江苏省东台市不同体质指数水平的血胆固醇边缘升高人群膳食特征分析-东南大学学报医学版

江苏省东台市不同体质指数水平的血胆固醇边缘升高人群膳食特征分析

作者：吴天宇¹ 姚胜红² 3 高宇思¹ 4 王煚楠¹ 严威¹ 王少康¹ 夏惠¹ 廖望¹ 孙桂菊¹

单位：1. 东南大学公共卫生学院环境医学工程教育部重点实验室/营养与食品卫生系, 江苏南京 210009;
2. 东南大学医学院, 江苏南京 210009;
3. 南通大学附属东台医院, 江苏东台 224200;
4. 无锡市锡山区疾病预防控制中心, 江苏无锡 214101

关键词：血胆固醇边缘升高宏量营养素膳食特征体质指数膳食干预建议

分类号：R151.4

出版年·卷·期（页码）：2025·44·第六期（889-897）

摘要：

目的: 探讨不同体质指数(BMI)水平的血胆固醇边缘升高患者的膳食特征,为个性化营养干预提供依据。方法: 选取2023年10月至12月在南通大学附属东台医院体检的81例血胆固醇边缘升高患者,使用InBody-770分析体成分,采用连续3 d 24 h膳食回顾法和简化版国际体力活动问卷收集膳食和体力活动数据。根据BMI水平分为正常、超重和肥胖组,分析并比较不同组别膳食特征的差异。结果: 研究对象的总体力活动的代谢当量为1 395.0(729.8,2 163.0) min·周^-1,伴有内脏脂肪堆积。参照《中国居民膳食指南(2022)》建议,超过50%的研究对象谷类摄入偏高,薯类和蔬菜摄入适中。血胆固醇升高伴超重组[(586.8±71.4) kcal]和肥胖组[(604.4±73.5) kcal]的脂肪供能显著高于正常组[(544.3±80.1) kcal,P=0.046],但蛋白质与碳水化合物摄入差异无统计学意义(P>0.05)。血胆固醇升高伴超重或肥胖组患者的膳食纤维摄入量低于正常BMI者,总脂肪酸、饱和脂肪酸及单不饱和脂肪酸摄入较高(P<0.05)。结论: 东台市血胆固醇边缘升高患者的膳食结构不均衡,谷类、水果、蛋类和奶制品的摄入亟待改善;超重及肥胖组志愿者脂肪摄入及脂肪供能比偏高,膳食纤维摄入不足,需加强个性化营养干预。

Objective: To investigate the dietary characteristics of patients with borderline hypercholesterolemia at different body mass index(BMI) levels and provide a basis for personalized nutritional interventions. Methods: A total of 81 patients with borderline hypercholesterolemia who underwent health examinations at Dongtai Hospital, Affiliated to Nantong University, from October to December 2023 were included. Body composition was analyzed using the InBody-770 system. Dietary intake and physical activity data were collected through a three-day 24-hour dietary recall and the short-form International Physical Activity Questionnaire. Participants were categorized into normal weight, overweight, and obese groups based on BMI, and differences in dietary characteristics among these groups were analyzed. Results: The median total weekly physical activity was 1 395.0(729.8, 2 163) min·week^-1, accompanied by visceral fat accumulation. Compared with the recommendations of "Dietary Guidelines for Chinese Residents(2022)", more than 50% of participants consumed cereals in excess, while intake of tubers and vegetables was moderate. Energy intake from fat was significantly higher in the overweight[(586.8±71.4) kcal] and obese[(604.4±73.5) kcal] groups than in the normal weight group[(544.3±80.1)kcal](P=0.046), whereas protein and carbohydrate intake showed no significant differences(P>0.05). Patients with borderline hypercholesterolemia who were overweight or obese had lower dietary fiber intake, while total fatty acids, saturated fatty acids, and monounsaturated fatty acids were significantly higher compared with those with normal BMI(P<0.05). Conclusion: The dietary structure of patients with borderline hypercholesterolemia in Dongtai is imbalanced, with suboptimal intake of cereals, fruits, eggs, and dairy products. Overweight and obese volunteers exhibit higher fat consumption and fat-derived energy ratios, alongside insufficient dietary fiber intake, underscoring the need for targeted nutritional interventions.

