2型糖尿病患者膳食质量与血糖控制的相关性研究

目的 评估2型糖尿病患者膳食质量与血糖控制的关系。方法 2019年采取整群抽样法，对蚌埠市某社区332名2型糖尿病患者进行问卷调查，获得人口社会学、膳食摄入、生化指标等信息。使用中国膳食平衡指数-16评价整体膳食质量，检测糖化血红蛋白评价血糖控制状况。构建受试者工作特征曲线以找到中国膳食平衡指数-16分值截断值，将患者分为膳食质量相对较低和较高组，对两个组别进行统计分析。建立logistic回归模型评价患者膳食质量与血糖控制的关系，以糖化血红蛋白含量≥7％作为因变量，调整月收入、生命质量、并发症、总胆固醇和低密度脂蛋白水平。结果 共有290例2型糖尿病患者被最终纳入分析。中国膳食平衡指数-16膳食质量距得分<26％为分组最佳截断值（受试者工作特征曲线下面积0.58，敏感性为74.0%，特异性为45.0%，P=0.020）。饮食质量较高组患者生命质量自我评分、血浆低密度脂蛋白水平较饮食质量较低组高(Z=-3.821、-2.317,P<0.05)，差异有统计学意义。调整混杂因素后，低饮食质量组患者血糖控制不良（OR=1.84，95%CI为1.06~3.20；P=0.03）的概率是高饮食质量组的2倍。结论 社区2型糖尿病患者较低的饮食质量（定义为DBI-16膳食质量距得分>26％）与血糖控制不良有关，通过评价整体饮食质量提供相关饮食建议可能是改善患者血糖控制水平的有效方法。

Diet quality and glycemic control in patients with type 2 diabetes

?o evaluate the relationship between diet quality and glycemic control in patients with type 2 diabetes. Methods In 2019, a cluster sampling method was adopted to conduct a questionnaire survey of 332 type 2 diabetes patients in a community of Bengbu City to obtain information on population sociology, dietary intake, and biochemical indicators. The Chinese Dietary Balance Index-16 was used to evaluate the overall diet quality, and the glycosylated hemoglobin was tested to evaluate the glycemic control. Construct a receiver operating characteristic curve to find the cut-off value of the Chinese Dietary Balance Index-16 score, divide the patients into relatively low and high diet quality groups, and perform statistical analysis on the two groups. A logistic regression model was established to evaluate the relationship between dietary quality and glycemic control in patients. Results A total of 290 patients with type 2 diabetes were included in the final analysis. The Chinese Dietary Balance Index-16 diet quality distance score <26% was the best cut-off value for the group (the area under the receiver operating characteristic curve was 0.58, the sensitivity was 74.0%, the specificity was 45.0%, (P=0.020). Patients with a higher diet quality self-score and plasma low-density lipoprotein levels were higher than those with a lower diet quality (Z=-3.821, -2.317, P<0.05), the difference was statistically significant. After adjusting for confounding factors, the probability of poor blood glucose control in the low-quality diet group (OR=1.84, 95%CI: 1.06-3.20; P=0.03) was twice that of the high-quality diet group. Conclusion The lower diet quality of patients with type 2 diabetes in the community (defined as DBI-16 diet quality distance score> 26%) is related to poor blood glucose control. Providing relevant dietary recommendations by evaluating the overall diet quality may be an effective way to improve the level of blood glucose control in patients.