Liu S J, Yu J G, Li J, Li S G, Chen B, Zhao G M
School of Public Health, Fudan University, Shanghai 200032, China.
Zhongshan Community Health Care Center, Songjiang District, Shanghai 201613, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2021 Apr 6;55(4):485-491. doi: 10.3760/cma.j.cn112150-20210114-00036.
To explore the relationship between the level of blood homocysteine (Hcy) and the total score of Chinese Healthy Eating Index (CHEI) and its item score. The subjects were recruited from the East China Natural Population Cohort Study, led by the School of Public Health in Fudan University, which was conducted in Zhongshan Community, Songjiang District of Shanghai from April to September 2017. By using the cluster random sampling method, 8 neighborhood committees were randomly selected from 18 neighborhood committees in Zhongshan community (Beimen, Baiyun, Dongwai, Huaqiao, Lantian village 1, Lantian village 2, Lantian village 4, and Lantian village 5). All the residents who met the standard and had lived in Shanghai for more than half a year were selected as research subjects. 4 995 subjects with complete survey information were finally included in this study. General information (age, sex, disease history, etc.), lifestyle (smoking, drinking, tea drinking, physical activity, etc.), food frequency and blood Hcy concentration were collected through questionnaire survey, physical examination and biological sample detection. The multivariate linear regression model was used to analyze the correlation between blood Hcy concentration and the total score of CHEI and its item score, and the multivariate logistics regression model was used to analyze the correlation between hyperhomocysteinemia (hHcy) and the total score of CHEI and its item score. The age of the subjects was (56.72±9.72) years. The proportion of females, people with middle and high school education and high physical activity was 64.90% (3 241), 50.80% (2 539) and 63.20% (3 157), respectively. The blood Hcy concentration was (11.25±4.90) μmol/L, and the total prevalence of hHcy was 9.3% (467 cases). The results of multivariate linear regression showed that after adjusting for the relevant confounding factors, the blood Hcy concentration of subjects decreased with the increase of the total score of CHEI and the item score of fruit, milk, seafood, poultry and egg, but increased with the increase of the item score of total grain and tuber. In males, blood Hcy levels decreased with the increase of the item score of seafood and poultry [β (95%) values were -0.343 (-0.582, -0.102) and -0.225 (-0.402, -0.046), respectively]. In females, the blood Hcy level decreased with the increase of the total score of CHEI and its item score of milk, egg, seafood and poultry [β (95%) values were -0.130 (-0.207, -0.052), -0.091 (-0.148, -0.034), -0.016 (-0.026, -0.007), -0.069 (-0.122, -0.016), and -0.087 (-0.157, -0.017), respectively]. The results of multivariate logistic regression showed that the higher the total score of CHEI and its item score of milk and seafood, the lower the risk of hHcy [ (95%) value were 0.986 (0.978, 0.995), 0.915 (0.864, 0.969), and 0.862 (0.806, 0.922), respectively]. In females, the higher the total score of CHEI and its item score of milk and seafood, the lower the risk of hHcy [ (95%) values were 0.984 (0.970, 0.999), 0.877 (0.802, 0.958), and 0.845 (0.760, 0.941), respectively]. In males, the higher the total score of CHEI and its item score of seafood, the lower the risk of hHcy [ (95%) values were 0.988 (0.977, 0.998) and 0.858 (0.791, 0.930), respectively]. The dietary pattern of residents in Zhongshan Community, Songjiang District, Shanghai can affect their own blood Hcy concentration and the risk of hHcy. The total score of CHEI and the item score of fruit, milk, seafood, poultry and eggs play an important role in reducing the level of blood Hcy. The higher the total score of CHEI and the item score of milk and seafood, the lower the risk of hHcy.
探讨血液同型半胱氨酸(Hcy)水平与中国健康饮食指数(CHEI)总分及其分项得分之间的关系。研究对象来自于由复旦大学公共卫生学院牵头的中国东部自然人群队列研究,该研究于2017年4月至9月在上海市松江区中山社区开展。采用整群随机抽样方法,从中山社区18个居委会(北门、白云、东外、华侨、蓝天一村、蓝天二村、蓝天四村和蓝天五村)中随机抽取8个居委会。选取所有符合标准且在上海居住半年以上的居民作为研究对象。最终纳入本研究的有4995名具有完整调查信息的受试者。通过问卷调查、体格检查和生物样本检测收集一般信息(年龄、性别、病史等)、生活方式(吸烟、饮酒、饮茶、体育活动等)、食物频率和血液Hcy浓度。采用多元线性回归模型分析血液Hcy浓度与CHEI总分及其分项得分之间的相关性,采用多元logistic回归模型分析高同型半胱氨酸血症(hHcy)与CHEI总分及其分项得分之间的相关性。受试者年龄为(56.72±9.72)岁。女性、具有高中及以上文化程度和体育活动水平较高者的比例分别为64.90%(3241人)、50.80%(2539人)和63.20%(3157人)。血液Hcy浓度为(11.25±4.90)μmol/L,hHcy总患病率为9.3%(467例)。多元线性回归结果显示,在调整相关混杂因素后,受试者的血液Hcy浓度随CHEI总分以及水果、牛奶、海鲜、禽肉和蛋类的分项得分增加而降低,但随全谷物和薯类的分项得分增加而升高。在男性中,血液Hcy水平随海鲜和禽肉分项得分增加而降低[β(95%)值分别为-0.343(-0.582,-0.102)和-0.225(-0.402,-0.046)]。在女性中,血液Hcy水平随CHEI总分以及牛奶、蛋类、海鲜和禽肉的分项得分增加而降低[β(95%)值分别为-0.130(-0.207,-0.052)、-0.091(-0.148,-0.034)、-0.016(-0.026,-0.007)、-0.069(-0.122,-0.016)和-0.087(-0.157,-0.017)]。多元logistic回归结果显示,CHEI总分以及牛奶和海鲜的分项得分越高,hHcy风险越低[(95%)值分别为0.986(0.978,0.995)、0.915(0.864,0.969)和0.862(0.806,0.922)]。在女性中,CHEI总分以及牛奶和海鲜的分项得分越高,hHcy风险越低[(95%)值分别为0.984(0.970,0.999)、0.877(0.802,0.958)和0.845(0.760,0.941)]。在男性中,CHEI总分以及海鲜的分项得分越高,hHcy风险越低[(95%)值分别为0.988(0.977,0.998)和0.858(0.791,0.930)]。上海市松江区中山社区居民的饮食模式可影响自身血液Hcy浓度及hHcy风险。CHEI总分以及水果、牛奶、海鲜、禽肉和蛋类的分项得分在降低血液Hcy水平方面发挥重要作用。CHEI总分以及牛奶和海鲜的分项得分越高,hHcy风险越低。