膳食多样化评估与老年糖尿病前期及2型糖尿病的关联性

The relationship between dietary diversity assessment and prediabetes and type 2 diabetes in the elderly

目的探讨膳食多样化评分(DDS)及膳食指南指数(CDGI-2018)与老年患者糖尿病前期及2型糖尿病的关联性。方法回顾性分析2016年—2020年于西京医院就诊的≥60岁患者的临床信息,其中糖尿病前期组100例、糖尿病组100例、对照组100例。对所有患者进行膳食多样化评估,分析各因素对糖尿病及糖尿病前期的预测效能。结果所有研究对象年龄60~76岁,平均(68.1±6.1)岁。3组间高血压病史、空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbAlc)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、DDS9和CDGI-2018评分差异均有统计学意义(P<0.01)。与对照组比较,糖尿病前期组和糖尿病组TG升高,高血压病史患者增多,DDS9评分降低,差异均有统计学意义(P<0.05)。与糖尿病前期组比较,糖尿病组FBG、2 hPG、HbAlc升高,CDGI-2018评分降低,差异有统计学意义(P<0.05)。与DDS9>6分组比较,DDS9≤6分组FBG、2 hPG、HbAlc、LDL-C和TG升高,糖尿病和糖尿病前期患者增多,CDGI-2018评分降低。HbAlc、LDL-C和高血压病史是糖尿病发病的危险因素,而DDS9是糖尿病发病的保护因素。回归模型区分糖尿病前期组与对照组的曲线下面积(AUC)为0.701(95%CI:0.639~0.764,P<0.001);区分糖尿病组与对照组的AUC为0.770(95%CI:0.708~0.833,P<0.001)。结论基于膳食多样化评估的风险评分模型,对老年患者糖尿病及糖尿病前期预测效能较好,具有一定的临床应用价值。

Objective To explore the relationship between Dietary Diversity Score(DDS)and Dietary Guidelines Index 2018(CDGI-2018)and prediabetes and type 2 diabetes in the elderly.Methods The clinical data of patients≥60 years old treated in Xijing Hospital from 2016 to 2020 were analyzed retrospectively.Among them,100 cases were in the prediabetic group,100 cases in the diabetes group,and 100 cases in the control group.All patients were evaluated for dietary diversification,and the predictive efficacy of various factors on diabetes and prediabetes was analyzed.Results The age of all subjects was 60-76 years old,with an average of(68.1±6.1)years old.There were significant differences in the history of hypertension,fasting blood glucose(FBG),2 h postprandial blood glucose(2 hPG),glycosylated hemoglobin(Hb Alc),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),DDS9 score and CDGI-2018 score among the three groups(P<0.01).Compared with the control group,TG increased in the prediabetic group and the diabetes group,the number of patients with a history of hypertension increased,and the DDS9 score decreased,and the differences were statistically significant(P<0.05).Compared with the prediabetic group,FBG,2 h PG,HbAlc of the diabetic group increased,and CDGI-2018 score decreased,the differences were statistically significant(P<0.05).Compared with DDS9>6 group,FBG,2 h PG,HbAlc,LDL-C and TG of DDS9≤6 group increased,diabetes and prediabetes patients increased,CDGI-2018 score decreased.HbAlc,LDL-C and history of hypertension were risk factors for the onset of diabetes,and DDS9 was a protective factor for the onset of diabetes.The area under the curve(AUC)of the regression model to distinguish the prediabetic group from the control group was 0.701(95%CI:0.639-0.764,P<0.001),and the AUC to distinguish the diabetes group from the control group was 0.770(95%CI:0.708-0.833,P<0.001).Conclusion The risk score model based on DDS has good clinical value in predicting diabetes and prediabetes in the elderly,and has certain clinical application value.