Dietary intake, inflammation,glycemia, & BP in T2 Diabetes: Examining disparities

描述（由申请人提供）：糖尿病在美国是一种日益增长的流行病，部分与美国人的饮食摄入模式质量差有关。西班牙裔和非西班牙裔黑人患2型糖尿病（T2D）的比例更高，而且饮食质量也比非西班牙裔白人差。与非西班牙裔白人相比，在少数族裔人群中也观察到炎症标志物升高、血糖控制较差和血压升高。较高水平的这些生物标志物与全因死亡率和其他不良健康结果的增加独立相关。T2D是一种炎症性和代谢性疾病，因为与胰岛素抵抗相关的高血糖导致炎症标志物增加。血压（BP）和炎症之间的关联也出现在文献中，但对T2D的这些关联知之甚少。研究表明，饮食摄入可能会影响炎症和血糖，地中海饮食已被证明可以降低c反应蛋白（CRP）和糖化血红蛋白（HbA1c）。同样，美国农业部的《美国人食品指南》也与改进的生物标志物有关。饮食摄入模式、炎症、血糖控制和T2D血压之间的关系尚未被全面研究与种族和民族的关系。拟议的研究是对NHANES 2009-2010收集的数据的二次分析。通过24小时回忆对患有和不患有T2D的成年人进行饮食评估，将为创建地中海饮食（MSDPS）和健康饮食指数（HEI）评分提供数据，并研究这些评分与CRP、HbA1c和BP之间的关系。种族和民族将作为分组变量进行检查，因为本研究旨在解释种族/民族之间健康结果的差异。具体来说，拟议研究的目的是：1)检查种族/民族与饮食模式评分（由MSDPS和HEI评分测量）和BMI介导的CRP、HbA1c和BP之间的直接和间接影响；2)探讨饮食摄入模式（通过MSDPS和HEI评分测量）和BMI介导的种族/民族对CRP、HbA1c和BP的间接影响是否被T2D状态所调节。这项研究的结果将深入了解饮食摄入模式和健康结果之间的关系，并展示它们在种族和民族群体之间的差异。这项研究将有助于了解饮食与健康结果之间的关系，并为未来的实验研究提供基础，研究多民族人群中饮食干预与健康结果的关系。

DESCRIPTION (provided by applicant): Diabetes is a growing epidemic in the U.S., related in part to the poor quality of dietary intake patterns of Americans. Hispanics and non-Hispanic Blacks have higher prevalence of type 2 diabetes (T2D), and have been found to have poorer diet quality than non-Hispanic Whites. Elevated markers of inflammation, poorer glycemic control, and higher blood pressure have also been observed in minority populations when compared to non-Hispanic Whites. Higher levels of these biomarkers are independently associated with increased all- cause mortality and other poor health outcomes. T2D is an inflammatory and metabolic disease, as hyperglycemia related to insulin resistance causes increases in inflammatory markers. Associations between blood pressure (BP) and inflammation are also appearing in the literature, but little is known about these associations in T2D. Research has suggested that dietary intake may affect inflammation and glycemia, and the Mediterranean diet has been shown to decrease C-reactive protein (CRP) and glycated hemoglobin (HbA1c). Similarly, the USDA Food Guidelines for Americans have also been associated with improved biomarkers. The associations between dietary intake patterns, inflammation, glycemic control, and BP in T2D have not been examined comprehensively in relation to race and ethnicity. The proposed research study is a secondary analysis of data collected from NHANES 2009-2010. Dietary assessment through 24-hour recall among adults with and without T2D will provide data to create Mediterranean Diet (MSDPS) and Healthy Eating Index (HEI) Scores, and the relation between these scores and CRP, HbA1c, and BP will be examined. Race and ethnicity will be examined as the grouping variable, as the disparity in health outcomes across race/ethnicity is what this study aims to explain. Specifically, the aims of the proposed research are to 1) examine the direct and indirect effects between race/ethnicity and CRP, HbA1c, and BP as mediated by dietary pattern score (measured by the MSDPS and HEI scores), and BMI; and 2) explore whether the indirect effects of race/ethnicity to CRP, HbA1c, and BP, as mediated by dietary intake pattern (measured by the MSDPS and HEI scores) and BMI, are moderated by T2D status. The findings from this study will provide insight into the associations between dietary intake patterns and health outcomes, and demonstrate how they differ between racial and ethnic groups. This study will contribute to knowledge regarding the association between diet and health outcomes, and provide the foundation for the development of future experimental research examining dietary interventions in multiethnic populations in relation to health outcomes.