| 刘珂,陈一佳,苏健,范习康,俞浩,覃玉,杨婕,朱政,官昊宇,沈冲,潘恩春,陆艳,周金意,武鸣.饮食摄入种类和体力活动与2型糖尿病患者死亡风险的前瞻性研究[J].中华流行病学杂志,2023,44(10):1591-1598 |
| 饮食摄入种类和体力活动与2型糖尿病患者死亡风险的前瞻性研究 |
| Association of category of dietary intake and physical activity with the risk of mortality in patients with type 2 diabetes mellitus： a prospective cohort study |
| 收稿日期:2023-03-28 出版日期:2023-10-12 |
| DOI：10.3760/cma.j.cn112338-20230328-00188 |
| 中文关键词: 糖尿病，2型 饮食摄入种类 体力活动 联合作用 死亡风险 |
| 英文关键词: Diabetes mellitus, type 2 Category of dietary intake Physical activity Combined effect Risk of mortality |
| 基金项目:江苏省医学领军人才和创新团队项目（K201105）；江苏省第五期“333工程”科研项目（BRA2020090）；江苏省卫生健康委2020年度医学科研项目（M2020085）；苏州市科技局民生科技-科技示范工程项目（SS202010） |
| 作者 | 单位 | E-mail | | 刘珂 | 东南大学公共卫生学院, 南京 210009 | | | 陈一佳 | 南京市疾病预防控制中心慢性非传染病防制科, 南京 210003 | | | 苏健 | 江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009 | | | 范习康 | 江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009 | | | 俞浩 | 江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009 | | | 覃玉 | 江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009 | | | 杨婕 | 江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009 | | | 朱政 | 江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009 | | | 官昊宇 | 南京医科大学公共卫生学院, 南京 211166 | | | 沈冲 | 南京医科大学公共卫生学院, 南京 211166 | | | 潘恩春 | 淮安市疾病预防控制中心慢性病预防控制科, 淮安 223001 | | | 陆艳 | 苏州市疾病预防控制中心慢性病预防控制科, 苏州 215004 | | | 周金意 | 江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009 | | | 武鸣 | 东南大学公共卫生学院, 南京 210009
江苏省疾病预防控制中心慢性非传染病防制所, 南京 210009 | jswuming@vip.sina.com |
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| 中文摘要: |
| 目的 探讨2型糖尿病（T2DM）患者饮食摄入种类和体力活动及其联合作用与全因死亡和特定原因死亡风险的关联。方法 2013年12月至2021年12月，对江苏省常熟市、淮安市清江浦区（原清河区）和淮安区纳入国家基本公共卫生服务管理的T2DM患者19 863人开展前瞻性队列研究。死亡信息和根本死因源于江苏省CDC死亡监测系统。利用Cox比例风险回归模型估计T2DM患者饮食摄入种类、体力活动以及联合作用与全因死亡及特定原因死亡风险的关联强度。结果 截至2021年12月31日，研究对象累计随访150 283人年，中位随访时间8.15年，随访期间共死亡3 293人，其中1 124人死于心血管疾病（CVD），875人死于肿瘤。Cox比例风险回归模型分析结果显示，与摄入0~1种食物的T2DM患者相比，摄入5~9种食物的患者全因死亡风险降低19%［风险比（HR）=0.81，95%CI：0.70~0.94］，CVD死亡风险降低33%（HR=0.67，95%CI：0.52~0.87）。与体力活动Q1组的T2DM患者相比，Q4组全因、CVD和肿瘤死亡风险分别降低50%（HR=0.50，95%CI：0.45~0.56）、50%（HR=0.50，95%CI：0.41~0.61）和27%（HR=0.73，95%CI：0.60~0.88）。联合作用显示，与摄入0~2种食物和低体力活动的T2DM患者相比，摄入4~9种食物和高体力活动的T2DM患者全因、CVD和肿瘤死亡风险分别降低55%（HR=0.45，95%CI：0.38~0.53）、56%（HR=0.44，95%CI：0.32~0.59）和40%（HR=0.60，95%CI：0.44~0.82）。结论 饮食摄入种类和体力活动及其联合作用与T2DM患者死亡风险降低相关。 |
| 英文摘要: |
| Objective To investigate the association between dietary intake and physical activity category and their combined effects on all-cause and cause-specific mortality risk in patients with type 2 diabetes mellitus (T2DM). Methods Between December 2013 and December 2021, a prospective cohort study was conducted on 19 863 T2DM patients in Changshu City, Qingjiangpu District (formerly Qinghe District), and Huai'an District, included in the national basic health service management. Information on deaths and underlying causes of death was obtained from the Jiangsu Provincial CDC and Prevention Death Surveillance System. Cox proportional hazards models were used to estimate the intensity of associations between dietary intake, physical activity, and their combined effects with all-cause and cause-specific mortality in patients with T2DM. Results As of December 31, 2021, the research subjects had been followed up for 150 283 person-years, with a median follow-up time of 8.15 years. During the follow-up period, 3 293 people died, including 1 124 deaths from cardiovascular disease (CVD) and 875 deaths from cancer. Cox regression analysis showed that compared with the population of 0-1 recommended food group, those having more than five recommended food groups had a 19% lower risk of all-cause mortality [hazard ratio (HR)=0.81, 95%CI: 0.70-0.94] and a 33% lower risk of all-cause mortality (HR=0.67, 95%CI: 0.52-0.87). Compared with the T2DM population in the physical activity Q1 group, the risk of all-cause mortality, CVD mortality, and cancer mortality among the physical activity Q4 group reduced by 50% (HR=0.50, 95%CI: 0.45-0.56), 50% (HR=0.50, 95%CI: 0.41-0.61), and 27% (HR=0.73, 95%CI: 0.60-0.88), respectively. The combined effect showed that compared with the population in the intake of food categories 0-2 and low physical activity groups, the risk of all-cause, CVD mortality, and cancer mortality in the intake of food categories 4-9 and high physical activity groups reduced by 55% (HR=0.45, 95%CI: 0.38-0.53), 56% (HR=0.44, 95%CI: 0.32-0.59), and 40% (HR=0.60, 95%CI: 0.44-0.82), respectively. Conclusion Type of dietary intake, physical activity, and their combined effects are associated with a reduced mortality risk in patients with T2DM. |
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