Analysis of dietary patterns and influencing factors in infertile women of childbearing age
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摘要:
目的 分析育龄期不孕症女性的膳食模式现状，并探究其膳食模式的影响因素，旨在为不孕症女性制定合理的饮食指导方案提供理论依据。 方法 采用便利抽样法选取2021年5月—2022年12月在安徽省某三甲医院生殖中心门诊就诊的拟行辅助生殖技术的育龄期不孕症女性，采用自行设计的问卷和3天24小时膳食回顾问卷对研究对象进行调查，利用因子分析建立膳食模式，无序多分类logistic回归法分析膳食模式的影响因素。 结果 育龄期不孕症女性共有4种膳食模式，分别为高油盐模式、荤素混合模式、谷类-蛋奶模式以及水果-坚果模式。多因素logistic回归分析显示，高油盐模式与年龄有相关性(OR=0.488, 95% CI: 0.254~0.938)；荤素混合模式与在职状态和BMI有相关性[OR(95% CI)分别为3.954(2.047~7.636)、3.392(1.486~7.744)]；谷类-蛋奶模式与长期居住地、不孕年限及助孕治疗有相关性[OR(95% CI)分别为2.758(1.129~6.740)、3.539(1.113~11.250)、0.400(0.172~0.929)]；水果-坚果模式与长期居住地有相关性(OR=4.884, 95% CI: 1.892~12.603)。 结论 育龄期不孕症女性目前更倾向于谷类-蛋奶模式，其膳食模式类型受到多种因素影响，应根据不同的膳食模式特点，为其提供针对性的饮食指导。 Abstract:Objective In order to provide theoretical basis for formulating rational dietary guidance program for infertile women, this paper analyzed the current situation of dietary pattern of infertile women and explored the influencing factors of dietary pattern. Methods A self-designed questionnaire and a 3-day 24-hour dietary review questionnaire were used to investigate the infertile women of childbearing age who intended to undergo assisted reproductive technology in the reproductive center outpatient clinic of a top three hospital in Anhui Province from May 2021 to December 2022. The dietary patterns were established by factor analysis, and the influencing factors of dietary patterns were analyzed by disordered multiple logistic regression method. Results There were four dietary patterns in infertile women of childbearing age, which were high oil and salt pattern, mixed meat and vegetable pattern, traditional dietary pattern and modern dietary pattern. Multiple logistic regression analysis showed that high oil and salt pattern was negatively correlated with age (OR=0.488, 95% CI: 0.254-0.938). Meat and vegetable mixing pattern was positively correlated with in-service status and BMI [OR (95% CI) were 3.954 (2.047-7.636) and 3.392 (1.486-7.744)]. Traditional dietary patterns were positively correlated with long-term residence and infertility years, but negatively correlated with pregnance-assisted treatment [OR (95% CI) were 2.758 (1.129-6.740), 3.539 (1.113-11.250), 0.400 (0.172-0.929)]. Modern dietary pattern was positively correlated with long-term residence (OR=4.884, 95% CI: 1.892-12.603). Conclusion Infertile women are more inclined to traditional dietary patterns at present, and their dietary patterns are affected by many factors. Therefore, targeted dietary guidance should be provided for infertile women of childbearing age according to the characteristics of their different dietary patterns. -
Key words:
- Infertility /
- Diet /
- Dietary pattern /
- Influencing factors
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表 1 不孕症女性的各类食物摄入量
Table 1. Various types of food intake in infertile women
食物类别 实际摄入量
[M(P25, P75), g]摄入不足
[例(%)]摄入正常
[例(%)]摄入过量
[例(%)]谷类 374.80(250.25, 523.10) 58(16.2) 59(16.5) 240(67.2) 薯类 0(0, 33.30) 318(89.1) 27(7.6) 12(3.4) 蔬菜类 212.40(143.80, 523.20) 252(70.6) 79(22.1) 26(7.3) 水果类 106.70(26.85, 203.30) 268(75.1) 62(17.4) 27(7.6) 动物性食物 231.30(152.20, 335.00) 60(16.8) 82(23.0) 215(60.2) 奶及奶制品 50.00(0，166.70) 329(92.2) 25(7.0) 3(0.8) 大豆及坚果 15.20(4.40, 32.45) 238(66.7) 41(11.5) 78(21.8) 
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表 2 膳食模式类型及其因子载荷
Table 2. Dietary pattern types and their factor loads
食物类别 高油盐模式 荤素混合模式 谷类-蛋奶模式 水果-坚果模式 油 0.851 0.100 -0.143 0.033 盐 0.848 -0.049 0.142 0.057 动物性食物 0.042 0.803 0.072 0.055 蔬菜类 0.353 0.620 -0.306 0.054 蛋类 0.360 0.489 0.449 0.024 薯类 -0.148 -0.249 0.690 0.170 谷类 -0.177 0.323 0.037 0.090 奶及奶制品 0.072 0.205 0.655 -0.135 水果类 0.072 -0.044 -0.061 0.805 大豆及坚果 0.000 0.227 0.064 0.663
