【摘要】：目的：通過(guò)對(duì)維吾爾族MODY家系、維吾爾族2型糖尿病人群、維吾爾族正常人群進(jìn)行膳食調(diào)查，了解此3組人群的食物和營(yíng)養(yǎng)素?cái)z入水平，探討MODY家系、2型糖尿病人群、正常人群在膳食及營(yíng)養(yǎng)狀況上是否存在差異。方法：本研究收集到3個(gè)新疆喀什、伊犁地區(qū)維吾爾族四代健在的MODY家系成員共72例，通過(guò)現(xiàn)場(chǎng)調(diào)查收集每個(gè)成員的一般資料，測(cè)量體格指標(biāo)、血糖血脂水平，結(jié)果與其隨訪前的指標(biāo)比較。采用半定量食物頻率問(wèn)卷調(diào)查方法對(duì)維吾爾族MODY家系、2型糖尿病人群、正常人群進(jìn)行膳食調(diào)查，本次食物頻率調(diào)查問(wèn)卷包括9個(gè)類(lèi)別的101種食物，食物攝入頻率分類(lèi)從“每月1～3次”到“每天3次”共8個(gè)類(lèi)別。每次攝入量分類(lèi)從“四分之一”到“三碗或碟以上”共8個(gè)量。膳食調(diào)查后，調(diào)查對(duì)象按不同性別、年齡、勞動(dòng)強(qiáng)度分組，并且每個(gè)人的食物攝入量錄入營(yíng)養(yǎng)計(jì)算器V2.5軟件，計(jì)算出來(lái)的各種營(yíng)養(yǎng)素?cái)z入量導(dǎo)入至excel，并采用SPSS17.0統(tǒng)計(jì)軟件對(duì)數(shù)據(jù)進(jìn)行分析處理。3組人群的食物攝入量分別與平衡膳食寶塔推薦攝入量比較，將3組人群的三大營(yíng)養(yǎng)素供熱比分別與中國(guó)、美國(guó)推薦比例和中華醫(yī)學(xué)會(huì)糖尿病學(xué)分會(huì)、美國(guó)糖尿病協(xié)會(huì)建議的比例比較。三組人群的營(yíng)養(yǎng)素?cái)z入量分別與RNI和RDA進(jìn)行比較。結(jié)果：①將MODY家系每一個(gè)成員隨訪后的體重、身高、BMI、腰圍、臀圍、WHR、空腹血糖、餐后2h血糖、TG、CHOL、HDL、LDL等指標(biāo)與其隨訪前的指標(biāo)比較發(fā)現(xiàn)，體重、身高、BMI、腰圍、臀圍有所增高，差異有統(tǒng)計(jì)學(xué)意義（P0.05）。而空腹血糖、餐后2h血糖、TG、CHOL與3年前比較有增高、HDL、LDL有降低，但差異均無(wú)統(tǒng)計(jì)學(xué)意義（P0.05）。②與中國(guó)平衡膳食寶塔推薦值比較，維吾爾族MODY家系和維吾爾族正常人群的谷類(lèi)薯類(lèi)、油脂類(lèi)攝入超標(biāo)，而維吾爾族2型糖尿病人群的符合推薦值。3組人群的禽畜肉類(lèi)、大豆類(lèi)及堅(jiān)果和鹽攝入量均高于推薦值，而奶類(lèi)及奶制品，蛋類(lèi)攝入量均低于推薦值。MODY家系的水果攝入量遠(yuǎn)遠(yuǎn)低于推薦值，只達(dá)到推薦值的0.76%。3組人群的魚(yú)蝦類(lèi)攝入量均顯著低于推薦值，分別達(dá)到推薦值的2.57%、3.01%、1.9%。③與RNI和RDA比較，3組人群中維生素B6、B12、葉酸和碘攝入量均較低，鈉和煙酸攝入超標(biāo)。MODY家系的維生素C和鈣攝入量均低。輕、中體力勞動(dòng)強(qiáng)度的女性維生素C攝入量分別只達(dá)RNI的26.35%、47.3%，輕、中、重體力勞動(dòng)強(qiáng)度的男性維生素C攝入量分別占RNI的14.25%、23.04%、11.70%。男性的維生素C攝入量占RDA的18.14%，女性為70.89%。輕、中體力勞動(dòng)強(qiáng)度的女性鈣攝入量分別只達(dá)RNI的63.67%、42.00%。輕、中、重體力勞動(dòng)強(qiáng)度的男性鈣攝入量分別占RNI的49.94%、62.79%、60.56%。④維吾爾族MODY家系和正常人群的能量、蛋白質(zhì)、脂肪、碳水化合物攝入量均高于RNI和RDA。而2型糖尿病人群的高于RDA。結(jié)論：維吾爾族MODY家系中谷類(lèi)、肉類(lèi)、油脂類(lèi)、鹽攝入過(guò)多，蔬菜水果、魚(yú)蝦類(lèi)攝入極少和奶類(lèi)攝入不足導(dǎo)致維吾爾族MODY家系成員熱量攝入過(guò)多，而某些與糖代謝有關(guān)的維生素（維生素B6、維生素B12、葉酸、維生素C）和礦物質(zhì)(鈣、碘)的攝入不足，反而鈉等對(duì)糖尿病不利的營(yíng)養(yǎng)素卻超標(biāo)的膳食攝入特點(diǎn)。而2型糖尿病人群中嚴(yán)格控制飲食的概念使他們體內(nèi)所需要的維生素和礦物質(zhì)受到一定程度的限制。正常維吾爾族人群由于對(duì)飲食沒(méi)有任何控制，，可能會(huì)增加其因?yàn)轱嬍吃蚣尤胩悄虿』颊咝辛械娘L(fēng)險(xiǎn)。應(yīng)該加強(qiáng)利用維吾爾語(yǔ)言和文字進(jìn)行健康教育，以提高其科學(xué)膳食的知識(shí)水平。本研究還表明膳食因素是導(dǎo)致維吾爾族糖尿病高發(fā)的重要因素之一。本研究結(jié)果將為維吾爾族人群中開(kāi)展疾病一級(jí)預(yù)防提供科學(xué)依據(jù)，為今后的行為干預(yù)與研究奠定重要的前期研究基礎(chǔ)。
[Abstract]:Objective: To investigate the dietary intake of food and nutrients among Uygur MODY family, Uygur type 2 diabetes mellitus population and Uygur normal population, and to explore whether there are differences in dietary and nutritional status among these three groups of people. A total of 72 members of four generations of Uygur MODY families in Kashgar and Yili areas of Xinjiang were enrolled in this study. The general data of each member were collected through field investigation, and the physical indexes, blood glucose and lipid levels were measured. The results were compared with those before follow-up. Semi-quantitative food frequency questionnaire was used to investigate the MODY families of Uygur and type 2 diabetes mellitus. The food frequency questionnaire included 101 kinds of food in 9 categories. The frequency of food intake ranged from 1-3 times a month to 3 times a day in 8 