Woo J, Ho S C, Sham A, Sea M M, Lam K S L, Lam T H, Janus E D
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Republic of China.
Eur J Clin Nutr. 2003 Apr;57(4):523-30. doi: 10.1038/sj.ejcn.1601586.
Associations between dietary factors and glucose tolerance observed in Caucasian populations may not be applicable to Chinese populations, since the traditional Chinese diet contains plentiful vegetables and is rice-based (which has a lower glycemic index than potatoes). To address this question, the dietary patterns in 988 Hong Kong Chinese subjects with normal and impaired glucose tolerance, and diabetes, were examined in a cross sectional survey to determine if there is any association between diet and glucose tolerance.
A stratified random population sample of 988 subjects (488 male, 500 female) was recruited. A food frequency questionnaire was used to determine dietary intake, and glucose tolerance was examined using the glucose tolerance test and the WHO criteria used to classify subjects into the three glucose tolerance categories.
Using the standardized world population of Segi, the prevalence rate for DM was 6.6% for men and 5.7% for women; and for IGT 10.3% for men and 15.4% for women aged 30-64 y. Abnormal glucose tolerance is associated with female gender, older age, lower educational attainment and higher body mass index (BMI). No clear pattern of association with dietary factors was observed after adjusting for confounding factors. However, if subjects with BMI>or=25 kg/m(2) were excluded, an increase in mean consumption of rice/noodles/pasta per week was observed in the DM group, after adjusting for total energy intake and other confounding factors. No association between dietary variety, which has been linked with body fatness, and glucose tolerance, was observed.
Dietary habit may not be a strong risk factor for the development of glucose intolerance in Chinese populations, given the favorable features of the Chinese diet. The high consumption of rice in the DM subjects who are of normal BMI suggests that further studies examining glycemic indices of Chinese food items may be beneficial. Obesity still remains the most important predisposing factor.
在白种人群中观察到的饮食因素与糖耐量之间的关联可能不适用于中国人群，因为传统的中国饮食包含大量蔬菜且以大米为主（大米的血糖生成指数低于土豆）。为解决这个问题，在一项横断面调查中对988名糖耐量正常、糖耐量受损及患有糖尿病的中国香港受试者的饮食模式进行了研究，以确定饮食与糖耐量之间是否存在关联。
招募了988名受试者（488名男性，500名女性）的分层随机人群样本。使用食物频率问卷确定饮食摄入量，并通过葡萄糖耐量试验和世界卫生组织用于将受试者分为三种糖耐量类别的标准来检查糖耐量。
按照Segi的标准化世界人口计算，30 - 64岁男性糖尿病患病率为6.6%，女性为5.7%；男性糖耐量受损患病率为10.3%，女性为15.4%。糖耐量异常与女性性别、年龄较大、教育程度较低和体重指数（BMI）较高有关。在调整混杂因素后，未观察到与饮食因素的明确关联模式。然而，如果排除BMI≥25 kg/m²的受试者，在调整总能量摄入和其他混杂因素后，糖尿病组每周大米/面条/面食的平均摄入量有所增加。未观察到与已与体脂相关的饮食多样性和糖耐量之间的关联。
鉴于中国饮食的有利特征，饮食习惯可能不是中国人群糖耐量异常发展的强风险因素。正常BMI的糖尿病受试者大米摄入量高表明，进一步研究中国食物的血糖生成指数可能有益。肥胖仍然是最重要的易感因素。
