上海市270名素食者肥胖及相关代谢状况的调查

Obesity and related metabolic indicators among 270 vegetarians in Shanghai

目的·了解上海市素食人群肥胖及相关代谢状况,并与非素食人群进行比较。方法·在上海市城区招募素食者270名(素食组),并按1:1匹配270名非素食者(非素食组)作为对照,进行一般情况问卷调查及膳食频率问卷调查。测量身高、体质量、腰围(waist circumference,WC),检测血脂、血压、血糖、血尿酸等实验室指标。分析素食组与非素食组之间各指标的差异;控制年龄、性别、锻炼时间、总能量等混杂因素后,采用广义估计方程分析素食饮食与各指标的关联性。结果·素食组体质量指数(body mass index,BMI)和WC低于非素食组(均P=0.000)。其中,以BMI为判断标准的超重或肥胖检出率,素食组为10.0%,低于非素食组的24.4%(P=0.000);以WC为判断标准的中心性肥胖检出率,素食组和非素食组分别为2.2%和12.6%(P=0.000);素食组总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、收缩压、空腹血糖、空腹胰岛素、女性血尿酸均低于非素食组(均P=0.000)。多因素广义估计方程分析结果显示,调整年龄、性别、锻炼时间、久坐时间、总能量等混杂因素后,二分类Logistic模型显示,素食组发生超重或肥胖的风险是非素食组的35.5%(OR=0.355,95%CI 0.211~0.598,P=0.000),发生中心性肥胖的风险是非素食组的13.1%(OR=0.131,95%CI 0.046~0.376,P=0.000);线性模型显示,素食组总胆固醇比非素食组低0.430 mmol/L(95%CI-0.573^-0.288),高密度脂蛋白胆固醇低0.151 mmol/L(95%CI-0.201^-0.101),低密度脂蛋白胆固醇低0.278 mmol/L(95%CI-0.385^-0.171),空腹血糖低0.144 mmol/L(95%CI-0.204^-0.083),女性血尿酸低14.387μmol/L(95%CI-23.339^-5.434),差异均有统计学意义(均P=0.000)。结论·素食人群的超重或肥胖检出率,尤其是中心性肥胖检出率均低于非素食人群,其他肥胖相关的血脂、血糖及血尿酸水平也低于非素食人群;素食饮食可能是肥胖的独立保护因素。

Objective·To explore the obesity rate and related metabolic status of vegetarians in Shanghai and to compare with omnivores.Methods·A total of 270 vegetarians were recruited in Shanghai,and 270 omnivores were matched with 1:1 as a control group.General information and food intakes were collected by questionnaires and food frequency questionnaires,respectively.Height,weight,waist circumference(WC),blood lipid,blood pressure,blood sugar and serum uric acid were collected and compared between vegetarians and omnivores.After controlling confounding factors such as age,gender,exercise time,and total energy,generalized estimation equation was used to analyze the association between vegetarian diet and various indicators.Results·Compared with omnivores,the body mass index(BMI)and WC of vegetarian were significantly lower(both P=0.000).Compared with omnivores,the overweight or obesity diagnosed by BMI and the central obesity diagnosed by WC were significantly lower in vegetarians(10.0%vs 24.4%,P=0.000;2.2%vs 12.6%,P=0.000),so were the total cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol,systolic blood pressure,fasting blood glucose,fasting insulin and female serum uric acid in vegetarians(all P=0.000).After adjusting for age,gender,exercise time,sedentary time,total energy and other confounding factors,multivariate binary Logistic analysis of generalized estimating equation showed that vegetarians had significantly lower risk of overweight or obesity(OR=0.355,95%CI 0.211-0.598,P=0.000)and of central obesity(OR=0.131,95%CI 0.046-0.376,P=0.000).Multivariate linear regression analysis of generalized estimating equation showed that vegetarians had lower levels of total cholesterol(β=-0.430 mmol/L,95%CI-0.573--0.288,P=0.000),high density lipoprotein cholesterol(β=-0.151 mmol/L,95%CI-0.201--0.101,P=0.000),low density lipoprotein cholesterol(β=-0.278 mmol/L,95%CI-0.385--0.171,P=0.000),fasting blood glucose(β=-0.144μmol/L,95%CI-0.204--0.083,P=0.000),and female serum uric acid(β=-14.387μmol/L,95%CI-23.339--5.434,P=0.000).Conclusion·Overweight or obesity in vegetarians,especially central obesity,is significantly lower than that in omnivores.Vegetarians have lower blood lipids,blood sugar and serum uric acid levels than omnivores.Vegetarian diet is an independently protective factor for obesity.