老年糖尿病前期人群饮食模式与2型糖尿病患病风险的研究  

Analysis of dietary patterns associated with type 2 diabetes risk in older prediabetic populations

作　　者：陈康 蔺曜 陈雅玲 黄霞 张文龙 杨辰 王潇 宁家琼 涂孟怡 何昭霞[1] Chen Kang;Lin Yao;Chen Yaling;Huang Xia;Zhang Wenlong;Yang Chen;Wang Xiao;Ning Jiaqiong;Tu Mengyi;He Zhaoxia(Health Management Medical Center,Wenjiang District People's Hospital of Chengdu,Chengdu 611135,China)

机构地区：[1]成都市温江区人民医院健康管理医学中心,成都611135

出　　处：《中华老年医学杂志》2025年第4期498-503,共6页Chinese Journal of Geriatrics

基　　金：国家自然科学基金项目(82371060);四川省科学技术厅2023年自然科学基金项目(2023NSFSC0514);四川省医院协会2023年县级医院科研专项资金项目(2023GL001);四川省教育厅人文社科重点研究基地、四川医院管理和发展研究中心2023年度项目(SCYG2023-16);四川省医疗卫生与健康促进会2023年度省级科研项目(KY2023SJ0112)。

摘　　要：目的探究饮食习惯对老年体检人群中糖尿病前期转化为2型糖尿病(type 2 diabetes mellitus,T2DM)的影响因素。方法横断面研究,选取2019—2022年在成都市温江区人民医院健康管理医学中心完成体检空腹血糖≥6.0 mmol/L且年龄60~70岁的人群,收集其人口学特征、饮食习惯问卷和空腹血糖值资料和指标,采用非条件二分类logistic回归分析糖尿病前期自然转化T2DM期的影响因素。根据logistic回归结果建立列线图预测模型,再通过计算C-统计量和绘制校准曲线评价模型预测能力。结果共纳入13681例空腹血糖≥6.0 mmol/L的老年体检者,糖尿病前期(空腹血糖6.0~7.0 mmol/L)4306例(31.5%)、年龄(63.54±16.49)岁,T2DM期(空腹血糖>7.0 mmol/L)9375例(68.5%)、年龄(63.09±16.21)岁。二分类logistic回归分析结果显示,常吃早餐(OR=0.777,95%CI:0.696~0.868,P<0.001)、饮食喜好清淡(OR=0.781,95%CI:0.710~0.858,P<0.001)、饮食喜好咸食(OR=0.571,95%CI:0.504~0.648,P<0.001)、生食(OR=0.327,95%CI:0.224~0.478,P<0.001)、辛辣(OR=0.124,95%CI:0.112~0.137,P<0.001)是老年体检人群T2DM的保护因素;而进食速率过快(OR=4.327,95%CI:3.978~4.772,P<0.001)、饮食喜好甜食(OR=5.168,95%CI:4.703~5.678,P<0.001)、高油脂(OR=1.401,95%CI:1.275~1.539,P<0.001)是老年体检人群T2DM的危险因素;列线图预测模型C-统计量为0.781;校准曲线的拟合优度检验χ^(2)=11.258,P=0.188,模型的预测效果良好。结论常吃早餐、清淡饮食、饮食喜好咸食、生食、辛辣是老年体检人群T2DM的保护因素,而进食速率过快、喜好甜食和高油脂饮食是其危险因素,且构建的风险预测模型有助于发现个体发生T2DM的风险大小,增加了从糖尿病前期到T2DM期诊断和预防的证据。Objective To explore the influencing factors of dietary habits on the progression from prediabetes to type 2 diabetes mellitus(T2DM)in elderly individuals undergoing health check-ups.Methods In the cross-sectional study,we enrolled individuals aged 60-70 years with fasting plasma glucose(FPG)≥6.0 mmol/L who underwent health examinations at the Health Management Medical Center of Wenjiang District People's Hospital in Chengdu from 2019 to 2022.Demographic characteristics,dietary habit questionnaires,and FPG values were collected.Unconditional binary logistic regression analysis was used to identify factors influencing the natural progression from prediabetes to T2DM.A nomogram prediction model was established based on logistic regression results,and its predictive performance was evaluated by calculating the C-statistics and drawing a calibration curve.Results A total of 13681 elderly participants with FPG≥6.0 mmol/L were included,comprising 4306(31.5%)prediabetes cases(FPG 6.0-7.0 mmol/L),aged(63.54±16.49)years and 9375(68.5%)T2DM cases(FPG>7.0 mmol/L),aged(63.09±16.21)years.Unconditional binary logistic regression analysis showed that frequent breakfast(OR=0.777,95%CI:0.696-0.868,P<0.001),dietary preference for light diet(OR=0.781,95%CI:0.710-0.858,P<0.001),salty taste(OR=0.571,95%CI:0.504-0.648,P<0.001),raw food(OR=0.327,95%CI:0.224-0.478,P<0.001)and spicy taste(OR=0.124,95%CI:0.112-0.137,P<0.001)were the protective factors for the conversion of prediabetes to the T2DM stage in the elderly physical examination population.While fast eating rate(OR=4.327,95%CI:3.978-4.772,P<0.001),dietary preference for sweets(OR=5.168,95%CI:4.703-5.678,P<0.001),and high-fat diet(OR=1.401,95%CI:1.275-1.539,P<0.001)were risk factors for conversion of prediabetes to T2DM stage.C-statistic of the Nomogram prediction model was 0.781;the goodness-of-fit test of the calibration curve wasχ^(2)=11.258,P=0.188,and the model predicted well.Conclusions Regular breakfast,light diet,and dietary preferences for salty,raw,and spicy foods

关 键 词：饮食习惯 糖尿病前期 糖尿病 2型 

分 类 号：R587.1[医药卫生—内分泌]