Associations of Abdominal Obesity-Related Dietary Patterns with Prediabetes and Type 2 Diabetes: Exploring the Mediating Effects of Body Composition and Altitude in Tibetan Adults

Abstract

Objectives: To investigate the association of dietary patterns (DPs) with prediabetes and Type 2 Diabetes among Tibetan adults, first to identify DPs associated with abdominal obesity and examine their relationships with prediabetes and type 2 diabetes. Additionally, the study aims to investigate the mediating effects of body fat distribution and altitude on the associations between these DPs and the prevalence of prediabetes and Type 2 Diabetes. Design: An open cohort among Tibetans. Setting: Community-based. Participants: The survey recruited 1003 participants registered for health check-ups from November to December 2018, and 1611 participants from December 2021 to May 2022. During the baseline and follow-up data collection, 1818 individuals participated in at least one of the two surveys, with 515 of them participating in both. Results: Two DPs were identified by reduced rank regression (RRR). DP1 had high consumption of beef and mutton, non-caloric drink, offal, and low intake in tubers and roots, salty snacks, onion and spring onion, fresh fruits, desserts and nuts and seeds; DP2 had high intake of whole grains, Tibetan cheese, light-colored vegetables and pork and low of sugar-sweetened beverages, whole-fat dairy and poultry. Individuals in the highest tertile of DP1 showed higher risks of prediabetes (OR 95% CI) 1.35 (1.05, 1.73) and T2D 1.36 (1.05, 1.76). In the highest tertile of DP2 exhibited an elevated risk of T2D 1.63 (1.11, 2.40) in fully adjustment. Conclusion: Abdominal adiposity-related DPs are positively associated with T2D. Promoting healthy eating should be considered to prevent T2D among Tibetan adults.