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The association of dietary patterns with insulin resistance in Korean adults: based on the 2015 Korea National Health and Nutrition Examination Survey

한국 성인의 식사 패턴과 인슐린 저항성 간의 상관성: 2015년도 국민건강영양조사를 이용하여

  • Kim, I Seul (Department of Clinical Nutrition, Graduate School of Public Health, Dongduk Women's University) ;
  • Yang, Yoon Jung (Department of Food and Nutrition, School of Natural Science, Dongduk Women's University)
  • 김이슬 (동덕여자대학교 임상영양학과) ;
  • 양윤정 (동덕여자대학교 식품영양학과)
  • Received : 2021.01.17
  • Accepted : 2021.03.16
  • Published : 2021.06.30

Abstract

Purpose: This study was conducted to identify the association between insulin resistance and the major dietary patterns of Korean adults. Methods: This study used data from the 2015 Korea National Health and Nutrition Examination Survey. The subjects were 2,276 adults aged 19 to 64 years old. Based on the food frequency questionnaire data, 112 food items were reclassified into 30 food groups. The principal component analysis method was applied to identify major dietary patterns. We used homeostatic model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) value as indicators of insulin resistance. The association between major dietary patterns and insulin resistance was investigated using logistic regression analysis. Results: Three major dietary patterns were identified and assigned descriptive names based on the food items with high loadings: 'healthy Korean meal pattern', 'western meal pattern', and 'white rice, alcohol, meat pattern'. As the 'white rice, alcohol, meat pattern' score increased, significant increasing trends for fasting glucose concentration and HOMA-IR and a significant decreasing trend for QUICKI were observed after adjusting for age and sex. The odds ratio of insulin resistance according to the 'healthy Korean meal pattern' and the 'western meal pattern' were not statistically significant. the 'white rice, alcohol, meat pattern' showed a significant positive association with the risk of insulin resistance after adjusting for covariates. Conclusion: These results suggest that the 'white rice, alcohol, meat pattern' is positively associated with the risk of insulin resistance. The white rice, alcohol, meat pattern was related to the high consumption of alcohol together with rice or meat. This pattern was also associated with the high intake of sodium and low intakes of vitamin C, calcium, potassium, and dietary fiber. To confirm the association, further longitudinal studies are required.

본 연구는 제6기 2015년도 국민건강영양조사 자료를 활용하여 만 19-64세 한국 성인의 주요 식사 패턴을 도출한 후, 식사 패턴과 인슐린 저항성 간의 상관성을 분석하기 위해 수행되었다. 그 결과는 다음과 같다. 대상자의 식사 패턴을 요인분석 방법으로 분석한 결과, 'Healthy Korean meal pattern', 'Western meal pattern', 'White rice, alcohol, meat pattern'으로 나타났다. 'Healthy Korean meal pattern' 점수가 높을수록 연령이 높게 나타났으며, 식사 패턴에 따른 영양소 섭취량 분석 결과, 'Healthy Korean meal pattern' 섭취 점수가 높을수록 총 에너지, 탄수화물, 단백질, 비타민 A, 비타민 C, 칼슘, 인, 철, 칼륨, 식이섬유의 섭취가 유의하게 증가하였으며 'Western meal pattern' 섭취 점수가 높을수록 총 에너지, 단백질, 지방, 콜레스테롤의 섭취가 유의하게 증가하였고, 'White rice, alcohol, meat pattern' 점수가 높을수록 총 에너지와 나트륨의 섭취는 유의하게 증가하였고, 탄수화물, 비타민 C, 칼슘, 인, 칼륨, 식이섬유의 섭취는 유의하게 감소하였다. 식사 패턴에 따른 인슐린 저항성의 위험도를 분석한 결과 'Healthy Korean meal pattern'과 'Western meal pattern'은 인슐린 저항성과 유의한 연관성을 보이지 않았고, 'White rice, alcohol, meat pattern'은 인슐린 저항성의 위험도와 양의 연관성을 보였다. 이상의 결과로부터 'White rice, alcohol, meat pattern'의 식사를 많이 할수록 인슐린 저항성의 위험도가 높아지는 것을 알 수 있었다. 본 연구는 단면연구라는 제한점이 있으므로 향후 식사 패턴과 인슐린 저항성의 상관성을 확인할 수 있는 전향적 코호트 등의 연구가 필요하다.

Keywords

Acknowledgement

This study was supported by the Dongduk Women's University Grant.

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