Association Between Composite Lifestyle Scores,Dietary Pattern And Type 2 Diabetes Mellitus In Rural Population Of Liaoning Province

Objective: At present,the prevalence of Type 2 diabetes mellitus(T2DM)continues to remain high,which brings not only a lot of physical and mental pain and economic burden to patients and their families but also a heavy burden to the national medical system and financial system.Many studies have demonstrated that lifestyle factors and dietary patterns,including smoking,alcohol consumption,sleep,exercise,and salt and oil intake,are important risk factors that should not be ignored and should be used as key prevention measures for T2 DM.However,few lifestyle scores meet the current needs of health among Chinese people,including sleep,exercise,smoking,drinking,oil intake,and salt intake.The dietary pattern with the characteristics of rural areas in Liaoning Province has not been established.Therefore,this study conducted a field survey among rural residents in a city of Liaoning Province to understand the prevalence of T2 DM,the distribution of lifestyle and daily dietary patterns of adults in rural areas of a city of Liaoning Province,and analyzed the correlation between T2 DM and T2 DM,providing a theoretical basis for efficient management of T2 DM.Method: In this study,a cross-sectional study was adopted.In 2020,a multi-stage random cluster sampling method was adopted in a city’s rural area in Liaoning Province.Subsequently,trained investigators obtained basic personal information,fasting plasma glucose,lifestyle,and dietary information from participants through questionnaires,physical exams and laboratory inspection.Finally,statistical methods are used to organize and analyze the collected data.Firstly,three different dietary patterns were calculated by principal component analysis.Multivariate Logistic regression was used to analyze the correlation between lifestyle and dietary patterns and T2 DM,and the odds ratio(OR)and 95 % confidence interval(95 %CI)were calculated for stratified analysis.Results: A total of 2536 participants were included in this study,including 875 males and 1661 females,with an average age of 60.88 years.In the full study population,the prevalence of T2 DM was 15.81 %,the total prevalence of males was 14.06 %,and the total prevalence of females was 16.74 %.For every one-point increase in the lifestyle score,the risk of T2 DM increased by 16 %(OR: 1.16,95 %CI: 1.06-1.27).The lowest risk of T2 DM was found in those with a lifestyle score of 0-2,compared with a41 % increased risk in those with a score of 3-4(OR: 1.41,95 %CI: 1.09-1.83)and an83 % increased risk in those with a score of 5-7(OR: 1.83,95 %CI: 1.28-2.65).The three dietary patterns obtained in this study are: meat dietary pattern,vegetable staple food dietary pattern,fruit milk nut dietary pattern.No statistically significant association was found between meat dietary patterns and the risk of T2 DM.For vegetable-staple dietary patterns,the risk of T2 DM was 69 % higher in the second quintile than in the first quintile(OR: 0.69,95 %CI: 0.52-0.91).The risk of T2 DM was 57 %(OR: 0.57,95 %CI: 0.44-0.75)in the second and 62 %(OR: 0.62,95 %CI:)compared with that in the first(OR: 0.57,95 %CI: 0.44-0.75)in the second and third quintiles(OR: 0.62,95 %CI: 0.46 to 0.82).Compared with non-healthy dietary patterns and lifestyle scores for vegetables and staple foods,a healthy lifestyle score alone was associated with a 50 %(OR: 0.50,95 %CI: 0.31-0.82)lower risk of T2 DM.Compared with non-healthy dietary pattern and lifestyle score,only healthy dietary pattern and lifestyle score were associated with a reduced risk of T2 DM by 51 %(OR:0.49,95 %CI: 0.31-0.77).Conclusion: The prevalence of T2 DM in rural areas of a city in Liaoning Province is higher than in other areas of China.The healthy level of lifestyle is lower than in the rest of the country.At the same time,the more unhealthy lifestyle behaviors maintained,the more closely associated with an increased risk of T2 DM.According to the dietary characteristics of residents,three different dietary patterns were constructed in this study: meat dietary pattern,vegetable staple food dietary pattern,and fruit milk nut dietary pattern.Among them,fruit milk nut dietary pattern was strongly negatively correlated with the risk of T2 DM.Compared with dietary patterns,a healthy lifestyle can reduce the risk of T2 DM,and combining the two methods can achieve the best control effect.