目的 探讨合肥市居民不同膳食模式与血脂异常的关联,为该地区血脂异常的防控提供科学依据。方法 采用多阶段分层整群随机抽样方法,对合肥市五个区县的10 024名≥18岁常住居民进行问卷调查和体格检查。其中膳食情况使用半定量食物频率表并采用因子分析法建立了多元膳食模式、加工食品模式、咸菜蛋类模式以及粮谷蔬菜类模式。将四类膳食模式按照因子得分进行四分位分组（G1-G4）并以G1水平为参数,最后通过Logistic回归分析探讨不同膳食模式与四类血脂异常患病率的关系。结果 调查对象的血脂异常总患病率为32.24%,其中高胆固醇（total cholesterol,TC）、高甘油三酯（triacylglycerol,TG）、低高密度脂蛋白胆固醇（high density lipoprotein-cholesterol,HDL-C）和高低密度脂蛋白胆固醇（low density lipoprotein-cholesterol,LDL-C）分别占5.04%、10.56%、13.20%和3.44%。调整多个混杂因素后,Logistic回归分析结果显示,多元膳食模式与高LDL-C血症患病风险呈负相关（G4：OR=0.658,95%CI：0.469~0.924);加工食品模式是血脂异常的危险因素,与高TC、低HDL-C和高LDL-C血症患病风险均呈正相关 (G4：OR=1.326,95%CI：1.031~1.705;OR=1.253,95%CI：1.056~1.486和OR=1.401,95%CI：1.05~1.868);粮谷蔬菜模式与高TC、高TG血症患病风险呈负相关(G2：OR=0.716,95%CI：0.549~0.933;OR=0.796,95%CI：0.657~0.964)。结论 不同膳食模式与血脂异常之间存在关联,居民在日常饮食中应减少油炸等加工食品的摄入,增加粮谷、蔬菜摄入并坚持均衡的多元膳食模式。
Abstract
Objective To explore the association between dietary patterns and dyslipidemia in adult residents of Hefei City, and to provide scientific basis for the prevention and control of dyslipidemia in this region. Methods A multi-stage stratified cluster random sampling method was used to conduct a questionnaire survey and physical examination among 10 024 permanent residents aged ≥18 years in five districts and counties of Hefei City. The dietary intakes were analyzed using a semi-quantitative food frequency table. Four dietary patterns were established, including multivariate dietary pattern, processed food pattern, salted vegetable and egg pattern, and cereal and vegetable pattern. Then the four dietary patterns were grouped into four quartiles according to the factor scores (G1-G4) and parameterized by the G1. Finally, the relationship between different dietary patterns and the prevalence of dyslipidemia in the four categories was explored by logistic regression analysis. Results The total prevalence of dyslipidemia among the survey respondents was 32.24%, with hypercholesterolemia, hypertriglyceridemia, hypo-HDL cholesterolemia and hyper-LDL cholesterolemia accounting for 5.04%, 10.56%, 13.20% and 3.44%, respectively. After adjusting for several confounders, logistic regression analysis showed that multivariate dietary pattern was negatively associated with the risk of hyper-LDL cholesterolemia (G4: OR=0.658, 95% CI: 0.469-0.924). Processed food pattern was a risk factor for dyslipidemia, and positively associated with the risk of hypercholesterolemia, hypo-HDL cholesterolemia, and hyper-LDL cholesterolemia ( G4: OR=1.326, 95% CI: 1.031-1.705; OR=1.253, 95% CI: 1.056-1.486 and OR=1.401, 95% CI: 1.05-1.868 respectively). Grain and vegetable pattern was negatively associated with the risk of hypercholesterolemia and hypertriglyceridemia (G2: OR=0.716, 95% CI: 0.549-0.933; OR=0.796, 95% CI: 0.657-0.964). Conclusion There is an association between dietary patterns and dyslipidemia. Residents should reduce the intake of fried and other processed foods, increase the intake of grains, cereals and vegetables and adhere to a balanced and diversified dietary pattern in their daily diet.
关键词
膳食模式 /
血脂异常 /
因子分析 /
成年居民 /
合肥市
Key words
dietary patterns /
dyslipidemia /
factor analysis /
adult residents /
Hefei City
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参考文献
[1] 北京高血压防治协会, 北京糖尿病防治协会, 北京慢性病防治与健康教育研究会,等. 基层心血管病综合管理实践指南2020[J]. 中国医学前沿杂志(电子版), 2020, 12: 1–73.
[2] 李建军. 《中国血脂管理指南(2023年)》核心要点解读[J]. 临床心血管病杂志, 2023, 39: 491–494.
[3] Guilbert JJ.The world health report 2002 - reducing risks, promoting healthy life[J]. Educ Health (Abingdon), 2003, 16: 230–235.
