西安市成年肥胖人群膳食多样化与肥胖代谢表型的关联性

Association between dietary diversity and obesity metabolic phenotypes in obese adults in Xi’an

目的了解西安市成年肥胖人群的膳食多样化与肥胖代谢表型的关系。方法数据来源于西北区域自然人群队列中西安城市队列人群的基线调查,选择具有血样且反映代谢表型指标完整的肥胖人群(BMI≥28 kg/m^(2))1069例。根据代谢综合征联合国际多学会联合声明的标准定义肥胖代谢表型。参考膳食多样化得分的评价规则,结合中国居民膳食指南构建膳食多样化指标。运用logistic回归分析模型探讨膳食多样化与肥胖代谢表型关系。结果研究对象的膳食多样化存在性别差异,不同肥胖代谢表型者的膳食多样化总分差异有统计学意义。与代谢正常肥胖者相比,代谢异常者膳食多样化得分较低[(4.20±1.88)vs.(4.51±1.97),P=0.010],其畜禽肉、鱼虾、蛋、奶及奶制品的摄入较低。控制混杂因素后,与膳食多样化得分最低的肥胖者相比,得分最高者患代谢异常的风险降低38%(OR=0.62,95%CI:0.40~0.96),膳食多样化得分每增加一个单位,肥胖者的代谢异常风险降低10%(OR=0.90,95%CI:0.82~0.99),这种关联在女性和强体力活动的肥胖人群中更明显。结论膳食多样化增加与成年肥胖人群代谢异常风险减少有关联。采取多样化膳食可能是预防和控制肥胖人群代谢异常的重要营养干预措施。

Objective To investigate the association between dietary diversity and metabolic phenotypes of obesity in obese adults in Xi’an.Methods Data were from the baseline survey of Xi’an urban population in the northwest natural population cohort.A total of 1069 obese participants assessed by BMI≥28 kg/m^(2) with blood samples were selected for analysis.Metabolic phenotypes of obesity were defined based on the metabolic syndrome by Joint Interim Statement criteria.By referring to the evaluation rules of dietary diversity score and the Chinese dietary guidelines the index for dietary diversity was establish.Logistic regression model was used to explore the association between dietary diversity and metabolic phenotypes of obesity.Results There were gender differences in dietary diversity.The total dietary diversity score of obesity participants with different metabolic phenotypes was significantly different.Compared with metabolically healthy obesity,the total dietary diversity score of participants with metabolically unhealthy obesity was lower[(4.20±1.88)vs.(4.51±1.97),P=0.010],mainly reflecting lower intake of meat,poultry,fish,eggs and dairy.After controlling for confounding factors,the participants with the highest score had a 38%lower risk of metabolic abnormalities compared to those with the lowest dietary diversity score(OR=0.62,95%CI:0.40-0.96).For each unit increase in dietary diversity score,the risk of metabolic abnormalities in obese people decreased by 10%(OR=0.90,95%CI:0.82-0.99),and this association was more obvious in women and strong metabolite equivalents obese people.Conclusions Increased dietary diversity may be associated with reduced risk of metabolic abnormalities in obese adults.Adopting diversified diet may be an important nutritional intervention to prevent and control metabolic abnormalities in obese people.