目的 探讨类黄酮膳食模式与老年人群血糖血脂水平之间的相关性及剂量-反应特征,为构建适合老年人群的类黄酮优化膳食模式、改善老年人血糖血脂水平及防控相关慢性病发生发展,提供流行病学依据。方法 以2024年5–10月在齐齐哈尔市社区参加体检的888名65岁以上的老年人为研究对象,收集社会人口学特征信息、体格检查、实验室检查和膳食营养素与类黄酮摄入数据;应用因子分析提取膳食模式,通过多元线性回归及广义加性模型（generalized additive model,GAM）分析类黄酮膳食模式与血糖血脂水平的关联及剂量-反应关系,采用贝叶斯核机器回归模型（bayesian kernel machine regression,BKMR）研究膳食模式中类黄酮亚类对血糖血脂水平影响的联合效应。结果 通过因子分析得到四种膳食模式：以黄酮醇、黄酮、花青素、黄烷醇、黄烷酮、异黄酮摄入为主的“多源黄酮模式”、以黄酮醇、黄烷醇、异黄酮摄入为主的“三类混合黄酮模式”、以黄酮醇、黄烷醇摄入为主的“双类协同黄酮模式”、以异黄酮摄入为主的“单类聚焦黄酮模式”;双类协同黄酮模式、单类聚焦黄酮模式人群的血清总胆固醇（total cholesterol,TC）水平低于其他模式;三类混合黄酮模式、单类聚焦黄酮模式人群的血清甘油三酯(triglyceride,TG)水平低于其他模式;多元线性回归结果显示,双类协同黄酮模式因子得分与血清TC水平成负相关（β=–0.157,P=0.021）;GAM分析结果显示,双类协同黄酮模式的黄烷醇摄入量与血清TC水平之间存在非线性剂量-反应关系;BKMR结果表明,双类协同黄酮模式中同时摄入黄酮醇、黄烷醇存在联合作用,可下调血清TC。结论 黄酮醇、黄烷醇联合摄入能够降低老年人血清总胆固醇水平,与其他模式相比双类协同黄酮模式更益于老年人血清总胆固醇水平的降低。
Abstract
Objective To explore the correlation and dose-response relationship between flavonoid dietary patterns and blood glucose and lipid levels in the elderly population, and provide epidemiological evidence for constructing optimized flavonoid dietary patterns suitable for the elderly, improving their blood glucose and lipid levels, and preventing the occurrence and progression of related chronic diseases. Methods A study was conducted among 888 participants over 65 years old in Qiqihar, China, between May and October 2024. Comprehensive sociodemographic, physical examination, laboratory examination, and dietary data were collected. Factor analysis was employed to identify distinct flavonoid dietary patterns,and the correlation and dose-response relationship were analyzed between flavonoid dietary patterns and glucose and lipid levels by multiple linear regression and generalized additive model (GAM). The combined effects were studied for flavonoid subclasses on glucose and lipid levels by bayesian kernel machine regression (BKMR). Results Based on factor analysis, four dietary patterns were obtained: multi-source flavone pattern with flavonols, flavones, anthocyanins,flavanols, flavanones and isoflavonoids as the main intake, three kinds of mixed flavone pattern with flavonols, flavanols and isoflavonoids as the main intake, two kinds of synergistic flavone pattern, flavonols and flavanols as the main intake and one kind of focused flavone pattern with isoflavonoids as the main intake. Participants adhering to the two kinds of synergistic flavone pattern and one kind of focused flavone pattern exhibited significantly lower total cholesterol (TC) levels, while three kinds of mixed flavone pattern and one kind of focused flavone pattern correlated with reduced triglycerides (TG). Multiple linear regression results show that the two kinds of synergistic flavone pattern score was negatively associated with TC (β = -0.157, P = 0.021). The GAM results showed that there was a nonlinear dose-response relationship between flavanols intake and TC level in the two-class synergistic flavonoids model. The BKMR results showed that there was a significant negative correlation between the joint exposure of flavonols and flavanols and TC in the two-class synergistic flavonoid model. Conclusion The combined intake of flavonols and flavanols can reduce the serum total cholesterol level in the elderly. Compared with other models, the two kinds of synergistic flavone pattern is more beneficial to the reduction of serum total cholesterol level in the elderly.
关键词
膳食模式 /
类黄酮 /
老年人 /
血糖血脂
Key words
dietary pattern /
flavonoids /
elderly people /
blood glucose and lipid levels
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基金
黑龙江省博士后科研启动资金项目（No.LBH-QY25001）; 齐齐哈尔医学院重点学科建设项目(No.QYZDXK-010); 2024齐齐哈尔医学院研究生创新基金项目（No.QYYCX2024-39）
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