The Research On The Relationship Among Dietary Patterns, Fatty Acids, Inflammatory Cytokines And Type 2 Diabetes Mellitus

ObjectiveThe purpose of this study was undertaken to investigate the difference of dietary patterns, demographic characteristics, plasma fatty acids, inflammatory cytokines and 25-hydroxyvitamin D3(25(OH)D3) among control, pre-diabetes mellitus(PDM) and type 2 diabetes mellitus(T2DM) group, and to analyze the relationship among dietary patterns, plasma fatty acids, inflammatory cytokines, 25(OH)D3 and diabetes, in order to provide nutrition guidelines and dietary intervention for prevention and control of diabetes..MethodsSubjects who were undergoing health examination in Health Education and Guidance Center in Heping district of Tianjin in 2013.9-2015.4 were asked to finish the physical examination, laboratory test and answer the frequency food questionnaire. According to WHO(1999) diagnostic criteria for diabetes, subjects were divided into three group: control group, PDM group and T2 DM group. The analysis of variance(ANOVA) was used to compare the differences among measurement datas, and chi-square test was used to compare the differences among count datas. And factor analysis method was used to obtain dietary patterns. Then Logistic regression model was used to illustrate the relationship between dietary patterns and diabetes.ResultsThe levels of age, body mass index(BMI), systolic blood pressure(SBP), diastolic blood pressure(DBP), waist circumference(WC), Hips, low-density lipoprotein cholesterol(LDL-C), total cholesterol(TC), triglycerides(TG) and fasting plasma glucose(FPG) in control, PDM and T2 DM group with both males and females showed a trend of increasing(P<0.05), while the levels of high-density lipoprotein cholesterol(HDL-C) showed a trend of decreasing(P<0.05). Both males and females, when compared with control group, T2 DM group showed a lower education and higher smoking rates(P<0.05). We did not find any difference of drinking and physical activity among control, PDM and T2 DM group.The multiple Logistic regression was used to analyze the relationship between dietary nutrients and T2 DM. The results showed that cholesterol(OR=1.65, 95%CI: 1.02-2.72), total fatty acid(OR=1.60,95%CI:1.02-2.75) and saturated fatty acid(OR =1.86,95%CI:1.10-3.13) were risk factors for PDM in highest intake of group of males. But females, after adjusting for age,BMI and total energy intake, the nutrients were not significantly associated with PDM and T2 DM.Both males and females, three dietary patterns were obtained: Vegetables-Fruits Pattern, Animal Offal-Dessert Pattern and White Rice-Red Meat Pattern. After adjusting for confounder factors, the multiple Logistic regression suggested that men's Vegetables-Fruits Pattern was a protective factor for PDM(OR=0.62, 95% CI:0.42-0.98) and Animal Offal-Dessert Pattern was a risk factor for PDM(OR=2.11, 95%CI:1.27-3.46), while White Rice-Red Meat Pattern was not significantly associated with DM in any of models.The levels of plasma myristic acid(MA) were higher in T2 DM when compared with control group(P<0.05).After adjusting for age and BMI, the levels of plasma MA were positively associated with FPG(r=0.159, P<0.05). Dietary intakes of total fatty acids and MA in control group, PDM and T2 DM group also had a trend of increasing(P <0.05).The deficiency rate of vitamin D in serum was higher in the groups of PDM and T2 DM than control group(P<0.05). The serum content of tumor necrosis factor ?(TNF-?) increased in T2 DM group while adiponectin(ADP) and 25(OH)D3 decreased in T2 DM group when compared with control group(P<0.05). We also found that C-reaction protein(CRP) and TNF-? were negatively associated with 25(OH)D3(r was-0.177 and-0.131 respectively, P<0.05).ConclusionThe Vegetables-Fruits Pattern was a protective factor for DM and Animal Offal-Dessert Pattern was a risk factor for DM. Therefore the populations of pre-diabetes and type 2 diabetes should be reasonable control diet meat intake. In daily life, reduce the intake of dessert, animal offal and fast food and increase the intake of vegetables and coarse cereals to keep a reasonable diet.The plasma fatty acids profile in T2 DM group was different from control group, The levels of plasma myristic acid were higher in T2 DM than control group and plasma MA was positively associated with FPG. Meanwhile, the intakes of dietary fatty acids in T2 DM group were different from control group, T2 DM group intaked more dietary MA and total fatty acids than control group.We also found that the levels of TNF-? increased in T2 DM group while adiponectin(ADP) and 25(OH)D3 decreased in T2 DM group when compared with control group. Moreover, CRP and TNF-? were negatively associated with 25(OH)D3, and this suggested that elevation of inflammatory factors was related to vitamin D deficiency.