中国八城市成年人膳食模式与骨健康关系研究

CORRELATIONS BETWEEN DIETARY PATTERN AND BONE HEALTH AMONG ADULTS IN EIGHT CITIES OF CHINA

目的了解中国八城市成年人骨健康现状,分析膳食模式与骨健康的关系。方法采用多阶段分层抽样的方法 ,抽取北京、广州、成都、兰州、许昌、吉林、芜湖及郴州八个城市十个社区的1694名18岁以上居民进行问卷调查、身体测量,并使用超声骨强度仪检测骨强度;应用因子分析提取膳食模式,通过方差分析比较不同膳食模式得分组间的骨强度值;使用多重线性回归分析膳食模式与骨健康的关系。结果 (1) 1694名居民的骨强度Z值平均值为(0.09±1.31)。65岁以上人群骨强度Z值低于其他两组年龄较低人群(P=0.001,P<0.001),已绝经女性的骨强度Z值低于未绝经女性(P=0.005)。(2)通过因子分析提取出四种膳食模式,命名为肉食模式、平衡模式、酒水模式和高钙和蛋白模式(膳食模式Ⅰ、Ⅱ、Ⅲ、Ⅳ)。将膳食模式得分按四分类分组,发现膳食模式Ⅰ不同得分组间骨强度Z值的差异存在统计学意义(P=0.045),高膳食模式Ⅰ组的骨强度Z值低于低膳食模式Ⅰ组。(3)应用多重线性回归模型,在调整了年龄、文化程度、是否绝经、身体活动水平、体质指数和体脂百分比后,结果显示,在45-64岁的男性中,膳食模式Ⅲ得分与骨强度Z值成负相关关系,β=-0.132,在45~64岁的女性中,膳食模式Ⅰ得分与骨强度Z值负相关,β=-0.296。结论膳食模式与骨健康存在一定关联,多摄入肉类或酒水的膳食模式,对于中老年人群的骨健康存在不利影响。[营养学报,2020,42 (5):423-428]

Objective To find out about the bone health status of adults in eight cities of China and the association between dietary pattern and bone health.Methods A multi-stage stratified sampling method was used to select 1694 residents aged 18 or older from ten communities in eight cities(Beijing,Guangzhou,Chengdu,Lanzhou,Xuchang,Jilin,Wuhu and Chenzhou) to conduct questionnaire surveys and physical examinations.A quantitative ultrasound(QUS) instrument was used to measure bone strength.Factor analysis was used to extract dietary patterns,while analysis of variance was conducted to compare the Z-scores between different groups of dietary pattern scores.Multiple linear regression was used to explore the correlations between dietary pattern and bone health.Results(1) The average Z-score of the 1694 residents was(0.09±1.31).Z-scores of the people over 65 years old were lower than those of the other two younger groups(P=0.001,P<0.001).Z-scores of the postmenopausal women were lower than those of the non-menopausal women(P=0.005).(2) Four dietary patterns were extracted and named "meat pattern,balanced pattern,alcohol pattern,calcium and protein pattern"(dietary pattern Ⅰ,Ⅱ,Ⅲ,and Ⅳ),respectively.The dietary pattern scores were ranked and divided into four groups with the boundaries of quarters(Q1,Q2,Q3,Q4).There was statistically significant difference in Z-scores between different dietary pattern Ⅰ groups(P=0.045).Z-scores of Q4 was lower than Q1 in dietary pattern Ⅰ.(3) After adjustment for age,level of education,menopause status,physical activity levels,body mass index,and body fat percentage,multiple linear regression showed that the dietary patternⅢ score was negatively correlated with Z-score among men aged 45 to 64,β=-0.132.The dietary pattern Ⅰ score was negatively correlated with Z-score among women aged 45 to 64,β=-0.296.Conclusion Dietary pattern is related to bone health.A dietary pattern that consumes much meat or alcohol has an adverse effect on bone health in people aged 45 to 64.[ACTA NUTRIMENTA SINICA,2020,42(5):423-428]