[Analysis of dietary pattern and diabetes mellitus influencing factors identified by classification tree model in adults of Fujian]

Zhonghua Liu Xing Bing Xue Za Zhi. 2017 May 10;38(5):602-610. doi: 10.3760/cma.j.issn.0254-6450.2017.05.009.
[Article in Chinese]

Abstract

Objective: To find out the dietary patterns and explore the relationship between environmental factors (especially dietary patterns) and diabetes mellitus in the adults of Fujian. Methods: Multi-stage sampling method were used to survey residents aged ≥18 years by questionnaire, physical examination and laboratory detection in 10 disease surveillance points in Fujian. Factor analysis was used to identify the dietary patterns, while logistic regression model was applied to analyze relationship between dietary patterns and diabetes mellitus, and classification tree model was adopted to identify the influencing factors for diabetes mellitus. Results: There were four dietary patterns in the population, including meat, plant, high-quality protein, and fried food and beverages patterns. The result of logistic analysis showed that plant pattern, which has higher factor loading of fresh fruit-vegetables and cereal-tubers, was a protective factor for non-diabetes mellitus. The risk of diabetes mellitus in the population at T2 and T3 levels of factor score were 0.727 (95%CI:0.561-0.943) times and 0.736 (95%CI: 0.573-0.944) times higher, respectively, than those whose factor score was in lowest quartile. Thirteen influencing factors and eleven group at high-risk for diabetes mellitus were identified by classification tree model. The influencing factors were dyslipidemia, age, family history of diabetes, hypertension, physical activity, career, sex, sedentary time, abdominal adiposity, BMI, marital status, sleep time and high-quality protein pattern. Conclusion: There is a close association between dietary patterns and diabetes mellitus. It is necessary to promote healthy and reasonable diet, strengthen the monitoring and control of blood lipids, blood pressure and body weight, and have good lifestyle for the prevention and control of diabetes mellitus.

目的: 分析福建省成年居民不同膳食模式及其他环境因素与糖尿病的关系。 方法: 在福建省10个疾病监测点采用多阶段随机抽样方法抽取≥18岁常住居民进行问卷调查、体格测量和实验室检测。采用因子分析方法建立膳食模式,并运用logistic回归模型分析膳食模式与糖尿病之间的关系;应用分类树模型分析糖尿病的影响因素。 结果: 因子分析得到4种膳食模式,分别为动物性食物模式、植物性食物模式、优质蛋白模式、油炸饮品模式;logistic回归分析发现植物性食物模式(新鲜果蔬、谷薯类因子负荷较大)是糖尿病的保护因素,因子得分处于T3、T2水平人群患糖尿病的风险分别是下四分位数水平的0.727、0.736倍(95%CI:0.561~0.943、95%CI:0.573~0.944);分类树模型筛选出13个影响因素:血脂异常、年龄、糖尿病家族史、高血压、体力活动、职业、性别、静坐时间、中心性肥胖、BMI、婚姻、睡眠时间、优质蛋白模式,以及11个糖尿病高危人群。 结论: 膳食因素与糖尿病具有密切关系,提倡健康合理的膳食,并加强监测和控制血脂、血压和体重,培养良好的生活行为习惯对糖尿病防控尤为重要。.

Keywords: Classification tree; Diabetes mellitus; Dietary pattern; Factor analysis; Influencing factors.

MeSH terms

  • Adult
  • Asian People / statistics & numerical data*
  • Blood Pressure
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / ethnology
  • Diabetes Mellitus / etiology
  • Diet Surveys
  • Diet*
  • Dyslipidemias / complications
  • Dyslipidemias / epidemiology*
  • Exercise
  • Factor Analysis, Statistical
  • Feeding Behavior*
  • Female
  • Fruit
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology*
  • Life Style*
  • Logistic Models
  • Male
  • Meat
  • Middle Aged
  • Risk Factors
  • Surveys and Questionnaires
  • Vegetables