Association of dietary pattern and Tibetan featured foods with high-altitude polycythemia in Naqu, Tibet: A 1:2 individual-matched case-control study

Jiaxue Cui; Duoji Zhaxi; Xianzhi Sun; Nan Teng; Ruiqi Wang; Yizhuo Diao; Chenxin Jin; Yongxing Chen; Xiaoguang Xu; Xiaofeng Li

doi:10.3389/fnut.2022.946259

Association of dietary pattern and Tibetan featured foods with high-altitude polycythemia in Naqu, Tibet: A 1:2 individual-matched case-control study

Front Nutr. 2022 Sep 23:9:946259. doi: 10.3389/fnut.2022.946259. eCollection 2022.

Authors

Jiaxue Cui¹, Duoji Zhaxi², Xianzhi Sun¹, Nan Teng¹, Ruiqi Wang¹, Yizhuo Diao¹, Chenxin Jin¹, Yongxing Chen¹, Xiaoguang Xu^{2

3}, Xiaofeng Li¹

Affiliations

¹ Department of Epidemiology and Health Statistics, Dalian Medical University, Dalian, China.
² Institute of High Altitude Medicine, People's Hospital of Naqu Affiliated to Dalian Medical University, Naqu, China.
³ Department of Neurosurgery, Second Affiliated Hospital of Dalian Medical University, Dalian, China.

Abstract

This study focused on the association of dietary patterns and Tibetan featured foods with high-altitude polycythemia (HAPC) in Naqu, Tibet, to explore the risk factors of HAPC in Naqu, Tibet, to raise awareness of the disease among the population and provide evidence for the development of prevention and treatment interventions. A 1:2 individual-matched case-control study design was used to select residents of three villages in the Naqu region of Tibet as the study population. During the health examination and questionnaire survey conducted from December 2020 to December 2021, a sample of 1,171 cases was collected. And after inclusion and exclusion criteria and energy intake correction, 100 patients diagnosed with HAPC using the "Qinghai criteria" were identified as the case group, while 1,059 patients without HAPC or HAPC -related diseases were identified as the control group. Individuals were matched by a 1:2 propensity score matching according to gender, age, body mass index (BMI), length of residence, working altitude, smoking status, and alcohol status. Dietary patterns were determined by a principal component analysis, and the scores of study subjects for each dietary pattern were calculated. The effect of dietary pattern scores and mean daily intake (g/day) of foods in the Tibetan specialty diet on the prevalence of HAPC was analyzed using conditional logistic regression. After propensity score matching, we found three main dietary patterns among residents in Naqu through principal component analysis, which were a "high protein pattern," "snack food pattern," and "vegetarian food pattern." All three dietary patterns showed a high linear association with HAPC (p < 0.05) and were risk factors for HAPC. In the analysis of the relationship between Tibetan featured foods and the prevalence of HAPC, the results of the multifactorial analysis following adjustment for other featured foods showed that there was a positive correlation between the average daily intake of tsampa and the presence of HAPC, which was a risk factor. Additionally, there was an inverse correlation between the average daily intake of ghee tea and the presence of HAPC, which was a protective factor.

Keywords: 1:2 individual matched case-control study; Tibet; dietary pattern; featured foods; high altitude polycythemia.