Association between PCA-derived dietary pattern and metabolic control among adults with diabetes in Guangdong Province: a cross-sectional study

To explore the dominant dietary patterns among patients with diabetes mellitus (DM) in Guangdong and examine their associations with metabolic control. This secondary cross-sectional analysis used data from the 2018–2020 China National Diabetic Chronic Complications Study. Participants with DM were recruited from four regions of Guangdong. Medical history and dietary intake were assessed using a questionnaire, and laboratory and metabolic parameters were collected. Principal component analysis (PCA) was used to derive the major dietary patterns, and multivariable logistic regression was used to evaluate associations between dietary pattern adherence and metabolic target attainment. A total of 1,465 eligible participants were included, of whom 48.19% were male. Compared with participants in the lowest tertile (T1) of prudent dietary pattern adherence, those in the intermediate tertile (T2) had higher odds of glycated hemoglobin (HbA1c) target attainment (adjusted OR = 1.428, 95% CI 1.074–1.898; p = 0.014), whereas those in the highest tertile (T3) had higher odds of blood pressure (BP) target attainment (adjusted OR = 1.439, 95% CI 1.042–1.989; p = 0.027). No statistically significant associations were observed with low-density lipoprotein cholesterol (LDL-C) target attainment or simultaneous attainment of all three metabolic targets after multivariable adjustment. Across sensitivity analyses, the association with BP target attainment was the most consistent. The association with HbA1c target attainment remained directionally positive but varied across alternative analytical specifications, whereas the findings for LDL-C and simultaneous attainment of all three metabolic targets remained nonsignificant. In this cross-sectional study, greater adherence to the PCA-derived prudent dietary pattern was most consistently associated with higher odds of BP target attainment among participants with DM in Guangdong Province. The parent study was registered in the Chinese Clinical Trial Registry (ChiCTR1800014432, registered on 13 January 2018). ChiCTR1800014432 (registered on 13 January 2018). https://www.chictr.org.cn/showproj.html?proj=24644 .