2014—2015年蚌埠市中老年居民血脂异常、高血压与膳食模式的关系

Relationship of different dietary patterns with dyslipidemia and hypertension among middle-aged and elderly residents in Bengbu City in 2014-2015

目的探讨蚌埠市中老年居民不同膳食模式与血脂异常、高血压发病风险之间的关系。方法 2014年9月—2015年9月,采用分层整群随机抽样的方法,选取蚌埠市6个社区的860名45岁以上(45~76岁)中老年居民进行问卷调查(年龄、性别、慢性病患病情况)、体格检查(身高、体重、腰围、臀围等)和膳食调查,检测其血脂及血压水平,采用因子分析法建立膳食模式,分析不同膳食模式对血脂异常、高血压发病风险的影响。结果 (1)因子分析得到4种主要的膳食模式,分别是主食蔬菜型模式、动物型模式、水果奶类型模式和饮酒型模式。(2)主食蔬菜型和动物型模式体质指数(BMI)的Q1与Q4差异有统计学意义(F=7.625和F=7.169,P<0.01);主食蔬菜型、动物型和饮酒型模式腰围(WC)的Q1与Q4差异有统计学意义(F=6.453、F=5.236和F=6.249,P<0.01);主食蔬菜型和饮酒型模式收缩压(SBP)的Q1与Q4差异有统计学意义(F=4.268和F=7.941,P<0.01)。(3)蛋白质在三大营养素供能比中的贡献率,主食蔬菜型、动物型Q4组高于Q1组(17.44%vs.13.63%,20.52%vs.17.55%,P<0.05),主食蔬菜型Q4组能量的平均摄入水平是Q1组的1.75倍。(4)Logistic回归分析显示无论是否控制性别、年龄、文化程度、体力活动、BMI等混杂因素,"动物型"和"饮酒型"模式Q4相对于Q1都显示较高的血脂异常患病风险(调整前OR=2.665,OR=1.926,P<0.01;调整后OR=1.835,OR=1.447,P<0.05)。结论主食动物型和主食饮酒型模式是蚌埠市中老年居民血脂异常和高血压的危险因素,减少膳食中肉类、酒精的摄入量,对预防和控制慢性病具有重要意义。

Objective To understand the dietary patterns of the middle-aged and elderly in Bengbu City and to analyze the associations of dietary patterns with dyslipidemia and hypertension.Methods During September of 2014 to September of 2015,the cluster random sampling method was used to select 860 residents aged ≥45 years old（ 45-76 years old） from 6 communities of Bengbu City.They answered a well-designed questionnaire（ age,gender,history of chronic disease）,received physical examinations （ height,weight,waist circumference,hip circumference） and dietary survey,measured the blood lipids and blood pressure.Factor analysis was applied to determine major dietary patterns in order to analyze the associations between dyslipidemia and hypertension.Results（ 1） Four dietary patterns was identified,namely ＂rice and vegetables＂ pattern,＂animal food＂ pattern,＂fruits and milk＂ pattern,＂drinking＂ pattern.（ 2） There were significant difference of BMI between the ＂rice and vegetables＂ pattern and ＂animal food＂ pattern（ P 〈 0.01）.There were significant difference of WC between the ＂rice and vegetables＂pattern,＂animal food＂ pattern and ＂drinking＂ pattern（ P 〈 0.01）.There were significant difference of SBP between the ＂rice and vegetables ＂ pattern and ＂drinking＂ pattern（ P 〈 0.01）.（ 3） The Q4 group of ＂rice and vegetables＂ pattern and ＂animal food＂ pattern had higher proportion of protein that contributed to total energy than the Q1 group（ 17.44% vs.13.63%,20.52% vs.17.55%,P 〈 0.05）.The Q4 group of ＂rice and vegetables＂ pattern had higher energy intake of 1.75-fold than the Q1 group.（ 4） Whether or not controlling the confounding factors of gender,age,degree of education,physical activity and BMI,a positively association was found between ＂animal food＂ pattern,＂drinking＂ pattern and dyslipidemia by logistic regression analysis between the Q4 group with the Q1 group（ unadjustment OR = 2.665,OR = 1.926,P 〈 0.01; after adjustment OR = 1.835,OR = 1.447,P 〈 0.05）.Conclusion ＂Animal food＂ pattern and ＂drinking＂ pattern may be risk factors for dyslipidemia and hypertension,reducing the intake of meat,oil in our meals may play an important role in the prevention and control of chronic diseases.