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目的探讨饮酒及其他生活方式因子的交互作用对2型糖尿病(type 2diabetes mellitus,T2DM)发生风险的影响。方法 2015年6月—2016年2月,利用简单随机抽样方法,在淮南市东方医院与淮南市体检中心分别选取320例T2DM患者和640例同期健康体检者,比较两组间一般人口学信息、饮酒、吸烟、体力活动和饮食行为方面的差异,运用非条件Logistic回归与广义多因子降维法(GMDR)进行统计分析。结果 (1)Logistic回归分析结果显示:调整混杂因素后,各食物条目摄入得分相对于Q1,粮谷类(OR=0.301,95%CI 0.153~0.628)、蔬菜水果类(OR=0.444,95%CI 0.245~0.806)、奶及奶制品(OR=0.510,95%CI 0.329~0.790)、豆类(OR=0.434,95%CI 0.212~0.901)、红肉类(OR=0.461,95%CI 0.229~0.926)、西方食物类(OR=0.223,95%CI 0.076~0.652)、含糖饮料类(OR=0.150,95%CI0.035~0.643)摄入得分为Q5以及体质指数<24.0(OR=0.189,95%CI 0.109~0.329)为罹患T2DM的保护因素;而经常饮酒(OR=3.936,95%CI 1.145~8.734)、中等强度体力活动<5次/周(OR=1.558,95%CI 1.013~2.876)为罹患T2DM的危险因素。(2)相乘交互作用分析显示:经常饮酒分别与摄入粮谷类(Q5)(OR=0.852,95%CI 0.765~0.949)、蔬菜水果类(Q5)(OR=0.862,95%CI 0.757~0.982)及中等体力活动≥5次/周(OR=0.613,95%CI 0.468~0.803)间存在相乘交互作用。(3)相加交互作用分析显示:经常饮酒分别与高摄入红肉、含糖饮料及中等体力活动≥5次/周间存在相加交互作用。(4)GMDR法分析显示:含糖饮料、红肉和经常饮酒三因素间存在交互作用共同影响T2DM的发生(P=0.001)。结论经常饮酒与其他多种可控因素间存在交互作用共同影响T2DM的发生。
Objective To investigate the effects of alcohol consumption and other lifestyle factors on the risk of type 2 diabetes mellitus (T2DM). Methods From June 2015 to February 2016, 320 T2DM patients and 640 healthy subjects were selected from Huainan City Eastern Hospital and Huainan Medical Center by simple random sampling method. The general demographic information was compared between the two groups. Drinking, smoking, physical activity and dietary behaviors. Statistical analysis was conducted by using unconditional Logistic regression and generalized multi-factor dimensionality reduction (GMDR). Results (1) Logistic regression analysis showed that after adjusting for confounding factors, intake of each food item relative to Q1, cereals (OR = 0.301, 95% CI 0.153-0.628), vegetables and fruits (OR = 0.444, 95% CI 0.245-0.806), milk and dairy products (OR = 0.510, 95% CI 0.329-0.790), pulses (OR 0.434, 95% CI 0.212-0.901), red meat ~ 0.926), Western food (OR = 0.223, 95% CI 0.076 ~ 0.652) and Q5 and body weight index (OR = 0.150,95% CI0.035 ~ 0.643) (OR = 3.936, 95% CI 1.145 ~ 8.734), moderate-intensity physical activity <5 times / week (OR = 1.558, 95% CI 1.013 ~ 2.876) are risk factors for T2DM. (2) Multiply interaction analysis showed that regular consumption of alcohol was associated with Q5 (OR = 0.852, 95% CI 0.765-0.949), fruits and vegetables (Q5) 0.982) and moderate physical activity ≥5 beats / week (OR = 0.613, 95% CI 0.468 ~ 0.803). (3) Additive interaction analysis showed that: regular alcohol consumption, respectively, with high intake of red meat, sugary drinks and moderate physical activity ≥ 5 times per week there interaction. (4) GMDR analysis showed that the interaction of three factors, sugary drinks, red meat and regular drinking, had an impact on the occurrence of T2DM (P = 0.001). Conclusion The interaction between alcohol consumption and other controllable factors often affect the occurrence of T2DM.