A Dietary Pattern Derived by Reduced Rank Regression is Associated with Type 2 Diabetes in An Urban Ghanaian Population
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Dietary Assessment
2.3. Covariate Assessment
2.4. Laboratory Procedures
2.5. Statistical Analysis
2.5.1. Descriptive Analysis
2.5.2. Reduced Rank Regression
2.5.3. Dietary Pattern and Type 2 Diabetes
2.5.4. Sensitivity Analyses
3. Results
3.1. Study Population
Characteristics | Controls ( n = 668) | Diabetes Cases ( n = 538) |
---|---|---|
Sex (female) | 516 (77.3) | 396 (73.6) |
Age (years) | 46.8 ± 15.7 | 54.7 ± 13.4 * |
BMI (kg/m2) | 25.8 ± 5.4 | 25.7 ± 4.9 |
Waist-to-hip ratio | 0.86 ± 0.08 | 0.91 ± 0.07 * |
Socio-economic status sum score | ||
Very low (0–4 points) | 118 (17.7) | 200 (37.2) * |
Low (5–8 points) | 355 (53.1) | 278 (51.7) |
Moderate (9–10 points) | 195 (29.2) | 60 (11.2) |
Family history of diabetes (yes) | 167 (25.0) | 314 (58.4) * |
Hypertension (yes) | 344 (51.5) | 332 (61.7) * |
Smoking (ever) | 27 (4.0) | 40 (7.4) * |
Lipid-lowering drug intake | 12 (1.8) | 16 (3.0) |
Anti-inflammatory drug intake | 6 (0.9) | 18 (3.4) * |
Energy expenditure (kcal/day) | 1214 (848–1630) | 1408 (815–1996) * |
Biomarkers | ||
Adiponectin (mg/mL) | 8.63 (6.50–11.63) | 7.42 (5.36–9.98) * |
HDL-cholesterol (mmol/L) | 1.37 (1.13–1.62) | 1.27 (1.04–1.54) * |
Triglycerides (mmol/L) | 1.19 (0.87–1.64) | 1.36 (1.02–1.87) * |
Fasting plasma glucose (mmol/L) | 4.40 (4.10–4.90) | 6.90 (5.30–10.30) * |
HOMA-IR | 1.37 (0.85–2.13) | 2.00 (1.17–3.40) * |
3.2. Dietary Pattern and Biomarkers
Food Item | Explained Variation (%) | Factor Loading 1 |
---|---|---|
Plantain | 23.6 | 0.31 |
Cassava | 23.0 | 0.31 |
Garden egg | 16.0 | 0.26 |
Rice | 24.0 | −0.32 |
Juice | 21.7 | −0.30 |
Vegetable oil | 19.7 | −0.29 |
Eggs | 15.2 | −0.25 |
Milo (chocolate drink) | 13.3 | −0.24 |
Sweets | 11.8 | −0.22 |
Red meat | 11.2 | −0.22 |
Groundnut | 9.70 | −0.20 |
Soft drinks | 9.00 | −0.19 |
Margarine | 7.46 | −0.18 |
Milk | 6.87 | −0.17 |
Fruits | 5.37 | −0.15 |
Carrot | 3.75 | −0.13 |
Beans | 3.29 | −0.12 |
Lettuce | 2.23 | −0.10 |
Cocoyam | 2.61 | 0.10 |
Cucumber | 1.70 | −0.08 |
Millet | 1.44 | −0.08 |
Yam | 1.03 | −0.07 |
Green leaves | 1.15 | 0.07 |
Coffee | 0.85 | −0.06 |
Palm oil | 0.75 | −0.06 |
Okro | 0.18 | 0.03 |
Maize (banku) | 0.26 | 0.03 |
Crab | 0.23 | 0.03 |
Poultry | 0.18 | −0.03 |
Porridge | 0.13 | 0.02 |
Alcoholic drinks | 0.07 | 0.02 |
Sweet potato | 0.13 | −0.02 |
Agushie (pumpkin seeds) | 0.02 | 0.01 |
Bread | 0.02 | −0.01 |
Fish | 0.005 | −0.004 |
3.3. Dietary Pattern and Type 2 Diabetes
Quintile of the Dietary Pattern Score | ||||||
---|---|---|---|---|---|---|
Characteristics | 1 | 2 | 3 | 4 | 5 | p for trend |
