The Study Of The Relationship Between Dietary Patterns And Type 2 Diabetes In Elderly In Community Of Beichen District Of Tianjin

ObjectiveThe purpose of this study was undertaken to investigate the difference of nutrient intake, dietary pattern and demographic characteristics between prediabetes, type 2 diabetes and control group, and to explore the influencing factors of prediabetes and diabetes, and to discuss the relationship between dietary patterns and disease through health examination, lifestyle and dietary habits investigation, which may provide the guidance for prevention and control of diabetes. MethodsThe case-control study was conducted during June 2013- April 2014. A total of 270 controls, 249 prediabetes(PDM), and 288 type 2 diabetes(T2DM) were selected from the Health Examination Center of Orchard Village Street and Shuangjie Town in Beichen District of Tianjin, China. Dietary intake was estimated by food frequency questionnaire(FFQ). Besides, the physical and biochemical indexes were measured. The analysis of variance(ANOVA), and rank test were used to compare the differences among multiple datas, and factor analysis method were used to obtain dietary pattern. Then Logistic regression model was used to illustrate the PDM and T2 DM influencing factors. ResultsMale’s systolic blood pressure(SBP), diastolic blood pressure(DBP), body weight, BMI, waist circumference(WC) and fasting plasma glucose(FPG) in control group, PDM and T2 DM group showed a trend of increasing, T2 DM group is higher than the other two groups(P<0.05). Female’s SBP, body weight, BMI, FPG in increasing trend between the three groups, T2 DM group is higher than the other two groups(P<0.05).There was no significant difference of the serum content of 25(OH)D3 in male and female.In male, there was significant difference in genotype and allele frequencies of VDR gene Bsm I and Taq I sites between control group, PDM group and DM group. Among them, the genotype “bb” and allele "b" of Bsm I site may have a protective effect for T2 DM, and the genotype “Bb” and allele "B" be a risk factor for T2 DM.The genotype “TT” and allele "T" of Taq I site may have a protective effect for T2 DM, and the genotype “t T” and allele "t" be a risk factor for T2 DM. In female, there was no significant difference in genotype and allele frequencies of VDR gene between the three groups.Male factor analysis method obtained three main dietary patterns: western pattern, plant food pattern, and traditional dietary pattern; Women factor analysis model obtained four main dietary patterns: vegetable-fruits pattern, animal food pattern, traditional pattern, and nuts-grains pattern.The univariate Logistic regression suggested that, in male, drink occasionally(OR=2.588, 95%CI: 1.061~6.316), weight(OR=2.020, 95%CI: 1.054~3.873) and TG(OR=0.023,95%CI:1.121~4.769)were risk factors for PDM, and age(OR=0.330, 95%CI: 0.167~0.653) and nuts(OR=0.492,95%CI: 0.254~0.952) were the protection factors for PDM; The weight(OR=2.311,95%CI: 1.212~4.405), WC(OR=2.521, 95%CI: 1.033~6.152) and SBP(OR=2.225, 95%CI: 1.038~4.767) were risk factors for T2 DM, and age(OR=0.382, 95%CI: 0.189~0.771), fruit(OR=0.455, 95%CI: 0.243~0.851), milk(OR=0.483, 95%CI: 0.262,0.890), vitamin B2(OR=0.488,95%CI: 0.258~0.924) and dietary patterns of plant(OR=0.490, 95%CI: 0.261~0.919) were protective factors for T2DM; Women’s weight(OR=1.919, 95%CI: 1.064~3.459), poultry(OR=2.622, 95%CI:1.378~4.990), animal dietary pattern(OR=1882, 95%CI: 1.049~3.373) were risk factors for PDM, and age(OR=0.402, 95%CI: 0.215~0.754) was the protection factor for PDM; Women’s SBP(OR=3.081, 95%CI: 1.449~6.548), body weight(OR=1.824, 95%CI: 1.041~3.195), WC(OR=2.771, 95%CI: 1.263~6.079) and poultry(OR=2.181, 95%CI: 1.162~4.096) were risk factors for T2 DM, and age(OR=0.310, 95%CI:0.170~0.567), fruits(OR=0.550, 95%CI: 0.317~0.956), nuts(OR=0.534, 95%CI: 0.304~0.939) and nuts-grains pattern(OR=0.483, 95%CI: 0.278~0.840) were protective factors for T2 DM.After adjusting age and the total energy intake, the multiple Logistic regression suggested that men’s triglycerides(OR=2.131, 95%CI: 1.040~4.366) was a risk factor for PDM, nuts(OR=0.454, 95%CI: 0.219~0.939) was a protection factor for PDM; Men’s SBP(OR= 3.639, 95%CI: 1.728~7.661), WC(OR=2.634, 95%CI: 1.111 ~ 6.245) as risk factors for T2 DM, and plant food pattern(OR=0.516, 95%CI: 0.268 ~ 0.994) was a protective factor for T2DM; Women’s poultry(OR=3.203, 95%CI: 1.609 ~ 6.374), and animal dietary pattern(OR=2.040, 95%CI: 1.095 ~ 3.800) were risk factors for PDM, SBP(OR=1.989, 95%CI: 1.101 ~ 3.593), WC(OR=2.968, 95%CI: 1.429 ~ 6.164) and poultry(OR= 2.870, 95%CI: 1.456 ~ 5.657) were risk factors for T2DM; fruit(OR= 0.503, 95%CI: 0.267~0.946) and nuts-grain dietary pattern(OR=0.552, 95%CI: 0.311 ~ 0.978) were protective factors for T2 DM. ConclusionThe plant food pattern of male and nuts-grain dietary pattern of female were protective factors for T2 DM, and animal dietary pattern of female was a risk factor for PDM. Meanwhile, the triglycerides, WC, SBP and poultry were risk factors, and fruit was a protective factor for disease.Therefore PDM and type 2 diabetic population should be reasonable control diet meat intake to avoid increasing the risk. In daily life, pay attention to the valley of plant-based food intake, such as nuts and grain and keep reasonable diet. At the same time, pay attention to the control of blood pressure, blood fat, and prevent obesity, which can be beneficial to prevent and control the occurrence and development of PDM and T2 DM.