Models based on dietary nutrients predicting all-cause and cardiovascular mortality in people with diabetes
Abstract Dietary intervention plays a vital role in improving the prognosis of people with diabetes mellitus (DM). Currently, there is a lack of systematic analysis of the relation between dietary nutrients and long-term mortality risk in people with DM. The study aims to establish models predicting...
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Nature Portfolio
2025-02-01
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| Online Access: | https://doi.org/10.1038/s41598-025-88480-9 |
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| author | Fang Wang Yukang Mao Jinyu Sun Jiaming Yang Li Xiao Qingxia Huang Chenchen Wei Zhongshan Gou Kerui Zhang |
| author_facet | Fang Wang Yukang Mao Jinyu Sun Jiaming Yang Li Xiao Qingxia Huang Chenchen Wei Zhongshan Gou Kerui Zhang |
| author_sort | Fang Wang |
| collection | DOAJ |
| description | Abstract Dietary intervention plays a vital role in improving the prognosis of people with diabetes mellitus (DM). Currently, there is a lack of systematic analysis of the relation between dietary nutrients and long-term mortality risk in people with DM. The study aims to establish models predicting long-term mortality and explore dietary nutrients associated with reduced long-term events to guide daily dietary decisions in people with DM. The retrospective cohort study collected 5060 participants with DM from the National Health and Nutrition Examination Survey (NHANES) 1999–2018. The least absolute shrinkage and selection operator (LASSO) regression and random forest (RF) algorithm were applied to identify key mortality-related dietary factors, which were subsequently incorporated into risk prediction nomogram models. The receiver operating characteristic (ROC) curve, calibration plot and decision curve analysis (DCA) were utilized to evaluate the performance of the models. The association of key dietary nutrients with all-cause and cardiovascular mortality were visualized by restricted cubic spline (RCS) models both in the whole and subgroups by sex, age, drinking and smoking status. The overall median age of the cohort was 62.0 years (interquartile range (IQR) 52.0–70.0), 2564 (50.67%) being male. During a median follow-up period of 56.0 months, 997 (19.70%) all-cause deaths were recorded, with 219 (21.97%) of which being ascribed to cardiovascular disease. The nomogram models based on key dietary nutrients identified by LASSO and RF demonstrated a significant predicative value for all-cause and cardiovascular mortality. Dietary fiber and magnesium were the common predictive nutrients in the two nomogram models. The RCS curve revealed that dietary fiber and magnesium were negatively associated with long-term mortality in the whole and subgroups of people with DM after adjustment of potential confounders. The diet of people with DM is closely associated with mortality. The nomogram models based on dietary nutrients can predict long-term mortality of people with DM, and the higher intake of dietary fiber and magnesium was associated with reduced risks of both long-term all-cause and cardiovascular mortality. |
| format | Article |
| id | doaj-art-02192366ea584fb1a8dcdf93357b0111 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-02192366ea584fb1a8dcdf93357b01112025-02-09T12:36:31ZengNature PortfolioScientific Reports2045-23222025-02-0115111810.1038/s41598-025-88480-9Models based on dietary nutrients predicting all-cause and cardiovascular mortality in people with diabetesFang Wang0Yukang Mao1Jinyu Sun2Jiaming Yang3Li Xiao4Qingxia Huang5Chenchen Wei6Zhongshan Gou7Kerui Zhang8Center for Cardiovascular Disease, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical UniversityCenter for Cardiovascular Disease, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical UniversityCenter for Cardiovascular Disease, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical UniversityDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical UniversityCenter for Cardiovascular Disease, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical UniversityCenter for Cardiovascular Disease, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical UniversityCenter for Cardiovascular Disease, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical UniversityCenter for Cardiovascular Disease, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical UniversityCenter for Cardiovascular Disease, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical UniversityAbstract Dietary intervention plays a vital role in improving the prognosis of people with diabetes mellitus (DM). Currently, there is a lack of systematic analysis of the relation between dietary nutrients and long-term mortality risk in people with DM. The study aims to establish models predicting long-term mortality and explore dietary nutrients associated with reduced long-term events to guide daily dietary decisions in people with DM. The retrospective cohort study collected 5060 participants with DM from the National Health and Nutrition Examination Survey (NHANES) 1999–2018. The least absolute shrinkage and selection operator (LASSO) regression and random forest (RF) algorithm were applied to identify key mortality-related dietary factors, which were subsequently incorporated into risk prediction nomogram models. The receiver operating characteristic (ROC) curve, calibration plot and decision curve analysis (DCA) were utilized to evaluate the performance of the models. The association of key dietary nutrients with all-cause and cardiovascular mortality were visualized by restricted cubic spline (RCS) models both in the whole and subgroups by sex, age, drinking and smoking status. The overall median age of the cohort was 62.0 years (interquartile range (IQR) 52.0–70.0), 2564 (50.67%) being male. During a median follow-up period of 56.0 months, 997 (19.70%) all-cause deaths were recorded, with 219 (21.97%) of which being ascribed to cardiovascular disease. The nomogram models based on key dietary nutrients identified by LASSO and RF demonstrated a significant predicative value for all-cause and cardiovascular mortality. Dietary fiber and magnesium were the common predictive nutrients in the two nomogram models. The RCS curve revealed that dietary fiber and magnesium were negatively associated with long-term mortality in the whole and subgroups of people with DM after adjustment of potential confounders. The diet of people with DM is closely associated with mortality. The nomogram models based on dietary nutrients can predict long-term mortality of people with DM, and the higher intake of dietary fiber and magnesium was associated with reduced risks of both long-term all-cause and cardiovascular mortality.https://doi.org/10.1038/s41598-025-88480-9DMNHANESLASSORFNomogramMortality |
| spellingShingle | Fang Wang Yukang Mao Jinyu Sun Jiaming Yang Li Xiao Qingxia Huang Chenchen Wei Zhongshan Gou Kerui Zhang Models based on dietary nutrients predicting all-cause and cardiovascular mortality in people with diabetes Scientific Reports DM NHANES LASSO RF Nomogram Mortality |
| title | Models based on dietary nutrients predicting all-cause and cardiovascular mortality in people with diabetes |
| title_full | Models based on dietary nutrients predicting all-cause and cardiovascular mortality in people with diabetes |
| title_fullStr | Models based on dietary nutrients predicting all-cause and cardiovascular mortality in people with diabetes |
| title_full_unstemmed | Models based on dietary nutrients predicting all-cause and cardiovascular mortality in people with diabetes |
| title_short | Models based on dietary nutrients predicting all-cause and cardiovascular mortality in people with diabetes |
| title_sort | models based on dietary nutrients predicting all cause and cardiovascular mortality in people with diabetes |
| topic | DM NHANES LASSO RF Nomogram Mortality |
| url | https://doi.org/10.1038/s41598-025-88480-9 |
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