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表 3 不孕症女性不同膳食类型的人口学分布情况[例(%)]
Table 3. Demographic distribution of different dietary types in infertile women [cases (%)]
变量 分类 高油盐模式
(n=77)荤素混合模式
(n=81)谷类-蛋奶模式
(n=107)水果-坚果模式
(n=92)χ2值 P值 年龄(岁) 21~30 25(32.5) 35(43.2) 42(39.3) 37(40.2) 2.045 0.563 31~40 52(67.5) 46(56.8) 65(60.7) 55(59.8) 长期居住地 城市 64(83.1) 66(81.5) 88(82.2) 84(91.3) 5.507 0.481 农村 13(16.9) 15(18.5) 19(17.8) 8(8.7) 在职状态 在职 38(49.4) 53(65.4) 58(54.2) 39(42.4) 14.136 0.022 非在职 39(50.6) 28(34.6) 49(45.8) 53(57.6) 不孕类型 原发不孕 46(59.7) 57(70.4) 80(74.8) 60(65.2) 8.821 0.184 继发不孕 31(40.3) 24(29.6) 27(25.2) 32(34.8) 不孕年限(年) ＜3 34(44.2) 41(50.6) 58(54.2) 28(30.4) 21.028 0.028 3~＜6 35(45.5) 32(39.5) 35(32.7) 51(55.4) 6~10 8(10.3) 8(9.9) 14(13.1) 13(14.2) 助孕治疗 是 18(23.4) 21(25.9) 14(13.1) 18(19.6) 5.557 0.135 否 59(76.6) 60(74.1) 93(86.9) 74(80.4) 不良妊娠史 是 54(70.1) 61(75.3) 80(74.8) 70(76.1) 0.908 0.824 否 23(29.9) 20(24.7) 27(25.2) 22(23.9) 体重指数 ＜18.5 5(6.5) 3(3.7) 5(4.7) 8(8.7) 6.475 0.692 18.5~＜24.0 40(51.9) 38(46.9) 53(49.5) 39(42.4) 24.0~＜28.0 16(20.8) 21(25.9) 32(29.9) 28(30.4) ≥28.0 16(20.8) 19(23.5) 17(15.9) 17(18.5)
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表 4 高油盐模式影响因素的logistic回归分析
Table 4. Logistic regression analysis of the influencing factors of high oil-salt pattern
变量 B SE Waldχ2 P值 OR值 95% CI 年龄 -0.717 0.333 4.635 0.031 0.488 0.254~0.938 长期居住地 -0.890 0.502 3.146 0.076 0.411 0.154~1.098 在职状态 -0.574 0.320 3.210 0.073 0.563 0.301~1.055 不孕类型 -0.260 0.446 0.340 0.560 0.771 0.322~1.848 不孕年限 0.641 0.547 1.374 0.241 1.899 0.650~5.550 助孕治疗 0.189 0.390 0.235 0.628 1.208 0.563~2.595 不良妊娠史 0.578 0.466 1.536 0.215 1.782 0.715~4.444 体质指数 1.451 0.786 3.405 0.065 4.266 0.914~19.915
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表 5 荤素混合模式影响因素的logistic回归分析
Table 5. Logistic regression analysis of the influencing factors of meat-vegetable mixing pattern
变量 B SE Waldχ2 P值 OR值 95% CI 年龄 0.206 0.339 0.367 0.545 1.228 0.631~2.389 长期居住地 -0.894 0.478 3.494 0.062 0.409 0.160~1.044 在职状态 1.375 0.336 16.672 ＜0.001 3.954 2.047~7.636 不孕类型 -0.184 0.448 0.169 0.681 0.832 0.346~2.001 不孕年限 0.099 0.531 0.035 0.852 1.104 0.390~3.127 助孕治疗 -0.035 0.378 0.008 0.927 0.966 0.460~2.028 不良妊娠史 0.384 0.470 0.666 0.414 1.468 0.584~3.687 体质指数 1.221 0.421 8.413 0.004 3.392 1.486~7.744
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表 6 谷类-蛋奶模式影响因素的logistic回归分析
Table 6. Logistic regression analysis of the influencing factors of the grain-egg milk pattern
变量 B SE Waldχ2 P值 OR值 95% CI 年龄 -0.353 0.330 1.143 0.285 0.703 0.368~1.342 长期居住地 1.015 0.456 4.953 0.026 2.758 1.129~6.740 在职状态 -0.252 0.322 0.614 0.433 0.777 0.414~1.460 不孕类型 0.802 0.461 3.022 0.082 2.230 0.903~5.509 不孕年限 1.264 0.590 4.587 0.032 3.539 1.113~11.250 助孕治疗 -0.916 0.430 4.540 0.033 0.400 0.172~0.929 不良妊娠史 0.138 0.478 0.083 0.773 1.148 0.450~2.927 体质指数 -0.238 0.712 0.111 0.738 0.788 0.195~3.185
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表 7 水果-坚果模式影响因素的logistic回归分析
Table 7. Logistic regression analysis of the influencing factors of the fruit-nut pattern
变量 B SE Waldχ2 P值 OR值 95% CI 年龄 0.362 0.334 1.180 0.277 1.437 0.747~2.762 长期居住地 1.586 0.484 10.749 0.001 4.884 1.892~12.603 在职状态 -0.485 0.322 2.260 0.133 0.616 0.327~1.159 不孕类型 -0.619 0.449 1.904 0.168 0.538 0.223~1.297 不孕年限 -0.789 0.556 2.016 0.156 0.454 0.153~1.350 助孕治疗 0.257 0.380 0.456 0.500 1.292 0.614~2.722 不良妊娠史 0.317 0.477 0.442 0.506 1.374 0.539~3.502 体质指数 0.231 0.710 0.105 0.745 1.259 0.313~5.064
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