参考文献：

[1] BERBERICH A J,HEGELE R A.A modern approach to dyslipidemia[J].Endocr Rev,2022,43(4):611-653.
[2] 高莹,窦克非,高润霖,等.加强我国基层血脂管理刻不容缓[J].中国循环杂志,2022,37(3):209-211.
[3] 王增武,刘静,李建军,等.中国血脂管理指南(2023年)[J].中国循环杂志,2023,38(3):237-271.
[4] 中国居民营养与慢性病状况报告(2020年)[J].营养学报,2020,42(6):521.
[5] THOMAS F,BEAN K,GUIZE L,et al.Combined effects of systolic blood pressure and serum cholesterol on cardiovascular mortality in young(<55 years) men and women[J].Eur Heart J,2002,23(7):528-535.
[6] WU L,PARHOFER K G.Diabetic dyslipidemia[J].Metabolism,2014,63(12):1469-1479.
[7] 邓青,罗俊,金琦曼,等.2016—2023年武汉市急性心肌梗死发病趋势分析[J].现代预防医学,2024,51(18):3295-3301.
[8] TRAUTWEIN E A,MCKAY S.The role of specific components of a plant-based diet in management of dyslipidemia and the impact on cardiovascular risk[J].Nutrients,2020,12(9):2671.
[9] NUSSBAUMEROVA B,ROSOLOVA H.Obesity and dyslipidemia[J].Curr Atheroscler Rep,2023,25(12):947-955.
[10] LAVIE C J,MILANI R V,VENTURA H O.Obesity and cardiovascular disease:risk factor,paradox,and impact of weight loss[J].J Am Coll Cardiol,2009,53(21):1925-1932.
[11] ALEBNA P L,MEHTA A,YEHYA A,et al.Update on obesity,the obesity paradox,and obesity management in heart failure[J].Prog Cardiovasc Dis,2024,82:34-42.
[12] 申毅力,吴申燕,钟建琴,等.贵州省少数民族人群体重矫正腰围指数与心血管疾病的关联性研究[J].现代预防医学,2024,51(15):2689-2694.
[13] RUAN H,RAN X,LI S S,et al.Dyslipidemia versus obesity as predictors of ischemic stroke prognosis:a multi-center study in China[J].Lipids Health Dis,2024,23(1):72.
[14] TANG N,MA J,TAO R,et al.The effects of the interaction between BMI and dyslipidemia on hypertension in adults[J].Sci Rep,2022,12(1):927.
[15] GAO Y,XUN R,XIA J,et al.Effects of phytosterol supplementation on lipid profiles in patients with hypercholesterolemia:a systematic review and meta-analysis of randomized controlled trials[J].Food Funct,2023,14(7):2969-2997.
[16] DUNCAN M S,FREIBERG M S,GREEVY R A Jr,et al.Association of smoking cessation with subsequent risk of cardiovascular disease[J].JAMA,2019,322(7):642-650.
[17] SCHWARZINGER M,POLLOCK B G,HASAN O S M,et al.Contribution of alcohol use disorders to the burden of dementia in France 2008-13:a nationwide retrospective cohort study[J].Lancet Public Health,2018,3(3):e124-e132.
[18] 曹清明,王蔚婕,张琳,等.中国居民平衡膳食模式的践行——《中国居民膳食指南(2022)》解读[J].食品与机械,2022,38(6):22-29.
[19] 中国营养学会.中国营养学会发布《2023版中国居民膳食营养素参考摄入量》[J].营养学报,2023,45(5):414.
[20] ZHAO D,LIU J,WANG M,et al.Epidemiology of cardiovascular disease in China:current features and implications[J].Nat Rev Cardiol,2019,16(4):203-212.
[21] 马煜盛,饶甲环,龙洁旎,等.脂蛋白(a)与冠心病患者临床稳定性及冠状动脉狭窄程度的关系[J].南方医科大学学报,2019,39(2):235-240.
[22] ZHENG C,LIU Y,XU C,et al.Association between obesity and the prevalence of dyslipidemia in middle-aged and older people:an observational study[J].Sci Rep,2024,14(1):11974.
[23] 国家心血管病专家委员会心血管代谢医学专业委员会,高莹,郭远林.基层血脂管理适宜技术与质量控制中国专家建议(2025年)[J].中国循环杂志,2025,40(3):213-218.
[24] MOHSENI P,KHALILI D,DJALALINIA S,et al.The synergistic effect of obesity and dyslipidemia on hypertension:results from the STEPS survey[J].Diabetol Metab Syndr,2024,16(1):81.
[25] 钟玉莲,陈希民,陈月晓,等.短期主食限制与主食替代饮食模式对肥胖人群代谢水平的影响[J].东南大学学报(医学版),2022,41(4):476-483.
[26] 王增武,郭远林.中国血脂管理指南(基层版2024年)[J].中国循环杂志,2024,39(4):313-321.
[27] 张燕,高志棣,高旖旎.青岛市体检人群日常膳食脂肪摄入调查分析[J].中国健康教育,2013,29(12):1122-1123,1126.
[28] WANG M,MA G,LI Y,et al.Potential modulatory roles of gut microbiota and metabolites in the associations of macronutrient-to-physical activity ratios with dyslipidemia[J].J Am Heart Assoc,2025,14(10):e040042.
[29] REYNOLDS A N,AKERMAN A P,MANN J.Dietary fibre and whole grains in diabetes management:systematic review and meta-analyses[J].PLoS Med,2020,17(3):e1003053.
[30] 向雪松,朱婧.膳食纤维定义与来源科学共识(2021)[J].营养学报,2022,44(1):1-5.
[31] CHIU S,BERGERON N,WILLIAMS P T,et al.Comparison of the DASH(Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins:a randomized controlled trial[J].Am J Clin Nutr,2016,103(2):341-347.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录