A Case-control Study On The Association Between Dietary Patterns And Coal-burning Fluorosis

Objective:1.To explore the risk factors and protective of dietary pattern,and to provide scientific evidence for the prevention and control of fluorosis.2.To explore the beneficial and harmful dietary pattern,which would be applied to the reasonable dietary guidance and the prevention and cure of coal-burning fluorosis?Methods:1.Research objects: This study adopted a 1:1 matched case-control study design.During June to September in 2015,200 patients,living in Zhijin more than ten years,were recruited for the case group from Zhijin County,Guizhou Province.One-to-one matched controls,matched according to age(±3 years)and gender,were selected from the same area based on the same criteria for cases.2.Data collection: A face-to-face questionnaire was used to investigate the dietary difference,demographic characteristics and other factors influencing the dietary factors.Dietary intake was recorded by food frequency table(75 food items).3.Statistical analysis: Using epidata3.0 software,the questionnaire was used to double check and check one by one.The scores of three dietary indices(DQI-I,AHEI,aMED)were calculated.At the same time,the factor analysis method was used to construct the dietary pattern,and the factor scores were obtained.The basic characteristics of case group and control group were compared by t test or chi square test.The scores of different dietary indices were divided into four levels,and the relationship between the score of dietary pattern scores and the incidence of coal-burning fluorosis was analyzed by univariate and multivariate conditional logistic regression.The lowest group was used as the reference group to calculate the odds ratios(odds ratio,OR)and 95% confidence intervals(confidence interval,CI)of the other two levels.Model 1 corrected energy.The model 2further corrected education,living in zhijin,income,stove improvement,kinds of coal,grain,smoke,fire roasted corn and pepper before use washing.The analysis was carried out using SPSS 19 software,P<0.05 was statistically significant.Results:1.In the study,a total of 200 eligible patients with fluorosis(male87,female 113)were enrolled in this study.The average age of the men was 51.14 years and the average age of the women was at the age of 48.42,with a total of 200 matched controls.2.In the analysis of the dietary patterns of the three dietary indices,we found the fluorosis areas were in the lower level for three dietary index scores compared with the control group,and dietary index scores higher risk of coal-burning fluorosis was low.We observed a negative correlation between the dietary index scores and the coal-burning fluorosis.The highest DQI-I ?aMED and AHEI scores were compared with the lowest score,and OR(95%CI)was 0.52(0.34,0.80)?0.35(0.20,0.61)and 0.44(0.27,0.71).In the adequacy score of DQI-I,the risk of coal burning fluorosis reduced 31%(6%,50%)than that of the median.3.This study also explored the factor analysis of the 3 dietary patterns,namely the high-nut-algae-milk model,high-corn-potato-gourd model and high meat-fried food model.After multivariate analysis,it was found that the risk of coal burning fluorosis was significantly decreased with the increase of the factor score of high-nut-algae-milk.(P-trend <0.001).Compared with the lowest score group,the risk the highest group reduced 77%(95%CI 57%-82%).The results suggested that there was an obvious positive dose-response relationship between the high-nut-algae – milk model and the coal-burning fluorosis(P-trend values were <0.05).After multivariate adjustment,the highest score of OR(95%CI)was 2.22(95%CI 1.47-3.34)compared with the lowest group.However,there was no significant association between the high meat-fried food pattern.Conclusion:1.With the dietary quality,especially in the diversity and quality of dietary adequacy and improvement of the overall quality of dietary balance,the coal-burning fluorosis area of patients has important significance in fluorosis risk reduction.Compared with DQI-I and AHEI,aMED dietary index score can sensitively reflect the risk of dietary quality and coal burning fluorosis contact.2.The high-nut-algae-milk model is a protective dietary pattern of coal-burningfluorosis,and the high corn-potato-gourd pattern significantly increases the risk of coal-burning fluorosis.