| 雷丽云,秦莉,王占国,王君,赵群,姬超琴,陈波,张庆军,周芳,武鸣,周金意,王文绢.膳食模式对社区管理2型糖尿病患者血糖控制影响的研究[J].Chinese journal of Epidemiology,2024,45(2):242-249 |
| 膳食模式对社区管理2型糖尿病患者血糖控制影响的研究 |
| Study of the effects of dietary patterns on glycemic control in community type 2 diabetic mellitus patients |
| Received:July 06, 2023 |
| DOI：10.3760/cma.j.cn112338-20230706-00418 |
| KeyWord: 糖尿病，2型 膳食模式 血糖控制 |
| English Key Word: Diabetes mellitus, type 2 Dietary patterns Blood glucose control |
| FundProject:世界糖尿病基金会（WDF13-805） |
| Author Name | Affiliation | E-mail | | Lei Liyun | Obesity and Metabolic Disease Prevention and Control Room, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | Qin Li | Obesity and Metabolic Disease Prevention and Control Room, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Department for Surveillance and Early Earning, Beijing Center for Public Health Emergency Management, Beijing 100053, China | | | Wang Zhanguo | Obesity and Metabolic Disease Prevention and Control Room, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Health Supervision Institute, Langfang Economic and Technological Development Zone, Langfang 065001, China | | | Wang Jun | Obesity and Metabolic Disease Prevention and Control Room, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Conrtol and Prevention, Beijing 100021, China | | | Zhao Qun | Obesity and Metabolic Disease Prevention and Control Room, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Department of Infectious Disease and Endemic Disease Control, Beijing Tongzhou District Center for Disease Control and Prevention, Beijing 101100, China | | | Ji Chaoqin | Obesity and Metabolic Disease Prevention and Control Room, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Chronic Disease Prevention and Treatment Department, Beijing Tongzhou District Center for Disease Control and Prevention, Beijing 101100, China | | | Chen Bo | Cancer and Key Chronic Disease Control and Prevention Laboratory, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China | | | Zhang Qingjun | Institute of Chronic and Non-communicable Diseases, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China | | | Zhou Fang | Institute of Chronic and Non-communicable Diseases, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China | | | Wu Ming | Department of Chronic and Non-communicable Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China | | | Zhou Jinyi | Department of Chronic and Non-communicable Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China | | | Wang Wenjuan | Obesity and Metabolic Disease Prevention and Control Room, National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China | wwj63131779@126.com |
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| Abstract: |
| 目的 了解膳食对社区管理2型糖尿病（T2DM）患者血糖控制的影响，为实施针对糖尿病患者的防治策略和措施提供依据。方法 于2015年在常熟市和武汉市随机抽取8个社区，对进行社区管理的T2DM患者进行问卷调查、身体测量和血糖检测。研究采用因子分析获得膳食模式。并分别以FPG、餐后2 h血糖控制是否达标为因变量，进行非条件多因素logistic回归分析影响因素。结果 最终共纳入1 818名T2DM患者，患者FPG控制率为57.59%（95%CI：55.30%~59.86%），餐后2 h血糖控制率为24.90%（95%CI：22.93%~26.91%）；因子分析得到5种膳食模式：动物性食物模式、水果-水产-薯类模式、蔬菜-谷物模式、蛋-奶-豆模式和油盐模式。非条件多因素logistic回归分析显示，调整其他因素后，FPG达标概率降低与动物性食物模式（OR=0.71，95%CI：0.52~0.98）、水果-水产-薯类模式（OR=0.71，95%CI：0.51~0.97）相关，餐后2 h血糖达标概率降低与水果-水产-薯类模式（OR=0.60，95%CI：0.40~0.90）相关，FPG和餐后2 h血糖达标概率增加均与蔬菜-谷物模式（OR=1.41，95%CI：1.03~1.94；OR=1.68，95%CI：1.13~2.51）、蛋-奶-豆模式（OR=1.75，95%CI：1.25~2.46；OR=1.56，95%CI：1.00~2.42）有关。与蛋-奶-豆模式Q4组相比，膳食模式组合（水果-水产-薯类模式Q4组、蔬菜-谷物模式Q2组、蛋-奶-豆模式Q3组）FPG控制达标可能性更高（OR=6.79，95%CI：1.15~40.23，P=0.035）；与蔬菜-谷物模式Q4组相比，膳食模式组合（水果-水产-薯类模式Q4组、蔬菜-谷物模式Q3组、蛋-奶-豆模式Q2组、油盐模式Q2组）餐后2 h血糖控制达标可能性更高（OR=12.78，95%CI：1.26~130.05，P=0.031）。结论 搭配得当的膳食模式及膳食模式组合更有利于武汉市和常熟市社区管理T2DM患者的FPG和餐后2 h血糖控制，应加强患者营养教育，提高患者食物搭配能力。 |
| English Abstract: |
| Objective To understand the impact of diet on glycemic control in community-managed patients with type 2 diabetes mellitus (T2DM) and provide evidence for implementing prevention strategies and measures for diabetes patients. Methods Eight communities were randomly selected from Changshu and Wuhan in 2015, and T2DM patients managed in the community were selected to conduct questionnaire surveys, physical measurements, and blood glucose testing. Factor analysis was used to obtain dietary patterns. A binary logistic regression model was used to analyze the factors affecting glycemic control. Results Finally, 1 818 T2DM patients were included, and the control rate of FPG was 57.59% (95%CI: 55.30%-59.86%), and the control rate of 2 h postprandial blood glucose (2 h PBG) was 24.90% (95%CI: 22.93%- 26.91%). Five dietary patterns were obtained by factor analysis: animal food pattern, fruit-aquatic products-potato patterns, vegetable-grain pattern, egg-milk-bean pattern, and oil-salt patterns. No-conditional multivariate logistic regression analysis showed that after adjusting for confounding factors, the reduced probability of FPG control was related to animal food pattern (OR=0.71, 95%CI: 0.52-0.98) and fruit-aquatic products-potato patterns (OR=0.71, 95%CI: 0.51-0.97). The decrease in the 2 h PBG control probability was related to fruit-aquatic products-potato patterns (OR=0.60, 95%CI: 0.40-0.90). The increased probability of FPG and 2 h postprandial glucose control were both related to vegetable-grain pattern (OR=1.41, 95%CI: 1.03-1.94; OR=1.68, 95%CI: 1.13-2.51) and egg-milk-bean pattern (OR=1.75, 95%CI: 1.25-2.46; OR=1.56, 95%CI: 1.00-2.42). Compared with the Q4 group of egg-milk-bean pattern, the FPG control rate of the combination of "fruit-aquatic products-potato pattern (Q4 group), vegetable-grain pattern (Q2 group), egg-milk-bean pattern (Q3 group)" was higher (OR=6.79, 95%CI: 1.15-40.23, P=0.035). Compared with the Q4 group of vegetable-grain pattern, the combination of "fruit-aquatic products-potato pattern (Q4 group), vegetable-grain pattern (Q3 group), egg-milk-bean pattern (Q2 group), oil-salt pattern (Q2 group)" had higher control rate of 2 h PBG (OR=12.78, 95%CI: 1.26-130.05, P=0.031). Conclusions A proper combination of dietary patterns and dietary patterns are more conducive to the control of FPG and 2 h PBG in T2DM patients managed in the communities of Wuhan and Changshu. Patient nutrition education should be strengthened, and the food-matching ability of patients should be improved. |
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