[4] Moran A, Gu D, Zhao D, et al. Future cardiovascular disease in China: markov model and risk factor scenario projections from the coronary heart disease policy model-China[J]. Circ Cardiovasc Qual Outcomes, 2010, 3: 243–252.
[5] 健康中国行动(2019—2030年)——心脑血管疾病防治行动[J]. 血管与腔内血管外科杂志, 2019, 5: 312.
[6] 陈冲, 涂青云, 丁甘玲,等. 江苏省居民不同膳食模式对四类血脂异常的影响[J]. 营养学报, 2020, 42: 331–337.
[7] 张桂婷, 丁贤彬, 唐文革,等. 重庆市35~79岁居民膳食模式与血脂异常的相关性研究[J]. 现代预防医学, 2023, 50: 3895–3900.
[8] 黄伦, 任泽萍, 赵俊康,等. 应用因子分析和降秩回归评估膳食模式与血脂异常的关系[J]. 现代预防医学, 2021, 48: 4442–4446.
[9] 中国小康网. 安徽合肥市肥东县行政区划[EB/OL]. (2019-10-16)[2024-4-3]. https://xianyu.chinaxiaokang.com/hefeishi/feidongxian/yilan/2019/1016/790540.html.
[10] 孙锋, 张磊, 王茜,等. 合肥市成年居民血脂异常的影响因素分析[J]. 预防医学, 2022, 34: 1251-1256, 1261.
[11] 中国肥胖问题工作组数据汇总分析协作组. 我国成人体重指数和腰围对相关疾病危险因素异常的预测价值:适宜体重指数和腰围切点的研究[J]. 中华流行病学杂志, 2002, 23: 5–10.
[12] 中国高血压防治指南修订委员会, 中国高血压联盟, 中华医学会心血管病学分会中国医师协会高血压专业委员会,等. 中国高血压防治指南( 2018年修订版)[J]. 中国心血管杂志, 2019, 24: 24–56.
[13] 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2017年版)[J]. 中华糖尿病杂志, 2018, 10: 4–67.
[14] 颜芳, 杨昭, 张茂镕,等. 昆明市2020年成人血脂水平与血脂异常分布特征及影响因素分析[J]. 中国慢性病预防与控制, 2023, 31: 534–538.
[15] 陶寄, 盛敏阳, 许云峰,等. 海宁市居民血脂异常的影响因素分析[J]. 预防医学, 2022, 34: 821–825.
[16] 李建彬, 刘建勋, 武恩平. 郑州市成年居民血脂异常知晓、治疗、控制现状及影响因素分析[J]. 中国慢性病预防与控制, 2022, 30: 525–529.
[17] 徐伟, 邢秀雅, 贺琴,等. 安徽省2015年成年人血脂异常流行现状及相关因素研究[J]. 中华流行病学杂志, 2020, 41: 195–200.
[18] 孟焕, 邱琳, 飒日娜,等. 陕西省成人血脂异常流行现状及相关因素研究[J]. 中国慢性病预防与控制, 2021, 29: 750–755.
[19] 林少凯, 赖善榕, 黄峥,等. 福建省居民膳食模式及高尿酸血症影响因素分类树分析[J]. 中国公共卫生, 2018, 34: 798–802.
[20] 《中国居民膳食指南(2022)》在京发布[J]. 营养学报, 2022, 44: 521–522.
[21] Rumawas ME, Meigs JB, Dwyer JT, et al. Mediterranean-style dietary pattern, reduced risk of metabolic syndrome traits, and incidence in the Framingham Offspring Cohort[J]. Am J Clin Nutr, 2009, 90: 1608–1614.
[22] 中国健康管理协会临床营养与健康分会, 中国营养学会临床营养分会, 《中华健康管理学杂志》编辑委员会. 血脂异常医学营养管理专家共识[J]. 中华健康管理学杂志, 2023, 17: 561–573.
[23] Kim J, Hoang T, Bu SY, et al. Associations of dietary intake with cardiovascular disease, blood pressure, and lipid profile in the Korean population: a systematic review and meta-analysis[J]. J Lipid Atheroscler, 2020, 9: 205–229.
[24] Qin P, Zhang M, Han M, et al. Fried-food consumption and risk of cardiovascular disease and all-cause mortality: a meta-analysis of observational studies[J]. Heart, 2021, 107: 1567–1575.
[25] Schoeneck M, Iggman D.The effects of foods on LDL cholesterol levels: a systematic review of the accumulated evidence from systematic reviews and meta-analyses of randomized controlled trials[J]. Nutr Metab Cardiovasc Dis, 2021, 31: 1325–1338.
[26] Qin C, Lv J, Guo Y, et al. Associations of egg consumption with cardiovascular disease in a cohort study of 0.5 million Chinese adults[J]. Heart, 2018, 104: 1756–1763.
基金
国家自然科学基金青年项目(No.72304004); 安徽医科大学校科研基金项目（No.2022xkj269）
