十堰市城区初诊2型糖尿病患者膳食质量及影响因素研究

Study on Dietary Quality and Its Influencing Factors in Newly Diagnosed Type 2 Diabetic Patients in Shiyan Urban Area

目的:了解十堰市城区2型糖尿病(T2DM)患者膳食质量,明确影响因素,为制定适宜干预措施提供依据。方法:采用1∶1年龄、性别匹配的病例对照研究,应用半定量食物频率问卷(FFQ)调查初诊T2DM患者与对照组人群人口社会学特征与健康相关行为、膳食营养摄入现况与人体测量指标,应用中国膳食平衡指数(DBI-16)评估膳食质量。结果:初诊T2DM患者膳食质量总分DBI_TS为-(7.4±8.0),膳食质量距DBI_DQD为32.4±7.4;奶及制品(60.9±23.7) g/d与蛋类(22.4±8.2) g/d的摄入水平未达到推荐摄入水平,盐(10.3±1.9) g/d与油(54.2±19.3) g/d的摄入水平超过推荐摄入水平;家族史[OR=11.300,95%CI(2.898,44.058)]、腰围过大[OR=1.102,95%CI(1.060,1.145)]、甘油三酯异常[OR=1.442,95%CI(1.086,1.914)]、膳食中肉类[OR=1.022,95%CI(1.006,1.038)]、盐[OR=1.108,95%CI(1.057,1.161)]与油[OR=1.074,95%CI(1.001,1.153)]摄入过多是T2DM的危险因素,豆类[OR=0.907,95%CI(0.870,0.947)]摄入是T2DM的保护因素。结论:初诊T2DM患者膳食摄入不足、低度膳食失衡,可增加奶及制品、蛋类与豆类的摄入量,减少肉类、盐与油的摄入量,保持膳食营养均衡,从而提高T2DM患者的膳食质量;将有糖尿病家族史、超重和肥胖人群纳入T2DM高危人群,维持健康体重与体型,减少膳食中脂肪的摄入,是预防和治疗糖尿病的关键。

Objective To clarify the dietary quality of type 2 diabetes patients(T2 DM) in urban areas of Shiyan city and identify the influencing factors, so as to provide some basis for formulating appropriate intervention strategies. Methods A 1∶1 age and sex matched case-control study was conducted. The demographic sociological characteristics and health-related behaviors, dietary nutrient intake and anthropometric indexes of newly diagnosed T2 DM patients and control group were investigated by semi quantitative food frequency questionnaire(FFQ), and the dietary quality was evaluated by Chinese dietary balance index(DBI-16). Results Total score of dietary quality DBI_TS of newly diagnosed T2 DM patients was-(7.4±8.0) and dietary quality distance(DBI_DQD) was 32.4±7.4. The intake levels of milk and products(60.9±23.7 g/d) and eggs(22.4±8.2 g/d) did not reach the recommended intake level. The intake levels of salt(10.3±1.9 g/d) and oil(54.2±19.3 g/d) exceeded the recommended intake level. Family history [OR=11.300, 95%CI(2.898, 44.058)], excessive waist circumference [OR=1.102, 95%CI(1.060, 1.145)], abnormal triglyceride [OR=1.442, 95%CI(1.086, 1.914)], dietary meat [OR=1.022, 95%CI(1.006, 1.038)], salt [OR=1.108, 95%CI(1.057, 1.161)], and oil [OR=1.074, 95%CI(1.001, 1.153)] were risk factors for T2 DM, while the intake of beans [OR=0.907, 95%CI(0.870, 0.947)] was a protective factor for T2 DM. Conclusion The newly diagnosed T2 DM patients have insufficient dietary intake and low dietary imbalance. Increasing the intake of milk and products, eggs and beans, reducing the intake of meat, salt and oil, and maintaining a balanced diet can improve the dietary quality of T2 DM patients. The key to preventing and treating diabetes is to include people with family history of diabetes, overweight and obesity into high-risk groups of T2 DM, maintain a healthy body weight and body shape, and reduce dietary fat intake.