天津市市区成年人膳食状况及维生素D和炎症因子与体成分关系分析

发布时间：2018-04-30 02:13

本文选题：膳食模式 + 维生素D　；参考：《天津医科大学》2017年硕士论文

【摘要】：目的通过对天津市和平区成年人进行医学体检、膳食调查、体成分测量、血清维生素D及炎症因子检测,分析该人群的主要膳食模式,探讨维生素D水平和炎症因子与体成分的关系,旨在了解该地区人群膳食营养状况以及维生素D和炎症因子对身体成分的影响,为人群健康提供合理的指导。方法本研究采用横断面研究,收集于2014年9月~2015年9月在天津市和平区健康教育指导中心参加体检的4323例体检人员作为研究对象,并对其进行膳食调查、体成分测量、维生素D及炎症因子检测。采用食物频率法结合3d24h膳食回顾法进行膳食调查;采用Inbody720分析仪测量体成分;血清维生素D检测采用高效液相法;血清炎症因子检测采用ELISA酶联免疫吸附实验;主要膳食模式的确定采用主成分分析法;血清维生素D水平与体成分的关系采用Logistic回归分析;采用偏相关分析炎症因子与体成分的关系。结果1.一般情况:男性人群体质指数(body mass index,BMI)、腰围(waist circumference,WC)、腰臀比(waist to hip ratio,WHR)、收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)、甘油三脂(triglyceride,TG)和低密度脂蛋白(low-density lipoprotein cholesterol,LDL-C)水平高于女性人群(P0.05),高密度脂蛋白(high-density lipoprotein cholesterol,HDL-C)水平低于女性人群(P0.05)。男性人群内脏脂肪面积(visceral fat area,VFA)和去脂体重指数(fat free mass index,FFMI)高于女性人群(P0.05);血清25-羟基维生素D3[25-hydroxyvitamin D3,25(OH)D3]水平、体脂百分比(percent body fat,PBF)和体脂肪指数(fat mass index,FMI)低于女性人群(P0.05)。维生素D缺乏组、不足组和充足组比较;男性人群年龄、TC、LDL-C水平、VFA和FFMI均呈递减趋势(P0.05);空腹血糖(fasting plasma glucose,FPG)和25(OH)D3水平呈递增趋势(P0.05);女性人群年龄、WC、SBP、DBP、TC、TG、LDL-C、FPG、VFA、PBF、FMI和FFMI均呈递减趋势(P0.05);HDL-C和25(OH)D3水平呈递增趋势(P0.05)。此外,男性人群的抵抗素(resistin,RES)水平高于女性人群(P0.05)。2.膳食营养状况:采用主成分分析法确定三种主要膳食模式,男女性膳食模式基本相同,分别命名为蔬菜-水果模式(以蔬菜类、水果类、葱蒜类、菌藻类等为主),内脏-小吃模式(以内脏类、小吃甜品类、速食类、酒类等为主)和肉类模式(以畜肉类、禽肉类、谷类、蛋类及制品为主)。与中国居民平衡膳食宝塔(2016版)推荐量相比,男女性人群水产品类的摄入量偏低;乳制品的摄入量严重不足。三大营养素供能比分析显示,两性人群三大宏量营养素功能比基本满足要求,蛋白质的供能比略偏高。与推荐摄入量相比,男性人群视黄醇、硫胺素、核黄素、钙和硒的摄入量不足,维生素C的摄入量偏低,维生素E和铁的摄入量基本满足推荐量;女性人群视黄醇、硫胺素、核黄素、钙和硒的摄入量不足,维生素C、维生素E、铁和锌的摄入量基本满足推荐量。两性人群来源于动物性食物和豆类食物的优质蛋白质摄入量超过全部蛋白质摄入量的三分之一,蛋白质质量较好。3.血清维生素D与体成分的关系:男性人群维生素D缺乏率为32.37%,女性人群为22.72%,均是70-岁年龄组最高。男女性维生素D与体成分指标(BMI、WC、WHR、VFA、PBF、FMI和FFMI)均呈显著负相关(P0.05)。在男性人群中,与维生素D充足组相比,缺乏组VFA和PBF水平越高,且WC、WHR和BMI的水平同样增高(P0.05),在女性人群中,与维生素D充足组相比,缺乏组FMI和FFMI的水平越高,同时,WC和BMI的水平也增高(P0.05)。4.炎症因子与体成分的关系:男性人群血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和瘦素(leptin,LEP)与BMI、WC和WHR均呈正相关性(均P0.05);VFA、PBF、FMI和FFMI的差异无统计学意义(P0.05)。女性人群血清TNF-α和LEP与BMI、WC、WHR、VFA、PBF、FMI和FFMI均呈正相关(P0.05);血清ADP与BMI、WC、VFA、PBF、FMI和FFMI均呈负相关(P0.05);血清抵抗素(resistin,RES)与WC、WHR、VFA、PBF、FMI和FFMI呈正相关(P0.05);血清白细胞介素-6(interleukin-6,IL-6)与PBF和FMI呈正相关(P0.05).结论1.膳食模式:天津市市区成年人的膳食模式分别为蔬菜-水果模式,内脏-小吃模式和肉类模式,其中以蔬菜-水果模式为主;三大营养素供能比基本合理;蛋白质质量较好。但是,该人群存在膳食不均衡问题,水产品类摄入偏低,乳制品摄入严重不足,部分维生素(视黄醇、硫胺素、核黄素)和矿物质(钙、硒)摄入不足。2.维生素D与体成分:天津市社区成年人维生素D缺乏率较高,维生素D水平越低,体脂肪含量越高,提示肥胖的发生与维生素D缺乏相关。3.炎症因子与体成分:血清炎症因子(TNF-α、LEP、ADP、RES、IL-6)的水平与体成分指标(BMI、WC、WHR、VFA、PBF、FMI、FFMI)具有较强相关性,提示炎症反应与肥胖发生具有关联性。
[Abstract]:Objective through the medical examination, dietary survey, body composition measurement, serum vitamin D and inflammatory factors in Tianjin peace zone, the main dietary patterns of the population were analyzed, and the relationship between vitamin D level and inflammatory factors and body components were discussed in order to understand the dietary nutrition status of the population and vitamin D and the cause of inflammation. The influence of the son on the body composition to provide reasonable guidance for the health of the population. Methods a cross-sectional study was used in this study to collect 4323 physical examination personnel who participated in physical examination in the health education guidance center of Tianjin city peace zone in September, September 2014, as the research object, and carried out a dietary survey, body composition measurement, vitamin D and inflammatory causes. The diet survey was carried out by food frequency method combined with 3d24h diet review method; body composition was measured with Inbody720 analyzer; serum vitamin D was detected by high performance liquid phase method; serum inflammatory factors were detected by ELISA enzyme linked immunosorbent assay; main dietary pattern was determined by principal component analysis; serum vitamin D level and serum levels of vitamin D were determined. The relationship between body composition and body composition was analyzed by Logistic regression. The relationship between inflammatory factors and body components was analyzed by partial correlation. Results 1. general conditions: the body mass