Zhang Yi, Wang Yanlei, Zhang Shengwu, Zhang Yulin, Zhang Qiu
Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230032, People's Republic of China.
Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, People's Republic of China.
Diabetes Metab Syndr Obes. 2023 Mar 11;16:749-767. doi: 10.2147/DMSO.S390101. eCollection 2023.
Health risk factors (HRFs), including the adjustment of disturbed sleep patterns (including disorders and duration) and improvement of dietary intake, have become relatively novel and critical strategies to prevent the development of diabesity and treat diabetic complications.
We aimed to explore 1) whether there was an association between diet styles (including healthy and unhealthy diets) and diabesity; 2) whether sleep patterns could moderate this relationship; and 3) whether there was a complex interaction association between sleep patterns, diet styles, and diabesity.
The study was based on a national survey conducted by the China National Diabetic Chronic Complications Study Group, this study extracted data from some cities in Anhui Province and obtained basic and lifestyle information using a detailed questionnaire for analysis. The primary exposure was diet styles, and the outcomes were body mass index (BMI) and waist circumference (WC), while HbA1c and FBG and sleep patterns were moderators. Data were pooled using logistic regression and moderation analysis.
The overall response rate was 92.0%. This study ultimately included 1765 participants. The mean age was 57.10 ± 10.0 years. Sociographically, participants with lower educational levels were more likely to have lower levels of WC ( = 2.73) and BMI ( = 3.47), were female (=6.54), were more likely to have lower educational levels (=13.78) and were older (=23.75), were more likely to have higher detection rates of sleep disorders and were more likely to have other HRFs (walking, SSBs, HbA1c and TG). Additionally, diet styles were also significantly associated with BMI and WC. In the moderation analysis, SES (socioeconomic status) also affected the correlation between healthy diet style, sleep disorders and WC (β=0.20), neither in BMI nor unhealthy diet style in BMI and WC; the combination effect between diet styles, sleep patterns and HbA1c was associated with WC and BMI.
Complex associations and interactions were found between diet styles, sleep patterns, HbA1c, and diabesity. Therefore, it is necessary to understand the dietary pattern and other HRFS that cause diabesity, so as to strengthen further preventive measures. These results can provide some theoretical basis for the treatment of diabesity in the public health field.
健康风险因素（HRFs），包括调整紊乱的睡眠模式（包括睡眠障碍和睡眠时间）以及改善饮食摄入，已成为预防糖尿病肥胖症发生和治疗糖尿病并发症的相对新颖且关键的策略。
我们旨在探讨1）饮食模式（包括健康饮食和不健康饮食）与糖尿病肥胖症之间是否存在关联；2）睡眠模式是否能够调节这种关系；3）睡眠模式、饮食模式和糖尿病肥胖症之间是否存在复杂的交互关联。
该研究基于中国国家糖尿病慢性并发症研究组开展的一项全国性调查，本研究从安徽省的一些城市提取数据，并使用详细问卷获取基本信息和生活方式信息进行分析。主要暴露因素为饮食模式，结局指标为体重指数（BMI）和腰围（WC），而糖化血红蛋白（HbA1c）、空腹血糖（FBG）和睡眠模式为调节因素。使用逻辑回归和调节分析对数据进行汇总。
总体应答率为92.0%。本研究最终纳入1765名参与者。平均年龄为57.10±10.0岁。从社会统计学角度来看，教育水平较低的参与者更有可能具有较低的WC水平（ = 2.73）和BMI水平（ = 3.47），为女性（=6.54），更有可能具有较低的教育水平（=13.78）且年龄较大（=23.75），更有可能具有较高的睡眠障碍检出率，并且更有可能具有其他健康风险因素（步行、含糖饮料、HbA1c和甘油三酯）。此外，饮食模式也与BMI和WC显著相关。在调节分析中，社会经济地位（SES）也影响健康饮食模式、睡眠障碍与WC之间的相关性（β=0.20），在BMI以及BMI和WC中的不健康饮食模式方面均无此影响；饮食模式、睡眠模式和HbA1c之间的联合效应与WC和BMI相关。
在饮食模式、睡眠模式、HbA1c和糖尿病肥胖症之间发现了复杂的关联和交互作用。因此，有必要了解导致糖尿病肥胖症的饮食模式和其他健康风险因素，以便加强进一步的预防措施。这些结果可为公共卫生领域中糖尿病肥胖症的治疗提供一些理论依据。
