曹大芳, 罗明江, 陶娜, 刘俊. 膳食质量与燃煤型氟中毒的关联[J]. 环境与职业医学, 2021, 38(7): 752-757, 774. DOI: 10.13213/j.cnki.jeom.2021.20562
引用本文: 曹大芳, 罗明江, 陶娜, 刘俊. 膳食质量与燃煤型氟中毒的关联[J]. 环境与职业医学, 2021, 38(7): 752-757, 774. DOI: 10.13213/j.cnki.jeom.2021.20562
CAO Dafang, LUO Mingjiang, TAO Na, LIU Jun. Association between dietary quality and coal-burning fluorosis[J]. Journal of Environmental and Occupational Medicine, 2021, 38(7): 752-757, 774. DOI: 10.13213/j.cnki.jeom.2021.20562
Citation: CAO Dafang, LUO Mingjiang, TAO Na, LIU Jun. Association between dietary quality and coal-burning fluorosis[J]. Journal of Environmental and Occupational Medicine, 2021, 38(7): 752-757, 774. DOI: 10.13213/j.cnki.jeom.2021.20562

膳食质量与燃煤型氟中毒的关联

Association between dietary quality and coal-burning fluorosis

  • 摘要: 背景

    目前膳食营养与氟中毒的研究主要探讨单一食物或营养素与氟中毒的关联,尚无研究报道膳食质量与氟中毒的关系。

    目的

    探索国际膳食质量指数(DQI-I)与燃煤型氟中毒的关系。

    方法

    在贵州织金按性别、年龄进行1:1匹配病例对照,年龄范围在18~70岁,居住时间大于10年的氟中毒患者200人及该地区无骨科相关疾病的正常对照200人。采用调查问卷面对面收集研究对象的人口学特征、与燃煤型氟中毒密切相关的生活行为方式以及使用食物频率问卷调查研究对象过去一年各类食物的饮食情况等资料。研究对象的饮食情况根据《中国食物成分表》计算出能量及各个营养素的摄入量后进行DQI-I评分。采用logistic回归分析膳食质量指数与燃煤型氟中毒的关联。

    结果

    本研究共200对病例和对照,女性占76.99%,病例组与对照组的年龄分别为(49.82±13.43)岁和(49.68±13.48)岁。病例组DQI-I得分为(49.00±7.69)分,对照组DQI-I得分为(53.08±7.62)分。对照组在膳食多样性、充足性和总体平衡性评分三方面均高于病例组,其中食物组间多样性,蔬菜、水果、膳食纤维、蛋白质、铁、钙、维生素C的充足性,膳食总体平衡性差异具有统计学意义(P < 0.05),进一步校正能量、文化程度、玉米和辣椒食用前不淘洗等因素后,膳食多样性评分、膳食充足性评分和饱和脂肪酸供能比评分与燃煤型氟中毒的风险仍呈负相关(P < 0.001),OR值及其95% CI分别为0.844(0.776~0.919)、0.894(0.842~0.949)、0.801(0.723~0.889)。

    结论

    DQI-I越高,燃煤型氟中毒风险越低,改善膳食质量可增强氟中毒的防治效果。

     

    Abstract: Background

    Many studies have reported associations between individual foods or nutrients and fluorosis. No studies, however, have reported the association between dietary quality and fluorosis.

    Objective

    This study evaluates the relationship between Dietary Quality Index-International (DQI-I) and coal-burning fluorosis.

    Methods

    This 1:1 matched case-control study was conducted in Zhijin, Guizhou with a sample size of 200 cases of fluorosis and 200 age-and gender-matched controls. Participants were 18-70 years old and lived in Zhijin for more than 10 years without orthopedic diseases. Sociodemographic characteristics, and lifestyle closely related to coal-burning fluorosis were collected using questionnaires by face-to-face interviews, and dietary consumption was assessed by the Food Frequency Questionnaire. Energy and nutrient intakes were computed based on the China Food Composition data, and scored according to DQI-I. Logistic regression analysis models were constructed to assess the association between DQI-I and coal-burning fluorosis.

    Results

    In present study, a total of 200 pairs of eligible cases and controls were enrolled, in which 76.99% participants were female. The average ages (mean±SD) of the case group and the control group were (49.82±13.43) and (49.68±13.48) years, respectively. The average DQI-I score of the case group was 49.00±7.69, and the average DQI-I score of the control group was 53.08±7.62. The scores of dietary diversity, adequacy, and balance of the control group were higher than those of the case group. There were statistical differences in food diversity, adequacy of vegetables, fruits, dietary fiber, protein, iron, calcium, and vitamin C, and overall dietary balance between the two groups (P < 0.05). After adjusting for energy, education level, and not washing corn and pepper before eating, the diversity score, adequacy score, and proportion of energy intake from saturated fatty acid were still negatively correlated with the risk of coal-burning fluorosis (P < 0.001); the ORs (95%CIs) were 0.844 (0.776-0.919), 0.894 (0.842-0.949), and 0.801 (0.723-0.889), respectively.

    Conclusion

    A higher DQI-I score is associated with a lower risk of coal-burning fluorosis. Improving dietary quality may assist the prevention and treatment effect of fluorosis.

     

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