[Relationship between dietary fiber intake and glucose metabolism in the elderly of China in 2015].

Weihua Dong, Qingqing Man, Yuqian Li, Shanshan Jia, Dongmei Yu, Liyun Zhao, Jian Zhang, Pengkun Song
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Abstract

Objective: To investigate the dietary fiber intake status and analyze the relationship between dietary fiber and glucose metabolic disorder of the elderly in China.

Methods: Data were collected from the participants of Chinese adult chronic diseases and nutrition surveillance in 2015. General information were collected by standardized questionnaires, anthropometric index and blood pressure of respondents were measured according to standard method. Food intake was collected by three consecutive day 24 h dietary recalls, dietary fiber was calculated through China food composition. Fasting venous blood were collected to measure glucose, HbA1C, and other related biochemical index. Subjects were divided into three groups: normal glucose(NG, normal glucose), pre-diabetes(Pre-DM, pre-diabetes mellitus) and diabetes(T2DM, type 2 diabetes mellitus). Multiple logistic regression model was used to analyze the relationship between dietary fiber intake and Pre-DM as well as T2DM.

Results: A total of 20 996 elderly people aged 60 years and above were included. There 10 773 cases were males(51.3%) and 10 223 cases were females(48.7%), the age of both gender were(68.21±6.26) years and(67.67±6.26) years. A total of 6526 cases of pre-diabetes were detected in 20 996 elderly participants with detection rate of 31.1%. There 3274 cases were male and 3252 cases were female, the detection rates of both genders were 30.4% and 31.8%, respectively. While 1572 participants were detected as T2DM(784 of males and 788 of females), the detection rate of T2DM was 7.5%, 7.3% for males and 7.7% for females. There were significant differences in mean age, BMI, waist circumference, systolic blood pressure, diastolic blood pressure, TC, TG, HDL-C, LDL-C, HbA1c level among different dietary intake groups(P<0.005). With the increase of dietary fiber intake, the proportion of overweight and obesity, central obesity and dyslipidemia showed an increasing trend(P<0.05), and the proportion of hypertension showed a decreasing trend(P<0.000 1). After adjusting for potential confounding factors, compared to participants with lowest fiber intake, participants in subgroups of lower, minor lower, and higher fiber intake were associated with decreased risk of pre-diabetes, the OR and 95%CI were(OR=0.911, 95%CI 0.835-0.993), (OR= 0.861, 95%CI 0.790-0.938) and(OR= 0.913, 95%CI 0.838-0.994), respectively. However, there was only a statistically significant negative association between the higher intake of dietary fiber and T2DM(OR = 0.848, 95%CI 0.726-0.991).

Conclusion: Dietary fiber intake was negatively related with diabetes and pre-diabetes mellitus. The risk of glucose metabolic disorder was decreased with the increase of dietary fiber intake.

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[2015年中国老年人膳食纤维摄入量与葡萄糖代谢的关系]。
目的:了解中国老年人膳食纤维摄入状况,分析膳食纤维与糖代谢紊乱的关系。方法:收集2015年中国成人慢性病与营养监测参与者的数据。采用标准化问卷收集一般资料,按标准方法测量被调查者的人体测量指数和血压。采用连续3天24 h膳食召回法收集摄食量,通过中国食品成分法计算膳食纤维。采集空腹静脉血,测定血糖、糖化血红蛋白等相关生化指标。受试者分为血糖正常组(NG, normal glucose)、糖尿病前期组(Pre-DM, pre-diabetes)和糖尿病前期组(T2DM, 2型糖尿病)。采用多元logistic回归模型分析膳食纤维摄入量与前期糖尿病及T2DM的关系。结果:共纳入20 996名60岁及以上老年人。其中男性10 773例(51.3%),女性10 223例(48.7%),男女年龄分别为(68.21±6.26)岁和(67.67±6.26)岁。20996名老年人共检出糖尿病前期6526例,检出率为31.1%。其中男性3274例,女性3252例,男女检出率分别为30.4%和31.8%。1572名参与者被检测为T2DM(男性784人,女性788人),T2DM的检出率为7.5%,男性7.3%,女性7.7%。不同膳食摄入组患者的平均年龄、BMI、腰围、收缩压、舒张压、TC、TG、HDL-C、LDL-C、HbA1c水平差异均有统计学意义(P<0.005)。随着膳食纤维摄入量的增加,超重和肥胖、中心性肥胖和血脂异常的比例呈增加趋势(P<0.05),高血压的比例呈下降趋势(P<0.000 1)。在调整潜在混杂因素后,与膳食纤维摄入量最低的参与者相比,膳食纤维摄入量较低、较低和较高亚组的参与者与糖尿病前期风险降低相关,OR和95%CI为(OR=0.911)。95%CI 0.835-0.993)、(OR= 0.861, 95%CI 0.790-0.938)和(OR= 0.913, 95%CI 0.838-0.994)。然而,高膳食纤维摄入量与T2DM之间只有统计学上显著的负相关(OR = 0.848, 95%CI 0.726-0.991)。结论:膳食纤维摄入量与糖尿病及糖尿病前期呈负相关。随着膳食纤维摄入量的增加,糖代谢紊乱的风险降低。
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