index (body mass index, BMI), the waist circumference (waist circumference, WC), the waist to hip ratio (waist to hip ratio), systolic pressure, systolic pressure, diastolic pressure, and diastolic pressure Essure, DBP), the levels of glycerol three fat (triglyceride, TG) and low density lipoprotein (low-density lipoprotein cholesterol, LDL-C) were higher than the female population (P0.05). The level of high density lipoprotein (high-density lipoprotein cholesterol) was lower than that of the female population. The fat free mass index (FFMI) was higher than the female population (P0.05); the serum 25- hydroxyl vitamin D3[25-hydroxyvitamin D3,25 (OH) D3] level, the percentage of body fat and body fat index were lower than that of the female population. The level of VFA and FFMI showed a decreasing trend (P0.05), and the level of fasting plasma glucose, FPG and 25 (OH) D3 showed an increasing trend (P0.05). RES) level is higher than that of women (P0.05).2. dietary nutrition status: using principal component analysis to determine three main dietary patterns, male and female dietary patterns are basically the same, respectively named vegetable fruit model (vegetables, fruits, onion, garlic, algae and algae, etc.), visceral snack pattern (with viscera, snack desserts, fast food, alcohol) And meat models (mainly animal meat, poultry, Cereals, eggs and products). Compared with the recommendation of the Chinese residents' balanced diet pagoda (2016 Edition), the intake of aquatic products in men and women is low; the intake of dairy products is seriously inadequate. The analysis of three major nutrients for energy ratio shows that the three macro nutrient function ratio base of the hermaphroditic population Compared with recommended intake, the intake of retinol, thiamine, riboflavin, calcium and selenium is insufficient, vitamin C intake is low, vitamin E and iron intake basically meet the recommended intake, and the intake of retinol, thiamine, riboflavin, calcium and selenium in female population is insufficient. The intake of vitamin C, vitamin E, iron and zinc basically meets the recommended intake. The high quality protein intake from animal foods and legumes is 1/3 higher than that of all protein intake. The protein quality is better.3. serum vitamin D and body composition: the vitamin D deficiency rate of male population is 32.37%, female population 22.72%, all were the highest in the 70- age group. Both male and female vitamin D were significantly negatively correlated with body components (BMI, WC, WHR, VFA, PBF, FMI and FFMI). The higher levels of FMI and FFMI were, while the levels of WC and BMI increased (P0.05).4. inflammatory factors and body components: the serum tumor necrosis factor - alpha (tumor necrosis factor- alpha, TNF- a) and leptin (leptin, LEP) were all positive in male population. Serum TNF- alpha and LEP are positively correlated with BMI, WC, WHR, VFA, PBF, FMI and FFMI; serum ADP and LEP are negatively correlated; serum resistin Conclusion (P0.05). Conclusion 1. dietary pattern: the dietary patterns of adults in Tianjin city are vegetable fruit model, visceral snack pattern and meat pattern, which are mainly vegetable and fruit pattern, and the three major nutrients are basically reasonable and protein quality is better. However, the population is not balanced with food, and the intake of aquatic products is low. Inadequate intake of dairy products, some vitamins (retinol, thiamine, riboflavin, riboflavin) and minerals (calcium, selenium) intakes of.2. vitamin D and body components: Tianjin community adults with higher vitamin D deficiency, lower vitamin D level, higher body fat content, suggest that obesity is associated with vitamin D deficiency associated with.3. inflammatory factors and body formation Scores: the levels of serum inflammatory factors (TNF-, LEP, ADP, RES, IL-6) have strong correlation with the body components (BMI, WC, WHR, VFA, PBF, FMI, FFMI), suggesting that the inflammatory response is associated with the occurrence of obesity.

【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R151.42

【参考文献】