成年居民膳食模式与2型糖尿病风险的关联研究

Association of dietary patterns and diabetes risk level among adult residents in Datong city of Shanxi Province

目的探索膳食模式与2型糖尿病(T2DM)风险的关联。方法采用两阶段分层随机抽样方法,于2013年从山西省大同市某大型煤矿集团的87个煤矿分公司中抽取3747名对象。采用自制问卷收集人口学特征、吸烟、饮酒和糖尿病家族史等资料,采用国际体力活动问卷评估体力活动状况,同时进行体格测量和糖脂代谢指标测定,按照T2DM风险得分分为高风险组与低风险组。采用半定量食物频率问卷收集对象既往1年的膳食数据,通过探索性因子分析和聚类分析进行膳食模式判别。采用非条件logistic回归模型分析膳食模式与T2DM风险的关系。结果研究对象年龄为(41.48±8.62)岁,其中男性2843名(84.31%),T2DM高风险组1819名,低风险组1553名。确定了4类膳食模式,分别为健康膳食、高盐膳食、肉类膳食以及高碳水化合物膳食。调整人口学特征、吸烟和饮酒等因素后,以健康膳食为参照,高盐膳食、高碳水化合物膳食和肉类膳食与T2DM风险的OR(95%CI)值分别为1.54(1.26~1.88)、1.80(1.43~2.28)和1.20(0.99~1.46)。结论高盐膳食和高碳水化合物膳食与T2DM风险存在正关联,肉类膳食与T2DM无关联。

Objective To explore the association of dietary pattern and type 2 diabetes mellitus(T2DM)risk.Methods In 2013,3747 participants from 87 coalmine branches of a large coal mine group in Datong City,Shanxi Province were selected by using a two stage cluster stratified sampling method.Data on demographic characteristics,smoking,drinking,and family history of diabetes were collected by using a self made questionnaire,and the International Physical Activity Questionnaire was used to assess the level of physical activity.Physical,glucose and lipid metabolism indicators were measured and subjects were divided into high risk groups and low risk groups of T2DM according to the T2DM risk score.Dietary data were collected by using Semi quantitative Food Frequency Questionnaire,and dietary patterns were derived by using the exploratory factor analysis and cluster analysis.The unconditional logistic regression model was used to assess the association of dietary patterns and T2DM risk.Results The age of the subjects was(41.48±8.62)years old,and 2843 of them were males(84.31%).A total of 1819 subjects were in the high risk group and 1553 in the low risk group.Four dietary patterns,healthy diet,high salt diet,meats diet,and carbohydrate rich diet,were identified in this study.The unconditional logistic regression analysis showed that compared with the healthy diet pattern,after the adjustment of demographic characteristics,smoking,and drinking,the OR(95%CI)of T2DM risk in high salt diet,carbohydrate rich diet and meats diet patterns was 1.54(1.26-1.88),1.80(1.43-2.28)and 1.20(0.99-1.46),respectively.Conclusion High salt diet and carbohydrate rich diet were positively associated with T2DM risk,whereas there was no association of meats diet and T2DM risk.