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促胰岛素抵抗膳食指数与胃癌前病变患病风险的病例对照研究

舒幸 李彬 姜皓琪 汤进芝 石嫦娥 赵奇红 杨万水 唐敏 胡安拉

舒幸, 李彬, 姜皓琪, 汤进芝, 石嫦娥, 赵奇红, 杨万水, 唐敏, 胡安拉. 促胰岛素抵抗膳食指数与胃癌前病变患病风险的病例对照研究[J]. 中华疾病控制杂志, 2024, 28(8): 944-949. doi: 10.16462/j.cnki.zhjbkz.2024.08.012
引用本文: 舒幸, 李彬, 姜皓琪, 汤进芝, 石嫦娥, 赵奇红, 杨万水, 唐敏, 胡安拉. 促胰岛素抵抗膳食指数与胃癌前病变患病风险的病例对照研究[J]. 中华疾病控制杂志, 2024, 28(8): 944-949. doi: 10.16462/j.cnki.zhjbkz.2024.08.012
SHU Xing, LI Bin, JIANG Haoqi, TANG Jinzhi, SHI Chang′e, ZHAO Qihong, YANG Wanshui, TANG Min, U Anla. A case-control study of empirical dietary index for insulin resistance and risk of gastric precancerous lesions[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(8): 944-949. doi: 10.16462/j.cnki.zhjbkz.2024.08.012
Citation: SHU Xing, LI Bin, JIANG Haoqi, TANG Jinzhi, SHI Chang′e, ZHAO Qihong, YANG Wanshui, TANG Min, U Anla. A case-control study of empirical dietary index for insulin resistance and risk of gastric precancerous lesions[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(8): 944-949. doi: 10.16462/j.cnki.zhjbkz.2024.08.012

促胰岛素抵抗膳食指数与胃癌前病变患病风险的病例对照研究

doi: 10.16462/j.cnki.zhjbkz.2024.08.012
基金项目: 

国家自然科学基金 81502806

预防医学国家级一流专业建设规划项目 AHMUPM-307

安徽医科大学临床医学学科建设项目 2020lcxk033

详细信息
    通讯作者:

    胡安拉,E-mail: huanla@ahmu.edu.cn

    唐敏,E-mail: tangpanpan1@163.com

  • 中图分类号: R153.9

A case-control study of empirical dietary index for insulin resistance and risk of gastric precancerous lesions

Funds: 

National Natural Science Fund 81502806

Preventive Medicine National First-class Professional Construction Planning Project AHMUPM-307

Clinical Medicine Discipline Construction Project of Anhui Medical University 2020lcxk033

More Information
  • 摘要:   目的  探讨促胰岛素抵抗膳食指数(empirical dietary index for insulin resistance, EDIR)与胃癌前病变(gastric precancerous lesions, GPL)患病风险的关系,为GPL人群的膳食防控提供流行病学依据。   方法  2021年9月―2022年7月在安徽医科大学第一附属医院招募102例GPL患者作为病例组,204例非萎缩性胃炎患者(non-atrophic gastritis, NAG)或正常胃黏膜者作为对照组,进行非匹配病例对照研究。   结果  病例组EDIR评分高于对照组,且差异有统计学意义(Z=-2.141, P=0.032);与对照组相比,病例组的精谷物摄入量更高(Z=-2.475, P=0.013);在对混杂因素进行调整后,较高的EDIR[Quartile 2: OR(95% CI): 4.36(1.61~11.84), P=0.003]与GPL风险的增加呈正相关。   结论  较高的EDIR评分和高精谷物摄入会增加GPL患病风险。
  • 图  1  EDIR评分及食物组分布情况图

    EDIR: 促胰岛素抵抗膳食指数;A:病例组和对照组的EDIR评分;B:病例组和对照组的精谷物摄入量。

    Figure  1.  EDIR score and distribution of food groups

    EDIR: empirical dietary index for insulin resistance; A: EDIR scores in case group and control group; B: refined grain intake in case group and control group.

