膳食锰与糖尿病前期及2型糖尿病关系的横断面研究

A cross-sectional study on association of dietary manganese with prediabetes and type 2 diabetes mellitus

目的探讨天津市成年人膳食锰摄入水平与糖尿病前期和2型糖尿病(T2DM)患病的关系,提出合理膳食建议。方法以在天津市和平区健康指导中心体检的20~88岁且符合纳入标准的2670名为调查对象,采用膳食频率法调查膳食摄入情况,并进行体格检查、血生化检查以及一般情况的问卷调查。采用单因素与多因素Logistic回归进行锰摄入水平与糖尿病前期及T2DM患病关系分析。结果天津市和平区体检成年人中T2DM患病率为6.33%,糖尿病前期患病率为6.74%。且T2DM患病率随膳食锰摄入量的增加,呈现上升趋势。调整混杂因素后,膳食锰摄入水平第3和第4四分位数最低四分位数的OR值分别为2.22(95%CI:1.34~3.68,P<0.01)和1.96(95%CI:1.19~3.23,P<0.01),是糖尿病的危险因素。相对于膳食锰摄入水平最低四分位数,第2四分位数摄入水平是糖尿病前期患病的保护因素,其OR值为0.62(95%CI:0.39~0.98,P>0.05)。结论过量摄入锰元素可增加T2DM患病风险,适量摄入锰元素可一定程度预防并控制T2DM发生和发展。

Objective To explore the relationship between dietary manganese intake level and type 2 diabetes(T2 DM)in adult population in Tianjin city,so as to provide reasonable dietary suggestions.Methods A total of 2670 adult residents aged 20 to 88 who participated in physical examination in Heping district health education guidance center of Tianjin city were selected for questionnaire survey of general condition,physical examination and laboratory test and dietary intake.Single-factor and multiple-factor logistic regression analysis were used to analyze the association of dietary manganese intake level with pre-diabetes and T2 DM.Results The prevalence of T2 DM among adult population in Heping district,Tianjin city was 6.33%,and that of pre-diabetes was 6.74%.With the increase of dietary Mn intake,the prevalence of T2 DM showed an increasing trend.After adjusted for confounders,the OR value of Mn intake levels for Q3 and Q4 were 2.22(95%CI:1.34-3.68,P<0.01)and1.96(95%CI:1.19-3.23,P<0.01),which is a risk factor for DM.Relative to Mn intake for Q1,Q2 was a protective factor for pre-diabetes,with an OR value of 0.62(95%CI:0.39-0.98,P>0.05).Conclusion Excessive intake of manganese can increase the risk of T2 DM,moderate intake of manganese can prevent and control the occurrence and development of T2 DM.