标题： 基于糖尿病状况的饮食模式推导方法：使用有序监督稳健轮廓聚类的结果来自西班牙裔社区健康研究/拉丁美洲人研究 显示英文标题

标题： Derivation of Dietary Patterns dependent on Diabetes status using ordinal Supervised Robust Profile Clustering: Results from Hispanic Community Health Study/Study of Latinos

摘要： 糖尿病的负担不成比例地影响了美国的西班牙裔/拉丁裔居民，饮食被认定为一个主要的可改变的风险因素。 结果依赖的饮食模式提供了关于哪些食物可能与糖尿病的严重程度和进展相关的见解。 然而，美国西班牙裔/拉丁裔成年人的种族和地理异质性使得在风险增加时难以识别和区分他们的饮食差异。 监督鲁棒轮廓聚类（sRPC）是一种灵活的联合模型，可以在排除由其种族和地理定义的模式的同时，识别与糖尿病相关的饮食模式。 然而，sRPC仅被应用于二元结果。 我们扩展了现有模型以开发序数sRPC。 使用来自西班牙裔社区健康研究/拉丁裔研究的基线饮食数据（2008-2011），我们展示了我们的模型在识别与三水平糖尿病状况（即正常、糖尿病前期、糖尿病）相关的饮食模式方面的实用性。 模拟研究证实，与标准的监督潜在类别模型相比，序数sRPC提高了对这些模式的识别和表征。 结果表明，水果、零食食品和精制谷物面包摄入量较高的参与者可能更有可能与糖尿病状况的严重程度增加相关。 显示英文摘要

摘要： The burden of diabetes has disproportionately impacted Hispanic/Latino residents in the United States, with diet recognized as a major modifiable risk factor. Outcome-dependent dietary patterns provide insight into what foods may be associated with the increased severity and progression of diabetes. However, the ethnic and geographical heterogeneity of US Hispanic/Latino adults makes it difficult to identify and distinguish differences within their diet as risk increases. Supervised robust profile clustering (sRPC) is a flexible joint model that can identify dietary patterns associated with diabetes, while partitioning out those defined by their ethnicity and geography. However, sRPC has only been applied to binary outcomes. We extend the existing model to develop the ordinal sRPC. Using baseline dietary data (2008-2011) from the Hispanic Community Health Study/Study of Latinos, we illustrate the utility of our model to identify dietary patterns associated with the three-levels of diabetes status (i.e. normal, pre-diabetes, diabetes). Simulation studies confirmed that ordinal sRPC improved identification and characterization of these patterns compared to a standard supervised latent class model. Results indicated that participants who had greater consumption of fruits, snack foods, and refined grain breads may be more likely to be associated with an increasing severity of diabetes status.