膳食模式、脂肪因子与肥胖相关性研究

发布时间：2018-02-10 09:53

本文关键词： 肥胖新婚夫妇体重增长膳食模式脂肪因子胰岛素抵抗　出处：《复旦大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的1.了解新婚夫妇的膳食摄入、营养状况以及肥胖的患病率,探讨该人群的主要膳食模式以及膳食模式与婚后体重增长的关系；2.从人群的角度出发,了解Ccdc80、血清生长激素释放多肽(Ghrelin)、葡萄糖依赖性胰岛素样肽(GIP)、瘦素(Leptin)、抵抗素(Resistin)等脂脂肪因子的血清学表达水平,探讨其与肥胖以及糖尿病、胰岛素抵抗(IR)之间的关系,并为进一步了解其生理功能提供依据。方法1.采用横断面调查的方法,使用食物频率法、24小时膳食调查法调查上海市宝山地区结婚1周年以内新婚夫妇的膳食摄入状况,并使用问卷的形式当场收集他们的基本信息以及身体测量指标。通过因子分析的方法分析该人群主要的膳食模式,并通过多元线性回归探索影响新婚夫妇婚后体重增长主要膳食模式。 2.收集来源于唐山市某医院正常体检人群和糖尿病病人的血清学样本,采用夹心法ELISA检测其血清Ccdc80水平,Bio-plex生物检测技术检测血清中Ghrelin、GIP、Leptin和Resistin表达水平,通过相关分析以及多元线性回归的方法,探索这些脂肪因子的血清表达水平与肥胖、糖尿病以及胰岛素抵抗的相关关系。结果1.在接受调查的总共342对新婚夫妇中,共有556人(男性281人,女性275人)符合纳入标准而被纳入到后续的分析中。调查对象婚后平均体重增长值为1.9kg(男性为2.2kg,女性为1.6kg)。因子分析提示有四种膳食模式较有意义,分别是蔬菜类膳食模式、高热量膳食模式、豆类膳食模式以及肉类、水果和杂粮类膳食模式。在调整潜在混杂因素后,多元线性回归模型发现,在男性对象中,高热量膳食模式的最高五分位组与婚后1年内体重增长显著相关(β=2.94；95%CI：0.75,5.15；p=0.01),而肉类、水果和杂粮类膳食模式最高五分位组则与婚后体重增长显著负相关(β=-1.21；95%CI：-2.32,-0.11；p=0.03)。 2.在非糖尿病人群中,我们通过Pearson偏相关分析发现,Leptin与BMI(r=0.80,p0.001)、腰围(r=0.80,p0.001)、腰臀比(r=0.56,p0.01)之间有显著的正相关关系；GIP与BMI(r=0.34,p0.05)、腰围(r=0.33,p0.05)也有显著的正相关关系；未发现Ccdc80、Ghrelin、Resistin与肥胖相关指标之间的关系。在所有研究对象中发现,Ccdc80与空腹血糖(FBG)、胰岛素抵抗因子(HOMA-IR)、甘油三酯(TG)均呈负相关关系,而与高密度脂蛋白(HDL-C)呈现正相关关系；而Leptin与空腹血糖(FBG)、胰岛素抵抗因子(HOMA-IR)、甘油三酯(TG)及Ccdc80均呈正相关关系,而与高密度脂蛋白(HDL-C)呈现负相关关系。结论1.以糖、油及调味品摄入为主要特征的高热量膳食模式是男性婚后体重增长的危险因素,而以禽肉、牛羊肉类、水果、杂粮摄入为主要特征的肉类、水果和杂粮类膳食模式则对婚后的体重增长具有预防作用。 2.首次发现血清Ccdc80与FBG及HOMA-IR之间具有负相关关系,提示其可能参与体内胰岛素代谢,是胰岛素抵抗的保护因素；而血清Leptin与肥胖以及胰岛素抵抗成正相关关系,Leptin是肥胖以及糖尿病的危险因素。
[Abstract]:Objective 1 . To investigate the dietary intake , nutritional status and prevalence of obesity in newly married couples , to explore the relationship between dietary patterns and dietary patterns and post - marital weight gain in the population . Method 1 . Using the method of cross - sectional survey , the dietary intake status of the newly married couple within 1 year of marriage in Baoshan district of Shanghai was investigated by using food frequency method , and their basic information and physical measurement indexes were collected in the form of questionnaire . The main dietary patterns of the population were analyzed by factor analysis . 2 . The serum Ccdc80 level was measured by sandwich ELISA , and the serum levels of insulin - related factors , such as obesity , diabetes and insulin resistance were investigated by means of correlation analysis and multivariate linear regression . As a result , a total of 342 new couples surveyed , 556 ( 281 men , 275 women ) met the inclusion criteria and were incorporated into the follow - up analysis . The average body weight gain after marriage was 1.9 kg ( 2.2 kg for men and 1.6 kg for women ) . The results suggested that there were four dietary patterns in dietary patterns of vegetable , high calorie diet , bean diet and meat , fruit and coarse cereals . After adjustment of potential confounders , multivariate linear regression model found that the highest quintile group of high calorie diet was significantly correlated with the body weight gain in the first year after marriage ( 尾 = 2.94 ; 95 % CI : 0.75 , 5.15 ; p = 0.01 ) , while the highest quintile group in meat , fruit and miscellaneous cereals was negatively correlated with the post - marital body weight gain ( 尾 = - 1.21 ; 95 % CI : - 2.32 , - 0.11 ; p = 0.03 ) . 2 . In non - diabetic population , we found that leptin was positively correlated with BMI ( r = 0.80 , p0.001 ) , waist circumference ( r = 0.80 , p0.01 ) , waist hip ratio ( r = 0 . 33 , p0.01 ) . Conclusion 1 . High calorie diet with sugar , oil and condiment as the main characteristic is a risk factor for the increase of body weight after marriage , while the dietary pattern of meat , fruit and coarse cereals , which is mainly characterized by the intake of poultry , mutton , fruit and coarse cereals , has the preventive effect on the growth of body weight after marriage . 2 . There was a negative correlation between serum Ccdc80 and FBG and insulin resistance , suggesting that it might be involved in the metabolism of insulin in vivo , which is the protective factor of insulin resistance , while serum leptin is positively related to obesity and insulin resistance , and leptin is a risk factor for obesity and diabetes .

【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R151.3

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