四川凉山地区成年居民膳食模式与高尿酸血症关系

Association between dietary pattern and hyperuricemia among adult residents in Liangshan prefecture of Sichuan province

目的了解四川凉山地区成年居民膳食模式及其与高尿酸血症(HUA)的关系,为HUA的预防控制提供参考依据。方法于2014年7月-2016年2月采用分层整群抽样方法在四川凉山地区抽取2970名≥18岁成年居民进行问卷调查、体格检查和实验室检测;采用降秩回归和因子分析提取膳食模式,log-binomial回归模型分析膳食模式与HUA患病的关系。结果四川凉山地区成年居民HUA患病率为26.6%,男性和女性居民HUA患病率分别为36.8%和14.8%。降秩回归在凉山地区成年居民中提取出HUA模式,以摄入较多鱼类、新鲜肉类、酒、含糖饮料、腌熏肉、小麦制品而较少摄入蔬菜、奶类为特征。因子分析在男性居民中提取出混合食物模式、酒肉模式、蔬果模式等3个膳食模式,累计方差贡献率为32.29%;在女性居民中提取出蔬菜鱼肉模式、混合食物模式、蔬菜主食模式等3个膳食模式,累计方差贡献率为34.94%。在调整了年龄、受教育年限、吸烟、饮酒、体质指数(BMI)、高血压、血脂异常等混杂因素后,结果显示,凉山地区成年居民HUA模式得分在Q4者的HUA患病率为得分在Q1者的2.255倍(PR=2.255,95%CI=1.850~2.773);男性居民酒肉模式得分在Q4者的HUA患病率为得分在Q1者的1.374倍(PR=1.374,95%CI=1.146~1.655),蔬果模式得分在Q4者的HUA患病率为得分在Q1者的0.744倍(PR=0.744,95%CI=0.616~0.897);女性居民蔬菜主食模式得分在Q3者和Q4者的HUA患病率分别为得分在Q1者的0.574倍(PR=0.574,95%CI=0.394~0.823)和0.663倍(PR=0.663,95%CI=0.462~0.940)。结论四川凉山地区成年居民HUA模式和男性居民酒肉模式与HUA患病率增加有关,男性居民蔬果模式和女性居民蔬菜主食模式与HUA患病率降低有关。

Objective To explore dietary pattern and its association with hyperuricemia(HUA)among adult residents in Liangshan Yi Autonomous Prefecture(Liangshan)of Sichuan province and to provide evidences for the prevention and control of HUA.Methods We recruited 2970 residents aged 18 years and older in one municipality and two counties of Liangshan using stratified cluster sampling;then we conducted a questionnaire survey,physical examinations and laboratory tests from July 2014 to February 2016.Dietary patterns were extracted with reduced rank regression and factor analysis,and log-binomial regression model was used to analyze the association between dietary patterns and HUA among the participants.Results The prevalence rate of HUA in the participants was 26.6%,and the rate was 36.8%and 14.8%in the male and female participants,respectively.The reduced rank regression extracted a HUA-related dietary pattern characterized by more intake of fish,fresh meat,wine,sugary drinks,cured bacon,wheat products and less intake of vegetables and milk among the participants.Three dietary patterns identified with factor analysis were mixed food pattern,meat and wine pattern,and fruit and vegetable pattern,accounting for 32.29%of total variance,among the male participants;while,among the female participants,the three patterns were vegetable and fish meat pattern,mixed food pattern,and vegetable and staple pattern,accounting for 34.94%.After adjusting for confounding factors as age,years of education,smoking,alcohol drinking,body mass index,hypertension,dyslipidemia,the participants with the first quartile(Q1)score of HUA-related dietary pattern had a higher risk of HUA(prevalence ratio[PR]=2.255,95%confidence interval[95%CI]:1.850–2.773)compared to those with the fourth quartile(Q4)score;the male participants with the Q4 score of meat and wine dietary pattern had a higher risk of HUA(PR=1.374,95%CI:1.146–1.565)compared to those with the Q1 score,while the male participants with the Q4 score of fruit and vegetable pattern had a lower risk of HUA(PR=0.744,95%CI:0.616–0.897)compared to those with the Q1 score;the female participants with higher score of vegetable and staple dietary pattern had a lower risk of HUA(Q3:PR=0.574,95%CI:0.394–0.823;Q4:PR=0.663,95%CI:0.462–0.940)in comparison with those with the Q1 score.Conclusion Among adult residents in Liangshan prefecture of Sichuan province,the HUA-related dietary pattern is associated with increased prevalence of HUA;in the male residents,the meat and wine dietary pattern is related to increased but fruit and vegetable pattern related to decreased HUA prevalence;in the female residents,the vegetable and staple dietary pattern is related to decreased HUA prevalence.