    表  1  EDIR食物组得分构成

    Table  1.   EDIR food groups score composition

    EDIR食物组变量Variable EDIR food groups 权重Weight
    正相关 Positive correlation
      精谷物 Refined grain 0.000 31
      红肉 Red meat 0.000 41
      其他水产品 Other aquatic products 0.003 90
      其他蔬菜 Other vegetables 0.000 42
    负相关 Negative correlation
      绿叶蔬菜 Green leafy vegetables -0.000 28
      深黄色蔬菜 Dark yellow vegetables -0.003 70
      米酒 Rice wine -0.002 00
    截距 Intercept -0.015 00
    注:EDIR, 促胰岛素抵抗膳食指数。
    Note: EDIR, empirical dietary index for insulin resistance.
    下载: 导出CSV

    表  2  一般人口学特征

    Table  2.   General demographic characteristics

    变量 Variable 病例组
    Case group
    (n=102)
    对照组
    Control group
    (n=204)
    χ2/Z值 value P值 value
    年龄组/岁 Age group/years 15.893 <0.001
      18~<45 10(9.8) 56(27.5)
      45~<60 53(52.0) 102(50.0)
      60~<80 39(38.2) 46(22.5)
    性别 Gender 4.106 0.043
      男性 Male 63(61.8) 101(49.5)
      女性 Female 39(38.2) 103(50.5)
    文化水平 Educational level 1.972 0.373
      小学及以下 Primary school and below 46(45.1) 76(37.3)
      初中/高中 Middle school/high school 36(35.3) 87(42.6)
      大专及以上 College and above 20(19.6) 41(20.1)
    家庭人均年收入/元 Per capita annual household income/ yuan 4.969 0.083
      <20 000 35(34.4) 50(24.5)
      20 000~<30 000 49(48.0) 125(61.3)
      ≥30 000 18(17.6) 29(14.2)
    职业 Occupation 6.786 0.079
      体力工人 Blue-collar worker 14(13.7) 30(14.7)
      农民 Peasant 35(34.3) 43(21.1)
      办公室职员 Office staff 27(26.5) 60(29.4)
      其他 Others 26(25.5) 71(34.8)
    婚姻状况 Marital status 1.311 0.252
      已婚 Married 93(91.2) 193(94.6)
      未婚/离异/丧偶 Unmarried/divorced or widowed 9(8.8) 11(5.4)
    吸烟 Smoking 0.605 0.437
      是 Yes 36(35.3) 63(30.9)
      否 No 66(64.7) 141(69.1)
    饮酒 Drinking 1.059 0.303
      是 Yes 38(37.3) 64(31.4)
      否 No 64(62.7) 140(68.6)
    饮茶 Drink tea 1.018 0.313
      是 Yes 41(40.2) 70(34.3)
      否 No 61(59.8) 134(65.7)
    高血压 Hypertension 4.449 0.035
      是 Yes 39(38.2) 54(26.5)
      否 No 63(61.8) 150(73.5)
    糖尿病 Diabetes 5.987 0.014
      是 Yes 16(15.7) 14(6.9)
      否 No 86(84.3) 190(93.1)
    BMI/(kg·m-2) 2.577 0.462
      <18.5 3(2.9) 10(4.9)
      18.5~<24.0 44(43.2) 101(49.5)
      24.0~<28.0 42(41.2) 75(36.8)
      ≥28.0 13(12.7) 18(8.8)
    Hp 5.767 0.016
      阳性 Positive 35(34.3) 44(21.6)
      阴性 Negative 67(65.7) 160(78.4)
    FPG/(mmol·L-1) 4.93(4.50, 5.56) 4.70(4.34, 5.06) -2.695 0.007
    TG/(mmol·L-1) 1.47(1.08, 1.98) 1.23(0.90, 1.85) -2.395 0.017
    HDL-C/(mmol·L-1) 1.02(0.86, 1.21) 1.07(0.87, 1.24) 0.325 0.325
    LDL-C/(mmol·L-1) 2.53(1.90, 3.06) 2.39(1.92, 2.91) -0.914 0.361
    TG/HDL-C 1.46(1.02, 2.25) 1.19(0.73, 1.98) -2.173 0.030
    营养/每 1 000 kcal Nutrient/per 1 000 kcal
      总能量 Energy(/(kcal·day-1) 2 516.30(1 844.25, 3 156.77) 2 401.66(1 896.87, 3 060.12) -0.195 0.846
      蛋白质 Protein/(g·d-1) 36.99(31.54, 41.91) 38.79(35.33, 43.63) 2.564 0.010
      脂肪 Fat/(g·d-1) 23.35(19.32, 29.15) 25.50(20.49, 31.21) 2.198 0.028
      碳水化合物 Carbohydrate/(g·d-1) 176.98(162.39, 188.71) 169.6(155.05, 186.22) -2.159 0.031
      纤维 Fiber/(g·d-1) 3.87(2.95, 5.57) 4.21(3.05, 6.29) 1.362 0.173
    注:Hp,幽门螺旋杆菌;FPG,空腹血糖;TG,三酰甘油;HDL-C,高密度脂蛋白胆固醇;LDL-C,低密度脂蛋白胆固醇; 其他职业:包括个体户、商人、自由职业、家庭主妇等。
    ①以人数(占比/%)或M(P25, P75)表示。
    Note: Hp, Helicobacter pylori; FPG, fasting plasma glucose; TG, triglyceride; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; Other occupations: including self-employed, businessmen, freelancers, housewives, etc.
    ① Number of people (proportion/%) or M(P25, P75).
    下载: 导出CSV