n | 68 | 70 | 68 | 69 | 68 | |
Sex (female) | 51 (75.0) | 53 (75.7) | 49 (72.1) | 54 (78.3) | 54 (79.4) | 0.87 |
Age (years) | 32.5 ± 13.4 | 40.8 ± 13.5 | 46.6 ± 14.0 | 53.0 ± 11.8 | 54.7 ± 14.9 | <0.001 |
BMI (kg/m2) | 24.0 ± 4.8 | 25.8 ± 4.7 | 27.1 ± 6.4 | 26.4 ± 6.4 | 27.0 ± 5.8 | 0.002 |
WHR | 0.82 ± 0.08 | 0.85 ± 0.07 | 0.87 ± 0.06 | 0.87 ± 0.08 | 0.89 ± 0.08 | <0.001 |
very low SES | 3 (4.4) | 8 (11.4) | 5 (7.4) | 21 (30.4) | 16 (23.5) | <0.001 |
Family history of diabetes | 18 (26.5) | 20 (28.6) | 21 (30.9) | 18 (26.1) | 14 (20.6) | 0.73 |
Smoking (ever) | 5 (7.4) | 4 (5.7) | 3 (4.4) | 1 (1.5) | 3 (4.4) | 0.57 |
Energy expenditure (kcal/day) | 1177 (901–1593) | 1289 (949–1731) | 1329 (962–1729) | 1222 (1015–1687) | 1245 (712–1786) | 0.92 |
Biomarkers | ||||||
Adiponectin (mg/mL) | 9.41 (6.34–11.94) | 8.27 (5.86–10.57) | 7.89 (5.93–11.93) | 8.88 (6.79–12.53) | 8.73 (6.52–12.33) | 0.19 |
HDL-cholesterol (mmol/L) | 1.37 (1.11–1.62) | 1.43 (1.30–1.69) | 1.35 (1.19–1.60) | 1.36 (1.16–1.53) | 1.38 (1.14–1.66) | 0.64 |
Triglycerides (mmol/L) | 0.97 (0.69–1.23) | 1.26 (0.86–1.63) | 1.10 (0.85–1.56) | 1.32 (0.97–1.89) | 1.48 (0.99–1.86) | <0.001 |
Food intake (times/week) 1 | ||||||
positive association | ||||||
Plantain | 1.5 (0.5–3.5) | 1.5 (1.5–3.5) | 3.5 (1.5–5.5) | 5.5 (3.5–7.0) | 7.0 (4.5–7.0) | <0.001 |
Cassava | 1.5 (0.5–1.5) | 1.5 (1.5–3.5) | 1.5 (1.5–3.5) | 3.5 (1.5–3.5) | 7.0 (3.5–7.0) | <0.001 |
Garden egg | 3.5 (1.5–7.0) | 3.5 (1.5–7.0) | 5.5 (2.5–7.0) | 7.0 (3.5–7.0) | 7.0 (7.0–7.0) | <0.001 |
inverse association | ||||||
Rice | 7.0 (5.5–7.0) | 7.0 (3.5–7.0) | 3.5 (3.5–7.0) | 3.5 (1.5–5.5) | 1.5 (0.5–3.5) | <0.001 |
Juice | 1.5 (0.5–5.5) | 1.0 (0.5–3.5) | 0.5 (0–1.5) | 0 (0–0.5) | 0 (0–0.5) | <0.001 |
Vegetable oil | 3.5 (1.5–7.0) | 3.5 (1.5–5.5) | 3.5 (1.5–3.5) | 1.5 (0.5–3.5) | 1.5 (0.5–3.5) | <0.001 |
Eggs | 2.5 (1.5–3.5) | 1.5 (0.5–1.5) | 0.5 (0.5–1.5) | 0.5 (0.5–1.5) | 0.5 (0–0.5) | <0.001 |
Milo (chocolate drink) | 3.5 (1.5–5.5) | 1.5 (0.5–3.5) | 1.5 (0.5–3.5) | 0.5 (0–3.5) | 0.5 (0–1.5) | <0.001 |
Sweets | 0.5 (0.5–1.5) | 0.5 (0.5–1.5) | 0.5 (0–1.5) | 0.5 (0–0.5) | 0 (0–0.5) | <0.001 |
Red meat | 3.5 (1.5–7.0) | 1.5 (1.5–3.5) | 1.5 (0.5–3.5) | 0.5 (0.5–1.5) | 0.5 (0.5–3.5) | <0.001 |
Odds Ratios (95% confidence intervals) for Quintiles | p for trend | OR per 1-score SD | |||||
---|---|---|---|---|---|---|---|
Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | |||
Training set | |||||||
No. of cases/controls | 17/65 | 33/65 | 58/65 | 76/65 | 94/65 | ||
Model 1 | 1.00 (ref.) | 1.69 (0.85–3.37) | 2.78(1.43–5.38) | 3.44 (1.78–6.65) | 4.05 (2.09–7.86) | <0.001 | 1.55 (1.27–1.88) |
