Abstract：
The association between dietary quality and type 2 diabetes mellitus (T2DM) based on the Chinese Dietary Balance Index (DBI-16) is seldom reported. We hypothesized that poor dietary quality might increase the risk of T2DM in the middle-aged and older populations. A total of 1816 individuals (≥50 years) were included in the study. Demographic characteristics and dietary intake data were collected. Logistic regression and restricted cubic spline (RCS) analyses were conducted to explore the association between DBI-16 indexes and the risk of T2DM. The insufficient intake of vegetables and dairy might decrease the risk of T2DM (ORVegetable = 0.77, 95% CI = 0.60-0.97; ORDairy = 0.58, 95% CI = 0.35-0.96), but the individuals with insufficient intake of fruit were more likely to have a higher risk of T2DM (ORfruit = 2.26, 95% CI = 1.69-3.06). Compared with the subjects with the lowest quartile of Low Bound Score (LBS) or Diet Quality Distance (DQD), the individuals with Q2 and Q3 level of LBS (ORQ2 = 1.40, 95% CI = 1.03-1.90, P = .033; ORQ3 = 1.52, 95% CI = 1.11-2.08, P < .01) or DQD (ORQ2 = 1.45, 95% CI = 1.06-1.99, P = .021; ORQ3 = 1.64, 95% CI = 1.20-2.24, P < .01) showed increased risk of T2DM with a nonlinear association observed by RCS analysis. We concluded that imbalanced dietary intake, especially insufficient daily fruit intake, might predict an increased risk of T2DM in the middle-aged and elderly Chinese.
摘要：
很少报道基于中国膳食平衡指数（DBI-16）的膳食质量与2型糖尿病（T2DM）之间的关联。我们假设饮食质量差可能会增加中老年人群的T2DM风险。该研究共纳入1816名个体(≥50岁)。收集人口统计学特征和饮食摄入数据。采用Logistic回归和限制性三次样条(RCS)分析DBI-16指标与T2DM发病风险的关系。蔬菜和乳制品的摄入不足可能会降低T2DM的风险（ORVegetable=0.77，95％CI=0.60-0.97;ORDairy=0.58，95％CI=0.35-0.96），但水果摄入不足的个体患T2DM的风险更高(ORfruit=2.26,95%CI=1.69~3.06).与低分数(LBS)或饮食质量距离(DQD)四分位数最低的受试者相比,具有Q2和Q3水平的LBS（ORQ2=1.40，95％CI=1.03-1.90，P=0.033；ORQ3=1.52，95％CI=1.11-2.08，P<.01）或DQD（ORQ2=1.45，95％CI=1.06-1.99，P=.021；ORQ3=1.64，95％CI=1.20-2.24，通过非线性分析观察到TCS我们得出的结论是饮食摄入不平衡，尤其是每日水果摄入量不足，可能预测中国中老年人患T2DM的风险增加。