categories. Labor intensity grouping, and each person's food intake into the nutrition calculator V2.5 software, the calculated nutrient intake into excel, and the use of SPSS17.0 statistical software for data analysis and processing. The nutrient intake of the three groups was compared with that of RNI and RDA. Results: 1. Weight, height, BMI, waist circumference, hip circumference, WHR, fasting blood glucose, meals of each member of the MODY family were followed up. After 2 hours of blood glucose, TG, CHOL, HDL, LDL and other indicators compared with the pre-follow-up indicators found that weight, height, BMI, waist circumference, hip circumference increased, the difference was statistically significant (P 0.05). But fasting blood glucose, 2 hours postprandial blood glucose, TG, CHOL and 3 years ago compared to increase, HDL, LDL decreased, but the difference was not statistically significant (P 0.05). Compared with the recommended values, the intake of cereals, potatoes and oils in Uygur MODY family and Uygur normal population exceeded the recommended values, while the intake of meat, soybeans, nuts and salt in poultry and livestock of Uygur type 2 diabetes mellitus group were higher than the recommended values, while the intake of milk and dairy products and eggs were lower than the recommended values. The intake of fish and shrimp was significantly lower than the recommended value (2.57%, 3.01%, 1.9%). Compared with RNI and RDA, the intake of vitamin B6, B12, folic acid and iodine was lower in the three groups, and the intake of sodium and nicotinic acid exceeded the recommended value (0.76%). The intake of vitamin C was only 26.35%, 47.3% in women with moderate physical labor intensity, 14.25%, 23.04% and 11.70% in men with light, moderate and heavy physical labor intensity respectively. The intake of vitamin C in men accounted for 18.14% of RDA and 70.89% in women with light and moderate physical labor intensity. Calcium intake of light, moderate and heavy physical labor intensity men accounted for 49.94%, 62.79% and 60.56% of RNI respectively. (4) Energy, protein, fat and carbohydrate intake of Uygur MODY family and normal population were higher than those of RNI and RDA. Excessive intake of cereals, meat, fats, salt, vegetables, fruits, fish and shrimps, and insufficient intake of milk led to excessive calorie intake in Uygur MODY family members, while some vitamins (vitamin B6, vitamin B12, folic acid, vitamin C) and minerals (calcium, iodine) related to glucose metabolism were inadequate intake, but sodium and so on to diabetes mellitus. The concept of strict diet control in type 2 diabetics limits the vitamins and minerals they need to a certain extent. Normal Uygurs, who have no control over their diet, may increase their participation in diabetes for dietary reasons. This study also showed that dietary factors were one of the important factors leading to the high incidence of diabetes in Uygurs. The results of this study will provide a scientific basis for the primary prevention of diseases in Uygur population, and for the future. It lays an important foundation for intervention and research.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類(lèi)號(hào)】：R151.45;R587.1

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