Model 2 | 1.00 (ref.) | 1.98 (0.93–4.22) | 3.42 (1.65–7.12) | 3.84 (1.86–7.95) | 5.04 (2.42–10.48) | <0.001 | 1.59 (1.28–1.96) |
Model 3 | 1.00 (ref.) | 1.88 (0.86–4.09) | 2.95 (1.39–6.29) | 3.28 (1.55–6.94) | 4.57 (2.14–9.76) | <0.001 | 1.52 (1.22–1.89) |
Validation set | |||||||
No. of cases/controls | 10/69 | 32/70 | 49/70 | 64/68 | 105/70 | ||
Model 1 | 1.00 (ref.) | 2.50 (1.12–5.57) | 3.15 (1.43–6.93) | 3.76 (1.72–8.24) | 6.08 (2.81–13.16) | <0.001 | 1.74 (1.42–2.13) |
Model 2 | 1.00 (ref.) | 2.25 (0.95–5.36) | 2.86 (1.21–6.75) | 3.04 (1.30–7.11) | 5.04 (2.19–11.60) | <0.001 | 1.60 (1.28–2.00) |
Model 3 | 1.00 (ref.) | 2.26 (0.92–5.54) | 2.81 (1.15–6.84) | 3.20 (1.33–7.70) | 4.43 (1.87–10.50) | <0.001 | 1.52 (1.20–1.92) |
Dietary Variable | OR per 1SD Score | CIE (%) 2 |
---|---|---|
Simplified dietary pattern score 1 | 2.17 (1.80–2.62) | |
Simplified dietary pattern score without milo (chocolate drink) | 1.74 (1.47–2.07) | −19.8 |
Simplified dietary pattern score without juice | 1.95 (1.63–2.32) | −10.1 |
Simplified dietary pattern score without plantain | 2.02 (1.69–2.43) | −6.9 |
Simplified dietary pattern score without sweets | 2.05 (1.71–2.46) | −5.5 |
Simplified dietary pattern score without garden egg | 2.10 (1.74–2.52) | −5.1 |
Simplified dietary pattern score without red meat | 2.11 (1.76–2.53) | −2.8 |
Simplified dietary pattern score without rice | 2.12 (1.76–2.55) | −2.3 |
Simplified dietary pattern score without vegetable oil | 2.17 (1.80–2.61) | - |
Simplified dietary pattern score without eggs | 2.25 (1.87–2.70) | +3.7 |
Simplified dietary pattern score without cassava | 2.74 (2.25–3.35) | +26.3 |
4. Discussion
5. Conclusions
Supplementary Files
Supplementary File 1Acknowledgments
Author Contributions
Conflicts of Interest
References
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Frank, L.K.; Jannasch, F.; Kröger, J.; Bedu-Addo, G.; Mockenhaupt, F.P.; Schulze, M.B.; Danquah, I. A Dietary Pattern Derived by Reduced Rank Regression is Associated with Type 2 Diabetes in An Urban Ghanaian Population. Nutrients 2015, 7, 5497-5514. https://doi.org/10.3390/nu7075233
Frank LK, Jannasch F, Kröger J, Bedu-Addo G, Mockenhaupt FP, Schulze MB, Danquah I. A Dietary Pattern Derived by Reduced Rank Regression is Associated with Type 2 Diabetes in An Urban Ghanaian Population. Nutrients. 2015; 7(7):5497-5514. https://doi.org/10.3390/nu7075233
Chicago/Turabian StyleFrank, Laura K., Franziska Jannasch, Janine Kröger, George Bedu-Addo, Frank P. Mockenhaupt, Matthias B. Schulze, and Ina Danquah. 2015. "A Dietary Pattern Derived by Reduced Rank Regression is Associated with Type 2 Diabetes in An Urban Ghanaian Population" Nutrients 7, no. 7: 5497-5514. https://doi.org/10.3390/nu7075233