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严重的流行病，部分与美国人饮食摄入模式的质量差有关。西班牙裔和非西班牙裔黑人的2型糖尿病（T2 D）患病率较高，并且发现饮食质量比非西班牙裔白人差。与非西班牙裔白人相比，在少数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。这些生物标志物的高水平与全因死亡率和其他不良健康结果的增加独立相关。2型糖尿病是一种炎症和代谢性疾病，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T2 D中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糖尿病，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（HbA 1c）。同样，美国农业部的《美国人食品指南》也与生物标志物的改善有关。饮食摄入模式、炎症、血糖控制和T2 D患者BP之间的相关性尚未全面研究与人种和种族的关系。拟议的研究是对2009-2010年NHANES收集的数据进行的二次分析。通过24小时回忆对患有和不患有T2 D的成人进行饮食评估，将提供数据以创建地中海饮食（MSDPS）和健康饮食指数（HEI）评分，并将检查这些评分与CRP、HbA 1c和BP之间的关系。人种和种族将作为分组变量进行检查，因为本研究旨在解释人种/种族之间的健康结局差异。具体而言，拟议研究的目的是：1）检查种族/民族与CRP、HbA 1c和BP之间的直接和间接影响（由饮食模式评分介导）（通过MSDPS和HEI评分测量）和BMI;以及2）探索种族/民族对CRP、HbA 1c和BP的间接影响是否由饮食摄入模式介导（通过MSDPS和HEI评分测量）和BMI，由T2 D状态调节。这项研究的结果将深入了解饮食摄入模式与健康结果之间的关联，并展示它们在种族和民族之间的差异。这项研究将有助于了解饮食和健康结果之间的关联，并为未来的实验研究提供基础，研究饮食干预在多民族人群中与健康结果的关系。

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.