2021年西藏昌都洛隆县大骨节病病区人群饮食结构

Analysis of diet structure of Kashin-beck disease area in Chamdo-Lhorong of Tibet in 2021

目的了解西藏昌都洛隆县大骨节病病区内患者与非患者的膳食结构并对其进行比较。方法采用病例-对照研究方法,回顾性选取西藏昌都地区洛隆县2021年全国大骨节病监测系统内已完成筛查并登记在册的患者作为病例组源人群,在同居住县域内随机抽取经筛查未患有大骨节病的人群作为对照组。使用自制膳食调查表,以一对一面谈方式记录被调查者家庭过去一年的食物消费种类、食物摄入频次,调查对象基本信息、家庭人口数等基本情况。结果病例组对大米(米饭/米粉)的消费率最高(97.33%),对照组对非小麦制品、非油炸面食(面包/馒头/面条/饺子,方便面除外)消费率最高(90%),78.7%的患者选择不食用当地产小麦(藏面),非患者选择每周食用非当地产小麦(藏面)3~4次的人数显著高于患者。病例组(93.33%)及对照组(90%)对肉及肉制品消费率应答最高的均为牦牛肉(当地),对照组人群还选择消费牛肉(非当地/羔羊肉/羊肉/其他非加工肉类)、禽类和畜类内脏、鱼类(所有海水和淡水鱼)、虾蟹或其他海产品,其消费率及摄入频次都显著高于病例组人群。对照组人群对西红柿、葱蒜类(蒜苗/韭黄/葱/洋葱)]和鲜蛋(鸡蛋/鸭蛋/鹌鹑蛋/鹅蛋)的消费率及摄入频次均显著高于病例组人群。两组人群对水果类和奶及奶制品的消费率及摄入频次没有显著差异。结论西藏昌都洛隆县大骨节病区人群主食除当地青稞(糌粑)外,多数人还选择了外购大米和面粉,改变了以往主食单一的状况。但与病区内健康人群相比,大骨节病人群对鱼类、虾蟹类、禽类及畜类内脏类、蛋类(鲜蛋)及蔬菜(西红柿、葱姜蒜)的消费率和摄入频次显著偏低,肉类品种选择单一,以当地牦牛肉为主,整体膳食结构仍呈现种类单一,膳食不均衡风险。

OBJECTIVE To investigate and compare the dietary structure between healthy people and patients in KBD area of Chamdo-Lhorong of Tibet.METHODS A case-control study design was used,retrospectively select patients who had completed screening and registered in the national Kashin-Beck Disease surveillance system in 2021 in Luolong County,Qamdo,Tibet as the source population of the case group,and randomly selected people who had not been screened for Kashin-Beck disease in the same county as the control group.The self-made diet questionnaire was used to record the types of food consumption,frequency of food intake,basic information of the respondents,family size and other basic information in the past year by one-on-one interview.RESULTS The staple food with the highest response among the patients(97.33%)was rice(rice/rice noodle),and the highest response among the healthy people(90%)was non-wheat products,non-fried pasta(bread/steamed bun/noodles/dumplings),except instant noodles.78.7%of patients chose not to eat local wheat(Tibetan noodles),and the number of non-patients who chose to eat non-local wheat(Tibetan noodles)3-4 times a week was significantly higher than that of patients.The meat and meat products with the highest response in both patients(93.33%)and healthy people(90%)was yak meat(local).The control group also chose to consume beef(non-local/lamb/mutton/other non-processed meat),poultry and livestock offal,fish(all seawater and freshwater fish),shrimp and crabs or other seafood,and their consumption rate and intake frequency were significantly higher than those of the case group.The consumption rate and frequency of tomato,onion and garlic(garlic shoots/leek/onion/onion)and fresh eggs(egg/duck egg/quail egg/goose egg)in control group were significantly higher than those in case group.There was no significant difference in consumption rate and frequency of fruits,milk and dairy products between the two groups.CONCLUSION In addition to the local highland barley(zanba),most people also chose to purchase rice and flour,which changed the situation of single staple food in the past.However,compared with the healthy population in the disease area,the consumption rate and intake frequency of fish,shrimp and crabs,poultry and livestock viscera,eggs(fresh eggs)and vegetables(tomatoes,scallions,ginger and garlic)in KBD patients were significantly lower,the selection of meat varieties is single,mainly local yak meat,and the overall dietary structure still presents the risk of single type and unbalanced diet.