Association of Dietary Patterns with Type 2 Diabetes Mellitus among Middle-Aged Adults in Uygur Population of Xinjiang Region

Observational and interventional studies have showed associations between dietary patterns and the risk of type 2 diabetes (T2DM). The aim of the present study was to identify dietary patterns and examine their association with incident of T2DM and physiopathologic mechanism in the Uygur population of Xinjiang, China. A community-based case control study in Urumqi, Xinjiang Uygur Autonomous Region, China. We enrolled 836 Uygur adults (345 newly diagnosed T2DM and 491 healthy controls) receiving physical examination in community health service centers. Dietary patterns were evaluated using a validated 121 items semi-quantitative food frequency questionnaire (SQFFQ). Dietary patterns were identified by exploratory factor analysis. Data on demographic, anthropometric, socioeconomic characteristics were collected. Homeostasis model assessment index for insulin resistance (HOMA-IR) and for beta cell function (HOMA-beta) were calculated. Multivariate logistic regression were used to estimate the associations between dietary patterns and the risk of T2DM and multiple linear regression were used to evaluate the association between dietary patterns and fasting plasm glucose (FPG), fasting insulin (FINS), HOMA-IR and HOMA-beta, adjusting for confounding factors. Five major dietary patterns were identified: (1) the "vegetable and tubes" pattern; (2) the "fruit and nut" pattern; (3) the "refined grains and meat" pattern; (4) the "dairy, legume and egg" pattern; and (5) the "oil and salt" pattern. Logistic regression results demonstrated that the "vegetable and tubes" dietary pattern and the "fruit and nut" dietary pattern were related to T2DM, OR values were 0.223 (95% CI: 0.135-0.371), 0.160 (95% CI: 0.093-0.275), respectively. The "refined grains and meat" dietary pattern and the "oil and salt" dietary pattern were related to T2DM, OR values were 6.146 (95% CI: 3.217-11.739), 9.554 (95% CI: 5.668-16.104), respectively. Multiple linear regression analysis showed that the above five dietary patterns were related to log (FPG), beta values were -0.040, -0.039, 0.028, -0.010 and 0.036, respectively, all p<0.05. The "vegetable and tubes" pattern, the "fruit and nut" pattern, the "refined grains and meat" pattern and the "oil and salt" pattern were related to log (HOMA-IR), beta values were -0.061, -0.060, 0.045, and 0.042, and were related to log (HOMA-beta), beta values were 0.071, 0.063, -0.035 and -0.070, respectively, all p<0.05. The "refined grains and meat" dietary pattern and the "oil and salt" dietary pattern may be the important reason for the rapid increase of T2DM incidence among Chinese Uygur residents. Our findings suggest that modifying dietary patterns could reduce T2DM incidence in the adult Uygur population.