本文選題：膳食模式 + 維生素D�。� 參考：《天津醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的通過對天津市和平區(qū)成年人進行醫(yī)學(xué)體檢、膳食調(diào)查、體成分測量、血清維生素D及炎癥因子檢測,分析該人群的主要膳食模式,探討維生素D水平和炎癥因子與體成分的關(guān)系,旨在了解該地區(qū)人群膳食營養(yǎng)狀況以及維生素D和炎癥因子對身體成分的影響,為人群健康提供合理的指導(dǎo)。方法本研究采用橫斷面研究,收集于2014年9月~2015年9月在天津市和平區(qū)健康教育指導(dǎo)中心參加體檢的4323例體檢人員作為研究對象,并對其進行膳食調(diào)查、體成分測量、維生素D及炎癥因子檢測。采用食物頻率法結(jié)合3d24h膳食回顧法進行膳食調(diào)查;采用Inbody720分析儀測量體成分;血清維生素D檢測采用高效液相法;血清炎癥因子檢測采用ELISA酶聯(lián)免疫吸附實驗;主要膳食模式的確定采用主成分分析法;血清維生素D水平與體成分的關(guān)系采用Logistic回歸分析;采用偏相關(guān)分析炎癥因子與體成分的關(guān)系。結(jié)果1.一般情況:男性人群體質(zhì)指數(shù)(body mass index,BMI)、腰圍(waist circumference,WC)、腰臀比(waist to hip ratio,WHR)、收縮壓(systolic blood pressure,SBP)、舒張壓(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)。男性人群內(nèi)臟脂肪面積(visceral fat area,VFA)和去脂體重指數(shù)(fat free mass index,FFMI)高于女性人群(P0.05);血清25-羥基維生素D3[25-hydroxyvitamin D3,25(OH)D3]水平、體脂百分比(percent body fat,PBF)和體脂肪指數(shù)(fat mass index,FMI)低于女性人群(P0.05)。維生素D缺乏組、不足組和充足組比較;男性人群年齡、TC、LDL-C水平、VFA和FFMI均呈遞減趨勢(P0.05);空腹血糖(fasting plasma glucose,FPG)和25(OH)D3水平呈遞增趨勢(P0.05);女性人群年齡、WC、SBP、DBP、TC、TG、LDL-C、FPG、VFA、PBF、FMI和FFMI均呈遞減趨勢(P0.05);HDL-C和25(OH)D3水平呈遞增趨勢(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.膳食營養(yǎng)狀況:采用主成分分析法確定三種主要膳食模式,男女性膳食模式基本相同,分別命名為蔬菜-水果模式(以蔬菜類、水果類、蔥蒜類、菌藻類等為主),內(nèi)臟-小吃模式(以內(nèi)臟類、小吃甜品類、速食類、酒類等為主)和肉類模式(以畜肉類、禽肉類、谷類、蛋類及制品為主)。與中國居民平衡膳食寶塔(2016版)推薦量相比,男女性人群水產(chǎn)品類的攝入量偏低;乳制品的攝入量嚴重不足。三大營養(yǎng)素供能比分析顯示,兩性人群三大宏量營養(yǎng)素功能比基本滿足要求,蛋白質(zhì)的供能比略偏高。與推薦攝入量相比,男性人群視黃醇、硫胺素、核黃素、鈣和硒的攝入量不足,維生素C的攝入量偏低,維生素E和鐵的攝入量基本滿足推薦量;女性人群視黃醇、硫胺素、核黃素、鈣和硒的攝入量不足,維生素C、維生素E、鐵和鋅的攝入量基本滿足推薦量。兩性人群來源于動物性食物和豆類食物的優(yōu)質(zhì)蛋白質(zhì)攝入量超過全部蛋白質(zhì)攝入量的三分之一,蛋白質(zhì)質(zhì)量較好。3.血清維生素D與體成分的關(guān)系:男性人群維生素D缺乏率為32.37%,女性人群為22.72%,均是70-歲年齡組最高。男女性維生素D與體成分指標(BMI、WC、WHR、VFA、PBF、FMI和FFMI)均呈顯著負相關(guān)(P0.05)。在男性人群中,與維生素D充足組相比,缺乏組VFA和PBF水平越高,且WC、WHR和BMI的水平同樣增高(P0.05),在女性人群中,與維生素D充足組相比,缺乏組FMI和FFMI的水平越高,同時,WC和BMI的水平也增高(P0.05)。4.炎癥因子與體成分的關(guān)系:男性人群血清腫瘤壞死因子-α(tumor necrosis factor-α,TNF-α)和瘦素(leptin,LEP)與BMI、WC和WHR均呈正相關(guān)性(均P0.05);VFA、PBF、FMI和FFMI的差異無統(tǒng)計學(xué)意義(P0.05)。女性人群血清TNF-α和LEP與BMI、WC、WHR、VFA、PBF、FMI和FFMI均呈正相關(guān)(P0.05);血清ADP與BMI、WC、VFA、PBF、FMI和FFMI均呈負相關(guān)(P0.05);血清抵抗素(resistin,RES)與WC、WHR、VFA、PBF、FMI和FFMI呈正相關(guān)(P0.05);血清白細胞介素-6(interleukin-6,IL-6)與PBF和FMI呈正相關(guān)(P0.05).結(jié)論1.膳食模式:天津市市區(qū)成年人的膳食模式分別為蔬菜-水果模式,內(nèi)臟-小吃模式和肉類模式,其中以蔬菜-水果模式為主;三大營養(yǎng)素供能比基本合理;蛋白質(zhì)質(zhì)量較好。但是,該人群存在膳食不均衡問題,水產(chǎn)品類攝入偏低,乳制品攝入嚴重不足,部分維生素(視黃醇、硫胺素、核黃素)和礦物質(zhì)(鈣、硒)攝入不足。2.維生素D與體成分:天津市社區(qū)成年人維生素D缺乏率較高,維生素D水平越低,體脂肪含量越高,提示肥胖的發(fā)生與維生素D缺乏相關(guān)。3.炎癥因子與體成分:血清炎癥因子(TNF-α、LEP、ADP、RES、IL-6)的水平與體成分指標(BMI、WC、WHR、VFA、PBF、FMI、FFMI)具有較強相關(guān)性,提示炎癥反應(yīng)與肥胖發(fā)生具有關(guān)聯(lián)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.

【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R151.42

【參考文獻】

相關(guān)期刊論文 前10條

1 孫永存;謝莉紅;;AD患者腦電圖δ+θ/α+β比值與炎癥因子的相關(guān)性分析[J];西南國防醫(yī)藥;2016年10期

2 陳敏敏;姜鑫;杜艷萍;洪維;唐雯菁;李慧林;鄭松柏;程群;;上海社區(qū)老年人血清25-羥維生素D水平影響因素的研究[J];中華老年醫(yī)學(xué)雜志;2016年09期

3 趙妍娟;孫經(jīng);陳永春;文靜;;鄭州市中學(xué)教職工體成分與血脂水平關(guān)系研究[J];現(xiàn)代預(yù)防醫(yī)學(xué);2016年17期

4 丁鋼強;高潔;;中國居民營養(yǎng)的發(fā)展與挑戰(zhàn)[J];中國食品學(xué)報;2016年07期

5 于冬梅;何宇納;郭齊雅;房紅蕓;許曉麗;房sリ，

本文編號：1822604