811)。通过因子分析提取3种膳食模式,累计方差贡献率为25.9%,其中奶蛋豆制品模式以酸奶、豆制品、蛋类、油炸面食和鲜奶为主,薯类畜肉模式以薯类、牛羊肉类、猪肉类和面粉为主,水果蔬菜模式以水果、蔬菜为主。调整混杂因素后,非条件logistic回归分析结果显示,奶蛋豆制品膳食模式与糖尿病呈正相关,有统计学意义(OR=1.426,P<0.05),薯类畜肉、水果蔬菜膳食模式与糖尿病无相关性(P>0.05)。结论云南省迪庆州藏区居民膳食模式中奶蛋豆制品膳食模式是2型糖尿病的危险因素。藏族居民更倾向于薯类畜肉模式,提倡该地区各民族增加水果、蔬菜摄入,减少红肉类食物摄入。

Objective To study the influence of dietary patterns on type 2 diabetes mellitus（T2 DM） in residents of Diqing Tibetan areas in Yunnan Province. Methods From September of 2012 to June of 2013, the multistage stratified cluster random sampling was used to select 3 586 residents（≥15 years old） as the subjects in Diqing Tibetan areas. The investigation was performed with questionnaires, food frequency dietary survey, physical examination and blood glucose. Factor analysis with a principal component analysis was used to establish the dietary pattern by SPSS 20.0. The logistic regression was used to analyze the effects of dietary patterns on T2 DM. Results The total diabetes morbidity was 18.4%（661/3 586）, the diabetes morbidities in Tibetan residents,Lisu residents and Naxi residents were 14.1%（192/1 366）, 18.6%（105/565） and 14.9%（121/811）, respectively. Three kinds of dietary patterns were found with the factor analysis. The cumulative variance contribution rate was 25.9%. The milk egg soybean model mainly contained the yogurt, bean products, eggs, fried pasta and milk; the tuber and meat model was mainly characterized by tuber, beef and mutton, pork and wheat powder; the fruit and vegetable model was highly associated with fruits and vegetables.After adjusting confounding factors, non-condition logistic regression analysis showed that the milk egg soybean model was correlated positively with T2 DM（OR =1.426, P〈0.05）, but the other two dietary patterns were not correlated with T2 DM（P〈0.05）. Conclusion In Diqing Tibetan areas, the milk egg soybean model is risk factor for T2 DM. Tibetan residents would like to choose the tuber meat model. The increase of fruit and vegetable intake and the decrease of red meat intake are advocated.