Epple Carolyn, Wright Anne L, Joish Vijay N, Bauer Mark
Sonoma State University, Rohnert Park, California 94928, USA.
Diabetes Care. 2003 Oct;26(10):2829-34. doi: 10.2337/diacare.26.10.2829.
We examined if active family nutritional support is associated with improved metabolic outcomes for Diné (Navajo) individuals living with type 2 diabetes.
The presence of family support, using variables identified in earlier ethnographic research, was assessed via surveys in a convenience sample of 163 diabetic individuals. Diabetes outcome measures (HbA(1c), serum glucose, triglycerides, total cholesterol, creatinine, and systolic and diastolic blood pressure measures) were extracted from participants' medical records. Bivariate analyses and multiple logistic regressions were conducted.
All measures of family support showed a relation with one or more indicators of metabolic control in bivariate analyses. In multivariate analyses, respondents were more likely to be in the best tertile for triglyceride (P < 0.05), cholesterol (P < 0.05), and HbA(1c) (P < 0.05) if another person cooked most of the meals. Respondents in families who bought/cooked "light" foods were more likely to be in the best tertile for triglyceride (P < 0.005) and cholesterol levels (P < 0.005), and those in families whose members ate "light" foods with them were more likely to be in the best tertile for triglycerides (P < 0.005). When all three support variables were entered into a multivariate model, only the variable "other family members cook the majority of the meals" was significantly associated with being in the lowest triglyceride (P = 0.05), HbA(1c) (P < 0.05), or cholesterol tertiles (P < 0.05). These relationships were most evident for women with diabetes.
Active family nutritional support, as measured by culturally relevant categories, is significantly associated with control of triglyceride, cholesterol, and HbA(1c) levels. The findings suggest that the family is a more useful unit of intervention for Diné individuals than for the individual alone when designing diabetes care strategies.
我们研究了积极的家庭营养支持是否与患有2型糖尿病的迪内（纳瓦霍）个体改善的代谢结果相关。
通过对163名糖尿病个体的便利样本进行调查，利用早期人种学研究中确定的变量来评估家庭支持的存在情况。从参与者的医疗记录中提取糖尿病结局指标（糖化血红蛋白、血清葡萄糖、甘油三酯、总胆固醇、肌酐以及收缩压和舒张压测量值）。进行了双变量分析和多元逻辑回归。
在双变量分析中，所有家庭支持指标均与一个或多个代谢控制指标存在关联。在多变量分析中，如果大部分饭菜由他人烹饪，受访者的甘油三酯（P < 0.05）、胆固醇（P < 0.05）和糖化血红蛋白（P < 0.05）更有可能处于最佳三分位数。购买/烹饪“清淡”食物的家庭中的受访者甘油三酯（P < 0.005）和胆固醇水平（P < 0.005）更有可能处于最佳三分位数，而家庭成员与他们一起食用“清淡”食物的家庭中的受访者甘油三酯更有可能处于最佳三分位数（P < 0.005）。当将所有三个支持变量纳入多变量模型时，只有“其他家庭成员烹饪大部分饭菜”这一变量与处于最低甘油三酯（P = 0.05）、糖化血红蛋白（P < 0.05）或胆固醇三分位数显著相关。这些关系在患有糖尿病的女性中最为明显。
以文化相关类别衡量的积极家庭营养支持与甘油三酯、胆固醇和糖化血红蛋白水平的控制显著相关。研究结果表明，在设计糖尿病护理策略时，家庭作为干预单位对迪内个体比单独的个体更有用。