    表  3  EDIR与GPL风险的多模型调整分析

    Table  3.   Multi-model adjustment analysis of EDIR and GPL risk

    EDIR Quartile 1
    (<0.06)
    Quartile 2
    (0.06~<0.12)
    Quartile 3
    (0.12~<0.19)
    Quartile 4
    (≥0.19)
    Ptrend值 value
    病例/对照 Case/Control   9/51   33/51   28/51   32/51
    模型1 Model 1 1.00 3.92(1.63~9.43) 0.90(0.47~1.74) 1.21(0.62~2.36) 0.022
    模型2 Model 2 1.00 4.47(1.79~11.16) 0.94(0.48~1.86) 1.23(0.62~2.45) 0.013
    模型3 Model 3 1.00 4.31(1.71~10.86) 0.87(0.43~1.75) 1.16(0.57~2.34) 0.020
    模型4 Model 4 1.00 4.36(1.61~11.84) 0.86(0.40~1.83) 1.17(0.56~2.43) 0.031
    注:EDIR,促胰岛素抵抗膳食指数;GPL,胃癌前病变。
    ①调整性别、年龄;②在模型1的基础上调整家庭人均年收入、职业、BMI、高血压、糖尿病;③在模型2的基础上调整FPG、TG、TG/HDL-C、Hp;④在模型3的基础上调整蛋白质、碳水化合物、脂肪;⑤ OR(95% CI)。Note: EDIR,empirical dietary index for insulin resistance;GPL,gastric precancerous lesions.
    ① Adjust gender, age; ② Adjusted per capita annual household income, occupation, BMI, hypertension and diabetes on the basis of model 1; ③ Adjust FPG, TG, TG/HDL-C, Helicobacter pylori on the basis of model 2; ④ Protein, carbohydrate and fat were adjusted on the basis of model 3; ⑤ OR(95% CI).
    下载: 导出CSV

    表  4  亚组间EDIR与GPL风险的多模型调整分析

    Table  4.   Multi-model adjustment analysis of EDIR and GPL risk among subgroups

    EDIR Quartile 1
    (<0.06)
    Quartile 2
    (0.06~<0.12)
    Quartile 3
    (0.12~<0.19)
    Quartile 4
    (≥0.19)
    Ptrend
    值value
    Pinteraction
    值value
    病例/对照 Case/control 9/51 33/51 28/51 32/51
    性别 Gender 0.904
      男性 Male 1.00 7.59(1.55~37.21) 0.57(0.21~1.54) 1.09(0.44~2.72) 0.191
      女性 Female 1.00 3.28(0.63~17.07) 1.62(0.37~7.15) 1.81(0.42~7.87) 0.204
    高血压 Hypertension 0.785
      是 Yes 1.00 1.15(0.22~6.01) 0.79(0.18~3.51) 1.32(0.33~5.35) 0.972
      否 No 1.00 8.07(1.85~35.18) 0.86(0.34~2.20) 1.10(0.44~2.73) 0.032
    Hp 0.150
      阳性 Positive 1.00 8.20(1.25~53.71) 1.02(0.19~5.57) 2.20(0.41~11.68) 0.064
      阴性 Negative 1.00 3.62(0.98~13.38) 0.80(0.32~2.01) 1.00(0.42~2.37) 0.195
    注:模型采用多变量logistic回归分析;调整性别、年龄、家庭人均年收入、职业、BMI、高血压、糖尿病、FPG、TG、TG/HDL-C、Hp、蛋白质、碳水化合物、脂肪。
    OR(95% CI);P<0.05。Note: Multivariate logistic regression analysis was used for the model; Adjusted for sex, age, per capita annual household income, occupation, BMI, hypertension, diabetes, FPG, TG, TG/HDL-C, Helicobacter pylori, protein, carbohydrate, fat.
    OR(95% CI); ② P<0.05.
    下载: 导出CSV
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  • 收稿日期:  2023-12-08
  • 修回日期:  2024-05-17
  • 网络出版日期:  2024-09-29
  • 刊出日期:  2024-08-10

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