新疆克拉玛依市某体检人群膳食模式与非酒精性脂肪肝病关系调查

目的 探索不同膳食模式与非酒精性脂肪肝病（NAFLD）的关系.方法 2011年4月至6月采用随机整群抽样方法对在新疆克拉玛依市接受健康体检的人员展开调查,入选符合要求对象2377例.测定体质指数（BMI）、腰臀比（WHR）、收缩压（SBP）、舒张压（DBP）、三酰甘油（TG）、总胆固醇（TC）、天冬氨酸转氨酶（AST）、血尿酸（SUA）等指标.采用专门设计的食物频数量表（FFQ）,应用主成分分析方法建立膳食模式,根据各个研究对象不同膳食模式的因子得分大小以四分位法将每种膳食模式分别分为Q1、Q2、Q3、Q4四组.采用方差分析与Logistic回归分析探讨不同膳食模式与非酒精性脂肪肝病患病率之间的关系.结果 主成分分析结果得到5种膳食模式,分别命名为调料模式、西方膳食模式、传统健康膳食模式、糕点零食与豆制品模式、动植物蛋白模式.调料模式、西方膳食模式与传统健康膳食模式下各个分组人群的NAFLD患病率的差异具有统计学意义（x2=149.873、8.247、18.766,P＜0.05）,3种膳食模式下各组的生化指标比较也有不同的差异,其中调料模式下的年龄、BMI、WHR、SUA、TG从Q1组到Q4组差异有统计学意义（F=8.42、5.64、12.78、10.72、9.63,P＜0.05）；西方膳食模式下年龄、WHR、SBP、SUA、TC与TG值在Q1 ～Q4组之间差异有统计学意义（F=9.84、6.87、6.11、10.61、6.87、8.13,P＜0.05）；而传统健康膳食模式下从Q1到Q4组的年龄、BMI、WHR、SBP、SUA、AST变化明显,差异有统计学意义（F=19.13、11.09、13.89、6.11、15.12、6.19,P＜0.05）.对年龄、BMI、WHR、SBP、SUA、AST、TC与TG进行调整后,调料膳食模式（OR=1.33,95％CI：0.95 ～1.87）、西方膳食模式（OR=1.36,95％CI：0.979 ～1.902）与NAFLD呈正相关,而传统健康膳食模式与NAFLD呈负相关（OR =0.79,95％ CI：0.51～1.226）.结论 膳食模式与NAFLD关系密切,养成健康的饮食习惯对预防NAFLD的发生至关重要.

Relationship between dietary patterns and non alcoholic fatty liver disease among Karamay adults

Objective To explore the relationship between dietary patterns and non alcoholic fatty liver disease （NAFLD） in Karamay adults.Methods A total of 2377 subjects aged 20-75 years old who took health check-up during April and June 2011 were included in this investigation.Body mass index （BMI）,waist to hip ratio （WHR）,systolic blood pressure （SBP）,diastolic blood pressure （DBP）,triglyceride （TG）,total cholesterol （TC）,aspartate aminotransferase （AST） and serum uric acid （SUA）were measured.Food intake patterns and life style of the participants were accessed by using food frequency questionnaire （FFQ）.Main component analysis and multivariate logistic regression model were used to explore the association of dietary patterns with NAFLD.Results Five dietary patterns were identified,including ＂condiment dietary pattern＂,＂ western dietary pattern＂,＂ conventional healthy dietary pattern＂,＂snacks and bean pattern＂,and ＂high protein dietary pattern＂.Subjects of ＂condiment dietary pattern＂,＂western dietary pattern＂ or ＂conventional healthy dietary pattern＂ showed significantly different prevalence of NAFLD （x2 values were 149.873,8.247 and 18.766,respectively; all P ＜ 0.05）.In condiment dietary pattern,age,BMI,WHR,SUA and TG were significantly different in Q4 group （F values were 8.42,5.64,12.78,10.72 and 9.63,respectively; all P ＜0.05）.For those with western dietary pattern,age,WHR,SBP,SUA,TC and TG showed significant different trend （F values were 9.84,6.87,6.11,10.61,6.87 and 8.13,respectively; all P ＜ 0.05）.However,subjects with conventional healthy dietary pattern showed a significant different trend of age,BMI,WHR,SBP,SUA and AST （F values were 19.13,11.09,13.89,6.11,15.12,6.19,respectively ; all P ＜ 0.05）.After age,BMI,WHR,SBP,SUA,AST,TC and TG were adjusted,the risk of NAFLD of those with ＂condiment pattern＂ or ＂western pattern＂ were significantly increased （odds ratio （OR） were 1.33 （95％ confidence interval （CI） 0.95-1.87） and 1.36 （95％ CI 0.979-1.902）,respectively）.Conclusion Dietary pattern may be associated with NAFLD.People need to learn healthy dietary habit to prevent NAFLD.