青海省藏族牧民肥胖流行状况及其与饮食模式关系的队列研究

李珂; 张海东; 简文秀; 孙晓敏; 赵磊; 汪海静; 尕藏卓玛; 王彦香; 许志华; 王友发; 彭雯

文章摘要

李珂,张海东,简文秀,孙晓敏,赵磊,汪海静,尕藏卓玛,王彦香,许志华,王友发,彭雯.青海省藏族牧民肥胖流行状况及其与饮食模式关系的队列研究[J].中华流行病学杂志,2023,44(8):1257-1263

青海省藏族牧民肥胖流行状况及其与饮食模式关系的队列研究

Prevalence of obesity and its association with dietary patterns:a cohort study among Tibetan pastoralists in Qinghai Province

收稿日期:2022-12-25 出版日期:2023-08-18

DOI：10.3760/cma.j.cn112338-20221225-01082

中文关键词: 肥胖中心性肥胖患病率饮食模式危险因素保护因素

英文关键词: Obesity Central obesity Prevalence Dietary pattern Risk factors Protective factors

基金项目:国家自然科学基金（82103846）；青海省重点研发与转化计划（2023-QY-204）；青海省重大科技专项（2021-NK-A3）；中国营养学会营养科普与传播研究基金（CNS-SCP2020-40）

作者	单位	E-mail
李珂	西安交通大学全球健康研究院公共卫生学院, 西安 710049
张海东	青海省格尔木市疾病预防控制中心, 格尔木 816000
简文秀	青海大学医学部营养健康促进中心公共卫生系, 西宁 810008
孙晓敏	西安交通大学全球健康研究院公共卫生学院, 西安 710049 西安交通大学国际肥胖与代谢性疾病研究中心, 西安 710049
赵磊	青海大学医学部营养健康促进中心公共卫生系, 西宁 810008
汪海静	青海大学医学部营养健康促进中心公共卫生系, 西宁 810008
尕藏卓玛	青海大学医学部营养健康促进中心公共卫生系, 西宁 810008
王彦香	青海大学医学部营养健康促进中心公共卫生系, 西宁 810008
许志华	青海省疾病预防控制中心慢性非传染病预防控制所, 西宁 810007
王友发	西安交通大学全球健康研究院公共卫生学院, 西安 710049 西安交通大学国际肥胖与代谢性疾病研究中心, 西安 710049	youfawang@gmail.com
彭雯	青海大学医学部营养健康促进中心公共卫生系, 西宁 810008 青海省糖脂代谢疾病防控中医药重点实验室, 西宁 810008	wen.peng2014@foxmail.com

摘要点击次数: 2844

全文下载次数: 678

中文摘要:

目的探索青海省城镇化转型中藏族牧民成年人肥胖的流行状况及其与饮食模式的关系。方法采用开放队列设计,2018年基线入组1 003人,2022年随访599人,新入组1 012人。共纳入 ≥ 18岁成年人1 913人,对其开展问卷调查和健康检查。使用因子分析法识别饮食模式,用混合效应模型分析饮食模式与肥胖关系。结果 2018-2022年超重、肥胖和中心性肥胖患病率分别为27.6%、33.8%和54.6%,肥胖和中心性肥胖年龄性别标化患病率均上升。共识别3种饮食模式:现代饮食模式(常食用猪肉、家禽肉类、加工肉类、新鲜水果、含糖饮料、咸味零食等)、城镇饮食模式(常食用精制碳水化合物、牛羊肉、蔬菜和鲜蛋类等)、牧区饮食模式(常食用糌粑、藏式奶酪、酥油茶/奶茶和乳制品等)。校正人口学特征、社会经济状况及生活行为方式后,相比城镇饮食模式得分T₁组,T₃组超重和超重/肥胖风险显著增加(超重:OR=2.09,95%CI:1.10~3.95;超重/肥胖:OR=1.23,95%CI:1.00~1.51),而牧区饮食模式得分T₃组超重、肥胖、超重/肥胖和中心性肥胖的风险降低(超重:OR=0.45,95%CI:0.24~0.84;肥胖:OR=0.81,95%CI:0.69~0.95;超重/肥胖:OR=0.75,95%CI:0.61~0.91;中心性肥胖:OR=0.58,95%CI:0.38~0.89)。结论城镇化转型中藏族牧民肥胖和中心性肥胖高发。城镇饮食模式是超重、超重/肥胖的危险因素,牧区饮食模式是超重、肥胖、超重/肥胖和中心性肥胖的保护因素。需制定针对性干预措施,提升健康水平。

英文摘要:

Objectives To explore obesity prevalence and its association with dietary patterns among Tibetan pastoralists during the urbanization transition in Qinghai Province. Methods Using an open cohort study design, 1 003 subjects were enrolled at baseline in 2018, 599 were followed up, and 1 012 were newly recruited in 2022. A total of 1 913 adults over 18 years were included in the study, and a questionnaire survey and health examination were conducted. Factor analysis was used to identify dietary patterns, and a mixed-effects model was used to analyze the association between dietary patterns and obesity. Results From 2018 to 2022, the prevalence rates of overweight, obesity, and central obesity were 27.6%, 33.8%, and 54.6%, respectively. Age-sex-standardized prevalence of obesity and central obesity increased. Three dietary patterns were identified:the modern pattern was characterized by frequent consumption of pork, poultry, processed meat, fresh fruits, sugary drinks, salty snacks, etcetera; the urban pattern was characterized by frequent consumption of refined carbohydrates, beef and mutton, vegetables and eggs, etcetera; and pastoral pattern featured frequent consumption of tsamba, Tibetan cheese, buttered/milk tea, and whole-fat dairy products. After adjusting for demographic characteristics, socioeconomic status, and lifestyle factors, compared with the T₁, subjects in the T₃ of urban pattern scores were more likely to be overweight (OR=2.09, 95%CI:1.10-3.95) and overweight/obese (OR=1.23, 95%CI:1.00-1.51), whereas those in the T₃ of pastoral pattern scores had a lower risk of overweight (OR=0.45, 95%CI:0.24-0.84), obesity (OR=0.81, 95%CI:0.69-0.95), overweight/obesity (OR=0.75, 95%CI:0.61-0.91) and central obesity (OR=0.58, 95%CI:0.38-0.89). Conclusions Prevalence of obesity and central obesity was high among Tibetan pastoralists during the urbanization transition. Urban dietary pattern was a risk factor for overweight and overweight/obesity, whereas pastoral dietary pattern was a protective factor for overweight, obesity, overweight/obesity, and central obesity. Tailored interventions are needed to improve local people's health.

查看全文 Html全文查看/发表评论下载PDF阅读器

关闭