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中国2型糖尿病患者饮食模式与中风的关联:倾向评分匹配分析

Association between dietary patterns and stroke in patients with type 2 diabetes mellitus in China: a propensity score-matched analysis.

作者信息

He Chenlu, Wang Wei, Chen Qian, Shen Ziyuan, Pan Enchun, Sun Zhongming, Lou Peian, Zhang Xunbao

机构信息

School of Public Health, Xuzhou Medical University, 209 Tong Shan Road, Xuzhou, Jiangsu221004, China.

Huai´an Center for Disease Control and Prevention, Huai´an, Jiangsu, China.

出版信息

Public Health Nutr. 2022 Aug;25(8):2188-2196. doi: 10.1017/S1368980022000763. Epub 2022 Mar 31.

Abstract

OBJECTIVE

This study aimed to examine the impact of different dietary patterns on stroke outcomes among type 2 diabetes mellitus (T2DM) patients in China.

DESIGN

Participants were enrolled by a stratified random cluster sampling method in the study. After collecting dietary data using a quantified FFQ, latent class analysis was used to identify dietary patterns, and propensity score matching was used to reduce confounding effects between different dietary patterns. Binary logistic regression and conditional logistic regression were used to analyse the relationship between dietary patterns and stroke in patients with T2DM.

SETTING

A cross-sectional survey available from December 2013 to January 2014.

PARTICIPANTS

A total of 13 731 Chinese residents aged 18 years or over.

RESULTS

Two dietary patterns were identified: 61·2 % of T2DM patients were categorised in the high-fat dietary pattern while 38·8 % of patients were characterised by the balanced dietary pattern. Compared with the high-fat dietary pattern, the balanced dietary pattern was associated with reduced stroke risk (OR = 0·63, 95 %CI 0·52, 0·76, < 0·001) after adjusting for confounding factors. The protective effect of the balanced model did not differ significantly (interaction > 0·05).

CONCLUSIONS

This study provides sufficient evidence to support the dietary intervention strategies to prevent stroke effectively. Maintaining a balanced dietary pattern, especially with moderate consumption of foods rich in quality protein and fresh vegetables in T2DM patients, might decrease the risk of stroke in China.

摘要

目的

本研究旨在探讨不同饮食模式对中国2型糖尿病(T2DM)患者中风结局的影响。

设计

采用分层随机整群抽样方法招募研究参与者。使用定量食物频率问卷收集饮食数据后,采用潜在类别分析确定饮食模式,并使用倾向得分匹配来减少不同饮食模式之间的混杂效应。采用二元逻辑回归和条件逻辑回归分析T2DM患者饮食模式与中风之间的关系。

背景

一项于2013年12月至2014年1月进行的横断面调查。

参与者

共有13731名18岁及以上的中国居民。

结果

确定了两种饮食模式:61.2%的T2DM患者被归类为高脂肪饮食模式,而38.8%的患者以均衡饮食模式为特征。在调整混杂因素后,与高脂肪饮食模式相比,均衡饮食模式与中风风险降低相关(OR = 0.63,95%CI 0.52,0.76,P < 0.001)。均衡模式的保护作用无显著差异(交互作用P > 0.05)。

结论

本研究提供了充分的证据支持饮食干预策略以有效预防中风。在中国,维持均衡的饮食模式,尤其是T2DM患者适度食用富含优质蛋白质的食物和新鲜蔬菜,可能会降低中风风险。

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